O'Herlihy C, Pepperell R J, Robinson H P
Obstet Gynecol. 1982 Jan;59(1):40-5.
Seventeen patients treated with clomiphene citrate were examined using real-time ultrasound timing 28 ovulatory cycles to determine the pattern of follicular development under clomiphene stimulation. The rate of growth was faster, but the follicular diameter range at ovulation was similar to that during spontaneous cycles. This information was used to time midcycle human chorionic gonadotropin (hCG) administration in over 97 cycles in 21 patients responsive to clomiphene who had not conceived. When hCG was given when the mean follicular diameter reached 18 mm, 92% of these cycles were ovulatory. Fourteen patients (67%) conceived within 6 ovulatory treatment cycles. Five of 7 patients (71%) who did not conceive were found to have endometriosis at laparoscopy. Midcycle cervical scores were significantly lower in clomiphene-treated as compared with spontaneous ovulatory cycles, and additional treatment with ethinyl estradiol did not effect a significant improvement. Timing of midcycle hCG using ultrasound is an effective method of inducing ovulation in patients in whom an estrogenic follicular response without ovulation is obtained with clomiphene treatment.
对17例接受枸橼酸氯米芬治疗的患者进行实时超声监测，记录28个排卵周期，以确定氯米芬刺激下的卵泡发育模式。卵泡生长速度更快，但排卵时的卵泡直径范围与自然周期相似。这些信息被用于为21例对氯米芬有反应但未受孕的患者的97多个周期安排周期中期人绒毛膜促性腺激素（hCG）给药时间。当平均卵泡直径达到18 mm时给予hCG，这些周期中有92%发生排卵。14例患者（67%）在6个排卵治疗周期内受孕。7例未受孕的患者中有5例（71%）在腹腔镜检查时发现患有子宫内膜异位症。与自然排卵周期相比，氯米芬治疗周期的周期中期宫颈评分显著较低，额外给予炔雌醇治疗并未带来显著改善。使用超声确定周期中期hCG给药时间是一种有效的促排卵方法，适用于使用氯米芬治疗后有雌激素性卵泡反应但未排卵的患者。
