Hull M G, Savage P E, Jacobs H S
Br Med J. 1979 May 12;1(6173):1257-61. doi: 10.1136/bmj.1.6173.1257.
A simple scheme of investigation and treatment to restore fertility in amenorrhoeic women is described. Fifty-nine patients with amenorrhoea not due to primary ovarian failure were treated variously as appropriate, mainly with clomiphene (25), bromocriptine (15), or human menopausal gonadotrophins (12), and six by diet to increase their weight. All ovulated, and by the end of the study 55 (93%) had conceived, 42 (71%) had delivered at least one surviving child, and five others (8%) were pregnant and awaiting delivery. Conception rates were 49% within two cycles of treatment and 66% within three cycles; using life-table method to standardise the cumulative conception rates by correcting for patients who did not continue as long as others in the study, the expected conception rate was 79% in six cycles, 94% in 12 cycles, and 98% after 16 cycles. The multiple pregnancy rate was 13% and abortion rate 22%. Delivery rate (for a viable baby) were 48% within 11 months of starting treatment and 53% within one year; expected rates were 76% in 18 months and 97% in two years. The results show that a relatively simple scheme of classifying amenorrhoeic disorders endocrinologically followed by treatment directed at inducing ovulation allows amenorrhoeic women without primary ovarian failure to achieve conception and delivery rates equal to those in normal women.
本文描述了一种恢复闭经女性生育能力的简单检查与治疗方案。59例非原发性卵巢功能衰竭所致闭经的患者，根据具体情况接受了不同治疗，主要使用克罗米芬（25例）、溴隐亭（15例）或人绝经期促性腺激素（12例），6例通过饮食增加体重。所有患者均排卵，研究结束时，55例（93%）已受孕，42例（71%）至少分娩了一名存活婴儿，另外5例（8%）已怀孕并待产。治疗两个周期内的受孕率为49%，三个周期内为66%；采用生命表法，通过对研究中未持续到其他人那么长时间的患者进行校正来标准化累积受孕率，预计六个周期内的受孕率为79%，12个周期内为94%，16个周期后为98%。多胎妊娠率为13%，流产率为22%。开始治疗11个月内的分娩率（活产婴儿）为48%，一年内为53%；预计18个月时为76%，两年时为97%。结果表明，一种相对简单的以内分泌学方法对闭经疾病进行分类，然后针对诱导排卵进行治疗的方案，可使无原发性卵巢功能衰竭的闭经女性实现与正常女性相当的受孕率和分娩率。
