Braat D D
Department of Obstetrics and Gynaecology, Academic Hospital, Vrije Universiteit, Amsterdam, The Netherlands.
Hum Reprod. 1993 Nov;8 Suppl 2:189-92. doi: 10.1093/humrep/8.suppl_2.189.
Pulsatile gonadotrophin releasing hormone (GnRH) treatment in patients with secondary hypothalamic amenorrhoea results in higher multiple pregnancy rates than expected. This multiple pregnancy rate is significantly higher when conception occurs during the first treatment cycle and when higher pulse doses are used. This is probably due to higher follicle stimulating hormone (FSH) levels, leading to multiple follicular growth. The endocrinology of pulsatile i.v. GnRH treatment cycles in patients with hypothalamic amenorrhoea as well as in patients with normal cycles revealed higher FSH levels during the first days of treatment compared with unstimulated control cycles. It was possible to induce multiple follicular growth in normally cycling women with pulsatile GnRH. To prevent multiple pregnancies in patients with hypothalamic amenorrhoea, a low pulse dose should be used, especially during the first treatment cycles.
对于继发性下丘脑性闭经患者，采用脉冲式促性腺激素释放激素（GnRH）治疗时，多胎妊娠率高于预期。当在第一个治疗周期内受孕以及使用较高脉冲剂量时，这种多胎妊娠率显著更高。这可能是由于促卵泡生成素（FSH）水平升高，导致多个卵泡生长。下丘脑性闭经患者以及月经周期正常的患者在接受脉冲式静脉注射GnRH治疗周期时，与未刺激的对照周期相比，治疗开始的头几天FSH水平更高。采用脉冲式GnRH能够使月经周期正常的女性出现多个卵泡生长。为预防下丘脑性闭经患者发生多胎妊娠，应使用低脉冲剂量，尤其是在第一个治疗周期期间。
