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[功能性不育女性的治疗结果。第二篇通讯:克罗米酚疗法(作者译)]

[Therapeutic results obtained from women with functional sterility. Second communication: clomiphene therapy (author's transl)].

作者信息

Weise W, Honza A, Prügel P

出版信息

Zentralbl Gynakol. 1982;104(1):9-16.

PMID:7090634
Abstract

Reported in this paper are results obtained from treatment of 246 patients for sterility in WHO Group II to whom clomiphene had been applied. Some of these patients had been earlier treated without success, using combined oestrogen-gestagen preparations. Primary sterility was manifest in 86 per cent of the cases, and biphasic cycle was recorded from 95 per cent of the probands.--The pregnancy rate was 30.1 per cent, but 22 per cent of pregnancies ended in abortion. Multiple pregnancy was observed in four per cent. Minor side effects occurred in 1.2 per cent of the cases.--Best results were 36 per cent in cases of secondary amenorrhoea and 32 per cent in cases of anovulation. Sixty-six per cent of all pregnancies occurred in the first three cycles of treatment. Eight per cent of the women grew pregnant six months within discontinuation of clomiphene medication. An unambiguous interdependence was found to exist between age of the patient, length over time of desire of children, and rate of conception. The pregnancy rate fell to 15 per cent in women beyond 30 years of age. A pregnancy rate of 35 per cent was achieved in 110 women in whom sterility had been solely caused by functional aspects, while 27 per cent were achieved for couples with additional fertility-depressing factors. Moderate increase of clomiphene doses, homologous insemination, and flanking HCG injections helped to improve success of the basic therapy to the order of 119 per cent.--Efforts in terms of monitoring and general therapeutic input are higher than those associated with ovarian hormone therapy of sterile couples, though justified by better results.

摘要

本文报道了对246例世界卫生组织II组不育患者应用克罗米芬治疗的结果。这些患者中有一些曾使用雌激素 - 孕激素联合制剂治疗但未成功。86%的病例表现为原发性不育,95%的先证者记录有双相周期。妊娠率为30.1%,但22%的妊娠以流产告终。观察到4%的多胎妊娠。1.2%的病例出现轻微副作用。继发性闭经病例的最佳结果为36%,无排卵病例为32%。所有妊娠的66%发生在治疗的前三个周期。8%的女性在停用克罗米芬药物后的6个月内怀孕。发现患者年龄、渴望生育的时间长度与受孕率之间存在明确的相互依存关系。30岁以上女性的妊娠率降至15%。仅由功能因素导致不育的110名女性的妊娠率为35%,而存在其他降低生育力因素的夫妇的妊娠率为27%。适度增加克罗米芬剂量、同种授精和辅助注射人绒毛膜促性腺激素有助于将基础治疗的成功率提高到119%。尽管监测和一般治疗投入方面的努力高于对不育夫妇进行卵巢激素治疗,但因其效果更好而合理。

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