Chabab A, Hedon B, Arnal F, Diafouka F, Bressot N, Flandre O, Cristol P
Hum Reprod. 1986 Nov;1(7):449-54. doi: 10.1093/oxfordjournals.humrep.a136453.
Oocytes of pre-ovulatory follicles were collected by laparoscopy for in-vitro fertilization in 118 women. Patients were treated either during the natural cycle, or after induction of ovulation with clomiphene citrate, or with human menopausal gonadotrophin (HMG), or clomiphene citrate combined with HMG. The oestrogens (oestrone + oestradiol) and total aromatizable androgens (androstenedione, testosterone and dehydroepiandrosterone and its sulphate) were assayed in follicular fluids using an enzymatic method. The levels of progesterone, 17 alpha OH-progesterone, thromboxane, and prostaglandins (PGE2 and PGF2 alpha) were determined by radioimmunoassay. The best follicular fluid indicator of oocyte fertilization in vitro was the A/E ratio, which was less than 1 when the oocyte was fertilized in vitro and led to a pregnancy. The lowest value for the A/E ratio was obtained with spontaneous ovulation protocols. Regardless of oocyte development, the progesterone level was always greater than 2000 ng/ml, and the PGE2/PGF2 alpha ratio was greater than 1 in all stimulated cycles. Our investigations show that a combination of clomiphene citrate and HMG provides the best stimulation, on the basis of follicular fluid analysis and the outcome of fertilized oocytes.
通过腹腔镜收集118名女性排卵前卵泡的卵母细胞用于体外受精。患者分别在自然周期、枸橼酸氯米芬诱导排卵后、人绝经期促性腺激素（HMG）治疗后或枸橼酸氯米芬联合HMG治疗后接受治疗。采用酶法测定卵泡液中的雌激素（雌酮+雌二醇）以及总可芳香化雄激素（雄烯二酮、睾酮、脱氢表雄酮及其硫酸盐）。采用放射免疫分析法测定孕酮、17α-羟孕酮、血栓素和前列腺素（PGE2和PGF2α）的水平。卵母细胞体外受精的最佳卵泡液指标是A/E比值，当卵母细胞体外受精并导致妊娠时，该比值小于1。自发排卵方案的A/E比值最低。无论卵母细胞发育情况如何，在所有促排卵周期中，孕酮水平始终大于2000 ng/ml，PGE2/PGF2α比值大于1。我们的研究表明，基于卵泡液分析和受精卵母细胞的结果，枸橼酸氯米芬和HMG联合使用可提供最佳的刺激效果。
