Ohkura T, Watabe H, Horinaka T, Segawa Y, Hayashi M, Yaoi Y
Department of Obstetrics and Gynecology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama.
Nihon Sanka Fujinka Gakkai Zasshi. 1994 Oct;46(10):1013-9.
The study was designed to investigate the efficacy of combined buserelin-pure FSH-hCG therapy in patients with polycystic ovary syndrome (PCO) and to analyse its underlying hormonal changes. Buserelin was intranasally administered daily to 13 patients (35 cycles) for 4-10 weeks with a mean week of 5.4 +/- 1.6 (SD), followed by concomitant pure FSH administration. Out of the 13 patients, 8 were the ones who had experienced ovarian hyperstimulation syndrome (OHSS) using pure FSH alone. Hormonal analyses were performed on these 8 patients. This combined regimen resulted in a 97.1% ovulation rate (34/35) and a 37.1% incidence rate of OHSS (13/35). In 4 out of the 8 patients who had experienced OHSS, no OHSS was observed in the first cycle of the therapy. Eight patients became pregnant with the therapy. Excluding one patient whose husband had oligozoospermia, 7 patients conceived at the first cycle of the therapy and the pregnancy rate per cycle was 25.0% (7/28). No abortion or multiple pregnancy was observed in any of the 8 cases. Pretreatment with buserelin resulted in significantly decreased serum LH, FSH, LH/FSH ratio, estradiol (E2), testosterone (T), and androstenedione (ASD). Serum E2, T and ASD levels at both preovulatory and midluteal phases were significantly lower with the combined regimen than with pure FSH alone. These results indicate that this combined regimen improves the characteristic endocrine profile of PCO and enables pure FSH to achieve ovulation regularly with a high pregnancy rate, although it does not always inhibit OHSS.
本研究旨在探讨布舍瑞林-纯促卵泡素（FSH）-人绒毛膜促性腺激素（hCG）联合疗法对多囊卵巢综合征（PCO）患者的疗效，并分析其潜在的激素变化。对13例患者（35个周期）每日经鼻给予布舍瑞林，持续4 - 10周，平均为5.4±1.6（标准差）周，随后同时给予纯FSH。在这13例患者中，有8例曾单独使用纯FSH时发生过卵巢过度刺激综合征（OHSS）。对这8例患者进行了激素分析。这种联合治疗方案导致排卵率为97.1%（34/35），OHSS发生率为37.1%（13/35）。在曾发生过OHSS的8例患者中，有4例在治疗的第一个周期未观察到OHSS。8例患者通过该治疗怀孕。排除1例其丈夫患有少精子症的患者，7例患者在治疗的第一个周期受孕，每个周期的妊娠率为25.0%（7/28）。8例病例中均未观察到流产或多胎妊娠。布舍瑞林预处理导致血清促黄体生成素（LH）、FSH、LH/FSH比值、雌二醇（E2）、睾酮（T）和雄烯二酮（ASD）显著降低。联合治疗方案在排卵前和黄体中期的血清E2、T和ASD水平均显著低于单独使用纯FSH时。这些结果表明，这种联合治疗方案改善了PCO的特征性内分泌状况，使纯FSH能够规律地诱导排卵并具有高妊娠率，尽管它并不总能抑制OHSS。
