Sudik R, Fliess F R, Kunkel S, Blödow G
Klinik für Gynäkologie und Geburtshilfe, Bereichs Medizin der Wilhelm-Pieck-Universität Rostock.
Zentralbl Gynakol. 1989;111(9):587-603.
FSH, LH, PRL, estradiol-17 beta and progesterone were determined in 651 follicular fluids of 173 patients treated by ovarian stimulation for IVF. The stimulation was performed according to 5 different schemes: clomiphene/HCG, HMG (Pergonal)/HCG, HPG (Anthrogon)/HCG, clomiphene/HPG/HCG, Folistiman (heterologeous pituitary gonadotropin)/HCG. The mean levels of hormones of all follicles of each stimulation scheme were determined and differences between the groups were estimated by Student's t-test and the x-square-test. Additionally, in a hierarchy of follicles made depending on the follicular fluid volume the hormonal levels were compared between different rank numbers of one stimulation group and between different groups of stimulation. The maturation of oocytes judged by a maturation index and their ability for cleavage in culture after insemination was investigated in relation to the hormonal content of the follicular fluid. Stimulation by gonadotropins (Pergonal, Anthrogon, Folistiman) led to an decreased mean level of follicular steroids. This was related to an increased part of follicles poor in steroids after stimulation by gonadotropins. Within the follicular population follicles stimulated by clomiphene/HCG had a reduction of the levels of estradiol in higher rank numbers, but there were no clear evidences for such a reduction in the other stimulated groups. In all stimulation groups a significant reduction of progesterone levels was observed in higher rank numbers of follicles. Oocytes with a high maturation index mainly derived from follicles rich in progesterone. After insemination, development of oocytes in culture was compatible even with very high or low levels of hormones. There was no relation of the levels in FSH and LH to cumulus expansion and levels of estradiol of the follicular fluid. There was also no clear correlation between the levels of prolactin in follicular fluid and the cleavage rate.
对173例接受体外受精卵巢刺激治疗患者的651份卵泡液进行了促卵泡生成素（FSH）、促黄体生成素（LH）、催乳素（PRL）、雌二醇-17β和孕酮的测定。刺激按照5种不同方案进行：克罗米芬/人绒毛膜促性腺激素（HCG）、人绝经期促性腺激素（HMG，普果那）/HCG、人垂体促性腺激素（HPG，安特罗贡）/HCG、克罗米芬/HPG/HCG、福力司他（异种垂体促性腺激素）/HCG。测定了每种刺激方案所有卵泡的激素平均水平，并通过学生t检验和卡方检验评估组间差异。此外，根据卵泡液体积对卵泡进行分级，比较同一刺激组不同等级卵泡之间以及不同刺激组之间的激素水平。根据成熟指数判断卵母细胞的成熟情况，并研究其受精后在培养中的分裂能力与卵泡液激素含量的关系。促性腺激素（普果那、安特罗贡、福力司他）刺激导致卵泡类固醇平均水平降低。这与促性腺激素刺激后类固醇含量低的卵泡比例增加有关。在卵泡群体中，克罗米芬/HCG刺激的卵泡在较高等级时雌二醇水平降低，但其他刺激组没有明显的降低证据。在所有刺激组中，较高等级卵泡的孕酮水平均显著降低。成熟指数高的卵母细胞主要来自孕酮含量高的卵泡。受精后，即使激素水平非常高或非常低，卵母细胞在培养中的发育也正常。卵泡液中FSH和LH水平与卵丘扩展及卵泡液雌二醇水平无关。卵泡液中催乳素水平与分裂率之间也没有明显的相关性。
