Polson D W, Mason H D, Saldahna M B, Franks S
Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London.
Clin Endocrinol (Oxf). 1987 Feb;26(2):205-12. doi: 10.1111/j.1365-2265.1987.tb00778.x.
Ten women with clomiphene-resistant chronic anovulation associated with polycystic ovary syndrome were treated with purified urinary FSH (urofollitrophin). The gonadotrophin was given s.c. by pulsatile infusion pump starting at a low dose (1 ampoule or 75 U/d) and increasing by 37.5 U/d at weekly stages in an attempt to induce ovulation of a single follicle. Seventy percent of the 33 cycles were ovulatory and in 18 of these (78%) a single dominant follicle developed and ovulated. Each of the 10 women ovulated when the optimum dose was reached and five of these women became pregnant. The maximum dose of FSH in uni-ovulatory cycles was 150 U/d or less. Endogenous LH concentrations which were raised at the onset of treatment were suppressed in the late follicular phase. The rate of follicular growth and gonadal steroid concentrations were consistent with those observed in spontaneous ovulatory cycles. This study demonstrates that by using low-dose gonadotrophin therapy it is possible to find the 'threshold' dose of FSH to promote maturation of a single dominant follicle. The high rate of ovulation and pregnancy suggest that this approach is of practical importance in treatment of infertile patients with polycystic ovaries.
10名患有与多囊卵巢综合征相关的克罗米芬抵抗性慢性无排卵的女性接受了纯化尿促卵泡素（尿促性素）治疗。促性腺激素通过皮下脉冲式输液泵给药，起始剂量较低（1安瓿或75 U/天），每周增加37.5 U/天，试图诱导单个卵泡排卵。33个周期中有70%发生排卵，其中18个周期（78%）有单个优势卵泡发育并排卵。10名女性在达到最佳剂量时均排卵，其中5名女性怀孕。单卵泡排卵周期中促卵泡素的最大剂量为150 U/天或更低。治疗开始时升高的内源性促黄体生成素浓度在卵泡晚期受到抑制。卵泡生长速率和性腺甾体激素浓度与自然排卵周期中观察到的情况一致。本研究表明，通过使用低剂量促性腺激素疗法，有可能找到促进单个优势卵泡成熟的促卵泡素“阈值”剂量。高排卵率和妊娠率表明，这种方法在治疗多囊卵巢不孕患者方面具有实际重要性。
