Campbell B F, Phipps W R, Nagel T C, Tagatz G E
University of Minnesota Medical School, Department of Obstetrics and Gynecology, Minneapolis.
Int J Fertil. 1988 Sep-Oct;33(5):329-33.
A high incidence of luteal phase defect (LPD) has been reported using subcutaneous pulsatile gonadotropin-releasing hormone for induction of ovulation. We reviewed all patients treated with the combination of subcutaneous pulsatile gonadotropin-releasing hormone during the follicular phase and human chorionic gonadotropin during the luteal phase (GnRH-hCG) who underwent endometrial biopsy during a treatment cycle. All of these patients had biopsy-proven LPD which persisted despite traditional therapy with progesterone vaginal suppositories and/or clomiphene citrate. The mean number of biopsies out of phase per patient prior to GnRH-hCG treatment was 2.8 +/- 0.2 (+/- SEM). When treated with GnRH-hCG, 15/16 patients (94%) showed a normal endometrial biopsy. The probability of this result occurring by chance alone allowing for a 50% treatment independent correction rate is less than .001. These results show that the combination of subcutaneous pulsatile gonadotropin-releasing hormone and luteal-phase human chorionic gonadotropin can result in normal endometrial maturation in a high percentage of cycles when administered as described. It appears to be an effective alternative to traditional treatment modalities for luteal phase defect should one be needed.
据报道，使用皮下脉冲式促性腺激素释放激素诱导排卵时，黄体期缺陷（LPD）的发生率较高。我们回顾了所有在卵泡期接受皮下脉冲式促性腺激素释放激素联合黄体期人绒毛膜促性腺激素（GnRH-hCG）治疗且在治疗周期内接受子宫内膜活检的患者。所有这些患者经活检证实存在LPD，尽管采用了传统的阴道用黄体酮栓剂和/或枸橼酸氯米芬治疗，但LPD仍持续存在。在GnRH-hCG治疗前，每位患者子宫内膜活检不同步的平均次数为2.8±0.2（±标准误）。接受GnRH-hCG治疗时，16例患者中有15例（94%）子宫内膜活检结果正常。仅考虑50%的治疗独立校正率，该结果偶然出现的概率小于0.001。这些结果表明，按照所述方法给药时，皮下脉冲式促性腺激素释放激素和黄体期人绒毛膜促性腺激素联合使用可在高比例的周期中使子宫内膜正常成熟。如果需要，它似乎是治疗黄体期缺陷的传统治疗方式的有效替代方法。
