Wu C H, Winkel C A
Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Fertil Steril. 1989 Oct;52(4):564-8. doi: 10.1016/s0015-0282(16)60964-0.
Eighty-seven anovulatory patients were treated with clomiphene citrate (CC) to induce ovulation in 414 cycles. Clomiphene citrate was initiated randomly on the 2nd, 3rd, 4th, or 5th day of the menstrual cycle to evaluate the effectiveness of therapy. The results of therapy were assessed in terms of ovarian response and pregnancy outcome. Ovarian response was evaluated employing basal body temperature (BBT) to define follicular, luteal, and cycle lengths, and a midluteal serum progesterone (P) level and the integrated luteal P to define luteal adequacy. Pregnancy outcome was evaluated in the categories of total pregnancy, live birth, first trimester abortion, and fecundity rates. There were no significant differences noted between the groups who started CC on the 2nd, 3rd, 4th, or 5th day of cycle in terms of anovulation rates (12% to 21%), luteal dysfunction (28% to 39%), and normal ovulation rates (42% to 57%). Pregnancy was achieved in 31% (n = 27/87) of patients with a spontaneous abortion rate of 19% (n = 5/27). The fecundity rates ranged between 5.7% and 9.4%. Pregnancy outcomes also were not significantly different between the groups. Significantly shorter luteal phase length and longer follicular phase length were observed in the cycles with luteal dysfunction. The luteal progesterone parameters, including midluteal serum P concentration, the integrated luteal P, and the luteal P amplitude were significantly lower in the cycles with luteal dysfunction.
87例无排卵患者接受枸橼酸氯米芬（CC）治疗以诱导排卵，共进行了414个周期。在月经周期的第2、3、4或5天随机开始使用枸橼酸氯米芬，以评估治疗效果。根据卵巢反应和妊娠结局评估治疗结果。采用基础体温（BBT）来定义卵泡期、黄体期和周期长度，以及黄体中期血清孕酮（P）水平和黄体期P积分来评估黄体功能，以此评估卵巢反应。妊娠结局按总妊娠、活产、孕早期流产和受孕率分类进行评估。在周期第2、3、4或5天开始使用CC的各组之间，无排卵率（12%至21%）、黄体功能障碍（28%至39%）和正常排卵率（42%至57%）方面无显著差异。31%（n = 27/87）的患者实现了妊娠，自然流产率为19%（n = 5/27）。受孕率在5.7%至9.4%之间。各组之间的妊娠结局也无显著差异。在黄体功能障碍的周期中观察到黄体期长度显著缩短，卵泡期长度延长。黄体功能障碍的周期中，黄体期孕酮参数，包括黄体中期血清P浓度、黄体期P积分和黄体期P幅度均显著降低。
