Tyson J E, Freedman R S, Perez A, Zacur H A, Zanartu J
Ciba Found Symp. 1976(45):49-71. doi: 10.1002/9780470720271.ch4.
The causes of puerperal infertility in lactating women are poorly understood. The controlling centres may be either the hypothalamic-pituitary axis or the ovary (or both). We studied the secretory dynamics of prolactin and gonadotropins in healthy, normal, lactating and non-lactating women after administering either gonadoliberin to assess pituitary responsiveness or human menopausal gonadotropins to assess ovarian responsiveness during the puerperium. A reciprocal relationship was observed between the secretion of gonadotropins and the secretion of prolactin after the nipples of mothers who were breast-feeding had been stimulated for 30 min. The absence of a short-loop negative feedback control by prolactin for gonadotropin secretion was not confirmed because cyclic secretion of gonadotropin was not necessarily impaired by hyperprolactinaemia. Hyperprolactinaemia did, however, appear to impair the function of the corpus luteum in women suffering from non-puerperal galactorrhoea. We postulate a multifactorial mechanism for puerperal infertility based initially on the peripheral concentration of prolactin and gonadotropins and, in some poorly defined way, on the cerebral concentration of catecholamines.
哺乳期妇女产后不孕的原因尚不清楚。控制中心可能是下丘脑 - 垂体轴或卵巢（或两者）。我们对健康、正常、哺乳期和非哺乳期妇女在产褥期给予促性腺激素释放素以评估垂体反应性或人绝经期促性腺激素以评估卵巢反应性后，研究了催乳素和促性腺激素的分泌动态。在对哺乳期母亲的乳头刺激30分钟后，观察到促性腺激素分泌与催乳素分泌之间存在相互关系。由于高催乳素血症不一定会损害促性腺激素的周期性分泌，因此未证实催乳素对促性腺激素分泌不存在短反馈负调控。然而，高催乳素血症似乎确实会损害非产褥期溢乳妇女的黄体功能。我们基于催乳素和促性腺激素的外周浓度，并以某种尚不明确的方式基于儿茶酚胺的脑内浓度，推测产后不孕存在多因素机制。
