Koninckx P R, Heyns W J, Corvelyn P A, Brosens I A
Fertil Steril. 1978 Mar;29(3):266-9. doi: 10.1016/s0015-0282(16)43150-x.
Two groups of infertility patients with regular cycles and apparently normal ovarian function were studied. In group I (n = 28) the infertility could be explained satisfactorily either by tubal occlusion or by infertility of the husband, or the women became pregnant within a few months. In group II (n = 32) no explanation was found for the infertility. Significantly fewer ovulation stigmata were present at laparoscopy in group II than in group I (P less than 0.05). In group I the basal body temperature (BBT) (P less than 0.001) and the plasma progesterone concentrations (P less than 0.05) were significantly elevated on the 1st day following the luteinizing hormone (LH) peak. In group II, THE BBT was slightly elevated on the 1st day following the LH peak (P less than 0.05), but the increase in the plasma progesterone concentrations occurred only on the 2nd day following the LH peak. In four women the onset of the BBT rise followed a normal LH peak with delays respectively, of 3, 4, 4, and 5 days, and in two women no LH peak occurred immediately prior to the onset of the BBT rise. The datings of the endometrial biopsies in these patients were in phase with the onset of the BBT rise but not with the LH peak. It is concluded that anovulation with in situ luteinization may be a rather frequent cause of infertility in regularly cycling women. A hypothesis about the mechanism of anovulation with in situ luteinization is proposed.
对两组月经周期规律且卵巢功能明显正常的不孕症患者进行了研究。第一组（n = 28），不孕症可通过输卵管阻塞、丈夫不育得到满意解释，或者这些女性在几个月内怀孕。第二组（n = 32），未找到不孕症的原因。腹腔镜检查发现，第二组的排卵迹象明显少于第一组（P < 0.05）。第一组中，黄体生成素（LH）峰值后的第1天，基础体温（BBT）（P < 0.001）和血浆孕酮浓度（P < 0.05）显著升高。第二组中，LH峰值后的第1天，BBT略有升高（P < 0.05），但血浆孕酮浓度仅在LH峰值后的第2天升高。4名女性BBT上升的起始时间分别在正常LH峰值后延迟3天、4天、4天和5天，2名女性在BBT上升起始前未出现LH峰值。这些患者的子宫内膜活检日期与BBT上升起始时间相符，但与LH峰值不符。结论是，原位黄素化无排卵可能是月经周期规律女性不孕症的常见原因。提出了关于原位黄素化无排卵机制的假说。
