Marut E L
Division of Reproductive Endocrinology, Michael Reese Hospital and Medical Center, Illinois 60616.
J Reprod Med. 1989 Jan;34(1 Suppl):104-7.
Polycystic ovary syndrome (PCOS) is a multifaceted clinical entity the hallmark of which is ovulatory dysfunction associated with a relative luteinizing hormone excess and follicle-stimulating hormone (FSH) deficiency. Clomiphene citrate has been the first-line drug for ovulation induction in women with PCOS: because it is an attenuated estrogen, its action blocks the acyclic estrone effect in PCOS. However, many women fail to ovulate or conceive on clomiphene, and an appropriate agent for them was unavailable until relatively recently. The use of a "pure" FSH preparation, Metrodin, provides physiologic replacement of the deficient gonadotropin in PCOS; thus, Metrodin is the ideal second-line drug. Its use with a low-dose regimen should avoid the hyperstimulation seen with human menopausal gonadotropin in PCOS; spontaneous ovulation is an end point. Thus, PCOS patients who do not achieve pregnancy with clomiphene citrate have available a new, more physiologic approach to ovulation induction.
多囊卵巢综合征（PCOS）是一种多方面的临床病症，其标志是排卵功能障碍，伴有相对的黄体生成素过多和促卵泡激素（FSH）缺乏。枸橼酸氯米芬一直是PCOS女性诱导排卵的一线药物：由于它是一种减弱的雌激素，其作用可阻断PCOS中无周期性雌酮的作用。然而，许多女性使用氯米芬后无法排卵或受孕，直到最近才出现适合她们的药物。使用“纯”FSH制剂美诺定，可对PCOS中缺乏的促性腺激素进行生理性替代；因此，美诺定是理想的二线药物。采用低剂量方案使用它应可避免PCOS患者使用人绝经期促性腺激素时出现的过度刺激；自发排卵是一个终点。因此，使用枸橼酸氯米芬未怀孕的PCOS患者现在有了一种新的、更符合生理的诱导排卵方法。
