Aisaka K, Tomonari R, Tawada T, Yoshimatsu J, Ando S, Kokuho K, Sasaki S, Yoshida K, Kaneda S, Mori H
Department of Obstetrics and Gynecology, San-ikukai Hospital, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1989 Feb;41(2):196-202.
To investigate a new treatment for so-called functional sterility, 17 out of 456 infertile patients were treated in the past three years (age: 32.7 +/- 3.6 years old, infertile period: 5.9 +/- 1.4 years, M +/- S.D.). These patients were treated with HMG-HCG. The injection of HMG (75-450iu) was started on the 5th day of the menstrual cycle, and the follicular development was observed by ultrasonography. Then, HCG (10,000-20,000iu) was injected when 3 or 4 matured follicles (with a diameter greater than 20mm) were observed. In some cases, the endometrial biopsy was done in the mid-luteal phase and the effect of the treatment was examined morphologically. Pregnancies were observed in 6 cases (35.3%) and all of them were singletons. One of them spontaneously aborted at 9 weeks of gestation, but remaining five cases delivered at full term without any complications. The total dose of HMG was 2,116.8 +/- 843.3iu, and OHSS was observed in 5 cycles out of 31 cycles (16.1%). There was no other severe complication during the treatment. The growth of the endometrium thickened in the treated cases, but no time lag in endometrial dating could be found in the morphological study. These results indicated that the intended superovulation method for the treatment of so-called functional sterility was effective through the mechanism of the improvement of the implantation ratio.
为研究一种针对所谓功能性不育的新疗法,在过去三年中,对456例不孕患者中的17例进行了治疗(年龄:32.7±3.6岁,不孕时长:5.9±1.4年,均值±标准差)。这些患者接受了人绝经期促性腺激素-人绒毛膜促性腺激素(HMG-HCG)治疗。月经周期第5天开始注射HMG(75 - 450国际单位),通过超声检查观察卵泡发育情况。当观察到3或4个成熟卵泡(直径大于20毫米)时,注射HCG(10,000 - 20,000国际单位)。在某些情况下,在黄体中期进行子宫内膜活检,并从形态学上检查治疗效果。观察到6例妊娠(35.3%),均为单胎妊娠。其中1例在妊娠9周时自然流产,但其余5例足月分娩,无任何并发症。HMG的总剂量为2,116.8±843.3国际单位,在31个周期中有5个周期(16.1%)观察到卵巢过度刺激综合征(OHSS)。治疗期间未出现其他严重并发症。治疗组子宫内膜增厚,但形态学研究未发现子宫内膜日期测定有时间滞后。这些结果表明,用于治疗所谓功能性不育的预期超排卵方法通过提高着床率机制是有效的。