Robertson S, Birrell W, Grant A
Acta Eur Fertil. 1976 Mar;7(1):83-7.
The results of stimulation with gonadotrophins at the Sterility Clinic (Crown Street) are presented. Two different techniques have been employed involving 86 patients. All patients have similar indications for treatment. All have received the same preliminary investigations and all have been treated previously with a minimum of three cycles of Clomiphene Citrate without satisfactory response (i.e. "clomid failures). Technique (1) involved 51 patients and consisted of daily injections of Human Pituitary Gonadotrophin (H.P.G.) followed by an ovulating injection of Human Chorionic Gonadotrophin (H.C.G.) and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. This technique had a pregnancy rate of 64 per cent and a multiple pregnancy rate of 34 per cent. Technique (2) involved 35 patients and consisted of 5 days priming with Ethinyl Oestradiol and Clomiphene Citrate together, followed immediately by daily injections of H.P.G., then an ovulating injection of H.C.G. and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. The results of this variation in technique were a pregnancy rate of 69 percent, a multiple pregnancy rate of 8 percent. It is suggested that the use of Clomiphene Citrate in the latter technique acts as a "buffer" against the more extreme ovarian responses to H.P.G. acting alone and has the apparent advantage of a higher pregnancy rate, a lower multiple pregnancy rate and a reduction in the number of foetuses in each of the multiple pregnancies.
本文呈现了皇冠街不育诊所使用促性腺激素刺激治疗的结果。采用了两种不同技术，涉及86名患者。所有患者的治疗指征相似。所有患者都接受了相同的初步检查，且之前均至少接受过三个周期的枸橼酸氯米芬治疗，但效果不佳（即“克罗米酚治疗失败”）。技术（1）涉及51名患者，具体操作是每日注射人垂体促性腺激素（H.P.G.），随后注射人绒毛膜促性腺激素（H.C.G.）以促排卵，并在排卵后第7天或第8天再次注射H.C.G.。该技术的妊娠率为64%，多胎妊娠率为34%。技术（2）涉及35名患者，先将炔雌醇和枸橼酸氯米芬联合使用5天进行预处理，随后立即每日注射H.P.G.，接着注射H.C.G.以促排卵，并在排卵后第7天或第8天再次注射H.C.G.。这种技术变化的结果是妊娠率为69%，多胎妊娠率为8%。有人认为，在后一种技术中使用枸橼酸氯米芬可作为一种“缓冲”，防止单独使用H.P.G.时卵巢出现更极端的反应，且具有明显优势，即妊娠率更高、多胎妊娠率更低，并且每个多胎妊娠中的胎儿数量减少。
