Jones G S, Muasher S J, Rosenwaks Z, Acosta A A, Liu H C
Fertil Steril. 1986 Nov;46(5):885-91. doi: 10.1016/s0015-0282(16)49829-8.
The perimenopause, incipient ovarian failure, is a major problem in stimulation failures during an in vitro fertilization program. This must be recognized as not necessarily related to age but also associated with adnexal inflammatory and operative processes. Although ovulation occurs uninterruptedly, the follicle-stimulating hormone in the early follicular phase is elevated and the luteinizing hormone is normal. Characteristically, there is no estradiol response to human menopausal gonadotropin therapy or a rapid response with a premature luteinizing hormone surge. These problems sometimes may be overcome with pulsatile intravenous gonadotropin-releasing hormone therapy, 5 or 10 micrograms/90 or 120 minutes. The major therapeutic problem is in the identification of a luteinizing hormone surge in these patients. Of eight women who were treated, two failed to respond with follicular maturation, three either had no oocytes aspirated from apparently postmature follicles or had postmature oocytes; and one had treatment cancelled due to ovulation. The four latter patients may have failed because of unrecognized ovulation. In the remaining two patients, one oocyte was fertilized and transferred, and one pregnancy occurred.
围绝经期，即卵巢功能初现衰竭，是体外受精程序中促排卵失败的一个主要问题。必须认识到，这不一定与年龄有关，还与附件炎症和手术过程有关。尽管排卵不间断地发生，但卵泡早期的促卵泡激素升高，黄体生成素正常。其特征是，对人绝经促性腺激素治疗无雌二醇反应，或出现过早的黄体生成素激增的快速反应。这些问题有时可通过静脉注射脉冲式促性腺激素释放激素治疗克服，剂量为5或10微克/90或120分钟。主要的治疗问题是识别这些患者中的黄体生成素激增。在接受治疗的8名女性中，2名对卵泡成熟无反应，3名要么没有从明显过熟的卵泡中吸出卵母细胞，要么有过熟的卵母细胞；1名因排卵而取消治疗。后4名患者可能因未识别出排卵而失败。在其余2名患者中，1个卵母细胞受精并移植，1例发生妊娠。
