Muechler E K, Huang K E, Zongrone J
Department of Obstetrics and Gynecology, University of Rochester, School of Medicine and Dentistry, New York.
Int J Fertil. 1987 Sep-Oct;32(5):359-65.
Five habitual aborters without a known organic cause of their pregnancy losses were studied in detail by serial blood sampling for immunoreactive estrogen, progesterone, follicle-stimulating hormone, luteinizing hormone, and the ratio of the two. All patients had premenstrual spotting regularly. Luteal phase progesterone levels on the 6th postovulatory day were significantly lower (11.8 +/- 1.2 ng/mL, mean +/- SEM) than in control patients (20.8 +/- 3.5 ng/mL, mean +/- SEM). Results of immunoreactive estrogen, FSH, and LH assays and the FSH/LH ratio did not reveal a discernible pattern of deviation from normal. Indirect immunofluorescence of blood samples from all habitual aborters showed evidence of autoimmunity in three of five patients without clinical symptoms of autoimmune disease. Treatment by superovulation produced at least one living child in each couple. The balance of pregnancy outcome changed from 100% abortion (N = 31) before treatment to 31% (N = 13) after treatment. These results suggest that treatment with superovulation may be the treatment of choice for habitual aborters with a subtle luteal phase deficiency.
对五名习惯性流产患者进行了详细研究，这些患者流产的原因并非已知的器质性病变。通过对免疫反应性雌激素、孕酮、促卵泡激素、促黄体生成素以及二者的比值进行连续采血检测。所有患者均有规律的经前点滴出血。排卵后第6天的黄体期孕酮水平显著低于对照组患者（分别为11.8±1.2 ng/mL，平均值±标准误；对照组为20.8±3.5 ng/mL，平均值±标准误）。免疫反应性雌激素、促卵泡激素、促黄体生成素检测结果以及促卵泡激素/促黄体生成素比值均未显示出与正常情况有明显的偏差模式。对所有习惯性流产患者的血样进行间接免疫荧光检测发现，五名患者中有三名无自身免疫性疾病的临床症状，但存在自身免疫的证据。通过超排卵治疗，每对夫妇至少生育了一个存活婴儿。妊娠结局的情况从治疗前100%流产（N = 31）转变为治疗后31%（N = 13）。这些结果表明，对于存在轻微黄体期缺陷的习惯性流产患者，超排卵治疗可能是首选的治疗方法。
