Breckwoldt M, Geisthövel F, Neulen J, Schillinger H
Department of Obstetrics and Gynecology, University of Freiburg, Federal Republic of Germany.
Fertil Steril. 1988 Apr;49(4):713-5. doi: 10.1016/s0015-0282(16)59844-6.
The treatment course of a 31-year-old infertility patient due to PCO disease is presented. Because the patient failed to conceive after various treatment cycles with CC, she was subjected to a combined GnRHa/hMG/hCG therapy. After plasma E2 levels had reached 2400 pg/ml, three leading follicles, with diameters of 20 to 24 mm, were detected. Induction of ovulation was achieved by 10,000 IU hCG. The patient conceived and developed ovarian hyperstimulation. At 8 weeks of gestation, seven cystic structures were detected within the uterine cavity, five containing single embryos, and two with twin embryos. All nine embryos were vital, as evidenced by their heart beats. Embryo reduction was achieved by transabdominal puncture on three occasions. The three surviving fetuses were carried to the 34th week of gestation. After delivery by cesarean section, three healthy babies developed normally. This communication illustrates the complications that can be associated with ovulation induction in PCO disease: ovarian hyperstimulation, polyovulation, multiple conceptions, and their clinical management.
本文介绍了一名31岁因多囊卵巢综合征（PCO）导致不孕患者的治疗过程。由于该患者在使用克罗米芬（CC）进行多个治疗周期后仍未受孕，故接受了促性腺激素释放激素激动剂（GnRHa）/人绝经期促性腺激素（hMG）/人绒毛膜促性腺激素（hCG）联合治疗。当血浆雌二醇（E2）水平达到2400 pg/ml后，检测到三个主导卵泡，直径为20至24毫米。通过注射10,000 IU hCG诱导排卵。患者成功受孕并出现卵巢过度刺激综合征。妊娠8周时，在子宫腔内检测到七个囊性结构，其中五个含有单胎胚胎，两个含有双胎胚胎。所有九个胚胎均存活，可见心跳。通过三次经腹穿刺进行了减胎术。三个存活胎儿顺利妊娠至34周。剖宫产术后，三个健康婴儿发育正常。本文阐述了PCO疾病诱导排卵可能相关的并发症：卵巢过度刺激、多卵泡排卵、多胎妊娠及其临床处理。
