Dlugi A M, Laufer N, Botero-Ruiz W, DeCherney A H, Polan M L, Haseltine F P, Mezer H C, Behrman H R
Fertil Steril. 1985 Jan;43(1):40-7. doi: 10.1016/s0015-0282(16)48315-9.
The pattern of periovulatory and luteal phase serum estradiol (E2) and progesterone (P) as well as follicular fluid (FF) E2, P, androgen, gonadotropin, and prolactin concentrations of eight women undergoing clomiphene citrate (CC)/human chorionic gonadotropin (hCG) stimulation and eight women undergoing human menopausal gonadotropin (hMG)/hCG stimulation of follicular development for the purpose of in vitro fertilization were compared. Ovulation was induced with either a 5-day course of CC (100 mg/day beginning on day 5 of the cycle) or an individualized hMG regimen, and laparoscopy was performed 36 hours after hCG administration. The length of the luteal phase was significantly longer (P less than 0.05) in the CC-treated group as compared with the hMG-treated group. The pattern of serum E2 levels differed significantly (P less than 0.01) in that E2 levels were lower in the early and midluteal phase in CC-stimulated cycles; in addition, a delayed second E2 peak was observed in the late luteal phase in these women. Serum P levels, however, were lower in the hMG-stimulated group. Analysis of FF hormone concentrations revealed significantly (P less than 0.05) higher concentrations of E2 and androsterone in the FF of hMG-treated patients. It is concluded that follicular development in CC-stimulated cycles differs markedly from that in hMG-stimulated cycles. These differences may reflect either an altered follicular maturational process or may represent a direct inhibitory effect of CC on follicular steroidogenesis.
比较了8名接受枸橼酸氯米芬（CC）/人绒毛膜促性腺激素（hCG）刺激的女性和8名接受人绝经期促性腺激素（hMG）/hCG刺激以进行体外受精的女性在围排卵期和黄体期血清雌二醇（E2）、孕酮（P）以及卵泡液（FF）中E2、P、雄激素、促性腺激素和催乳素的浓度模式。采用5天疗程的CC（从周期第5天开始，每天100mg）或个体化的hMG方案诱导排卵，并在注射hCG后36小时进行腹腔镜检查。与hMG治疗组相比，CC治疗组的黄体期明显更长（P<0.05）。血清E2水平模式有显著差异（P<0.01），即CC刺激周期中黄体早期和中期的E2水平较低；此外，这些女性在黄体晚期观察到第二个E2峰值延迟。然而，hMG刺激组的血清P水平较低。卵泡液激素浓度分析显示，hMG治疗患者的卵泡液中E2和雄酮浓度显著更高（P<0.05）。结论是，CC刺激周期中的卵泡发育与hMG刺激周期中的卵泡发育明显不同。这些差异可能反映了卵泡成熟过程的改变，或者可能代表了CC对卵泡类固醇生成的直接抑制作用。
