Check J H, Wu C H, Check M L
Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Fertil Steril. 1988 Mar;49(3):542-3. doi: 10.1016/s0015-0282(16)59789-1.
A 43-year-old woman with a history of 5 years of amenorrhea sought help in achieving a pregnancy. Her gonadotropins were found to be elevated and thus she was diagnosed as having ovarian failure. She was made to ovulate on many occasions by suppressing her gonadotropins first with estrogen, then stimulating her ovaries with hMG. However, she became refractory to this therapy and she was switched from estrogen to LA to suppress gonadotropins. The woman ovulated three times just with leuprolide therapy before any hMG was added. A possible hypothesis is that, on the way down to subnormal levels of LH and FSH, a critical level of gonadotropins was attained where they were still high enough to stimulate the follicles, but low enough to allow restoration of gonadotropin receptors, which previously had been down-regulated by the elevated gonadotropin levels.
一名有5年闭经史的43岁女性寻求帮助以实现怀孕。发现她的促性腺激素升高，因此被诊断为卵巢功能衰竭。她多次通过先用雌激素抑制促性腺激素，然后用hMG刺激卵巢来诱导排卵。然而，她对这种治疗产生了耐药性，于是从雌激素换成亮丙瑞林来抑制促性腺激素。在添加任何hMG之前，仅用亮丙瑞林治疗该女性就排卵了三次。一个可能的假说是，在促黄体生成素（LH）和促卵泡生成素（FSH）降至低于正常水平的过程中，达到了一个关键的促性腺激素水平，此时它们仍足够高以刺激卵泡，但又足够低以允许促性腺激素受体恢复，这些受体之前因促性腺激素水平升高而被下调。
