Tal J, Paz B, Samberg I, Lazarov N, Sharf M
Fertil Steril. 1985 Sep;44(3):342-9. doi: 10.1016/s0015-0282(16)48858-8.
Forty-six women remaining infertile with clomiphene citrate (CC) with or without human chorionic gonadotropin (hCG) were treated by either human menopausal gonadotropin (hMG, 44 cycles) or CC + hMG (33 cycles) and monitored by serum estradiol (E2) and ultrasonography. Ovarian hyperstimulation syndrome (OHS) and pregnancy outcome were compared in both regimens. In the presence of dominant follicles (greater than or equal to 18 mm) alone or with a single secondary follicle (14 to 16 mm) at hCG administration, OHS did not develop. A significant increase in OHS was noted when three or more secondary follicles were observed. Overall pregnancy rates were similar in both regimens but significantly higher when hCG was injected before rather than after the E2 peak. The results suggest secondary follicles rather than dominant follicles are a valuable sign of possible OHS development; and CC + hMG should be considered in CC-failure patients.
46名使用克罗米芬（CC）联合或不联合人绒毛膜促性腺激素（hCG）治疗后仍未受孕的女性，接受了人绝经期促性腺激素（hMG，44个周期）或CC + hMG（33个周期）治疗，并通过血清雌二醇（E2）和超声检查进行监测。比较了两种治疗方案的卵巢过度刺激综合征（OHS）和妊娠结局。在注射hCG时，仅存在优势卵泡（大于或等于18 mm）或伴有单个次级卵泡（14至16 mm）时，未发生OHS。当观察到三个或更多次级卵泡时，OHS显著增加。两种治疗方案的总体妊娠率相似，但在E2峰值之前而非之后注射hCG时，妊娠率显著更高。结果表明，次级卵泡而非优势卵泡是OHS可能发生的重要标志；对于CC治疗失败的患者，应考虑CC + hMG治疗方案。
