Mahadevan M M, Fleetham J, Taylor P J
Department of Obstetrics and Gynecology, University of Calgary, Alberta, Canada.
Fertil Steril. 1988 Dec;50(6):935-7. doi: 10.1016/s0015-0282(16)60376-x.
The present study extends the information on the effects of progesterone (P) on the luteinizing hormone (LH) release, and estradiol (E2)/P ratio in the luteal phase in women superovulated for in vitro fertilization and embryo transfer (IVF-ET). Two groups of 34 patients were induced for ovulation with clomiphene citrate and human menopausal gonadotropins. One group was given 25 mg P (Gesterol, Steris Laboratory Inc., Phoenix, AZ) at the time of, or 4 to 6 hours before human chorionic gonadotropin (hCG) administration and another group served as control (no Gesterol). Of the 34 patients in the Gesterol group, 10 had Gesterol 4 to 6 hours before the administration of hCG, 13 at the time of hCG, and 11 after the spontaneous LH surge. Administration of Gesterol 4 to 6 hours before hCG significantly increased the LH values (19.0 +/- 10.3) compared with those who had Gesterol at the time of hCG (6.8 +/- 2.8, P = 0.0006). A single dose of Gesterol (25 mg P) significantly reduced the E2/P ratio during the luteal phase (P = 0.0005). However, the outcome of IVF-ET was the same in the Gesterol and no-Gesterol groups. It is concluded that a significant increase in P triggers an LH surge and a single dose of Gesterol decreases E2/P ratio in the luteal phase of women after ovarian stimulation. The biochemical mechanisms are unclear.
本研究扩展了关于孕酮（P）对体外受精和胚胎移植（IVF-ET）超排卵女性黄体期促黄体生成素（LH）释放及雌二醇（E2）/P比值影响的信息。两组各34例患者采用枸橼酸氯米芬和人绝经期促性腺激素进行促排卵。一组在注射人绒毛膜促性腺激素（hCG）时或hCG注射前4至6小时给予25mg孕酮（Gesterol，Steris Laboratory Inc.，亚利桑那州凤凰城），另一组作为对照（未给予Gesterol）。在Gesterol组的34例患者中，10例在hCG注射前4至6小时给予Gesterol，13例在hCG注射时给予，11例在自发LH峰出现后给予。与在hCG注射时给予Gesterol的患者（6.8±2.8，P = 0.0006）相比，在hCG注射前4至6小时给予Gesterol显著提高了LH值（19.0±10.3）。单剂量Gesterol（25mg P）显著降低了黄体期的E2/P比值（P = 0.0005）。然而，Gesterol组和未给予Gesterol组的IVF-ET结局相同。得出的结论是，P的显著增加引发LH峰，单剂量Gesterol降低卵巢刺激后女性黄体期的E2/P比值。其生化机制尚不清楚。
