Corson S L, Batzer F R, Gocial B, Maislin G
Department of Obstetrics and Gynecology, Pennsylvania Hospital.
Fertil Steril. 1993 Jun;59(6):1251-6. doi: 10.1016/s0015-0282(16)55985-8.
To use a GnRH agonist (GnRH-a) to induce ovulation after priming with exogenous hMG.
Prospective, randomized double-blind protocol using one or two doses of intranasal nafarelin.
Office-based ovulation induction program. PATIENTS, INTERVENTIONS: Infertile women not conceiving after use of clomiphene citrate for at least 6 months who were given hMG and nafarelin. No luteal support was given.
Serum concentrations of FSH, LH, E2, and P acutely and at 6 days after GnRH-a administration. Duration of the luteal phase was assessed.
Ovulation with elevation of both FSH and LH was achieved. The two-dose regimen was more effective than one dose for sustained LH release. Luteal phase P values and luteal phase duration were both less than usually seen with gonadotropin hCG therapy in the absence of luteal phase support.
Ovulation induction with GnRH-a after hMG priming produces unacceptable luteal phase cycles in the absence of hormonal support.
在外源性人绝经期促性腺激素（hMG）启动后使用促性腺激素释放激素激动剂（GnRH-a）诱导排卵。
采用前瞻性、随机双盲方案，使用一剂或两剂鼻内用那法瑞林。
基于办公室的排卵诱导项目。
患者、干预措施：使用枸橼酸氯米芬至少6个月后仍未受孕的不孕女性，给予hMG和那法瑞林。未给予黄体支持。
GnRH-a给药后即刻及6天时血清促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇（E2）和孕酮（P）的浓度。评估黄体期持续时间。
实现了FSH和LH升高的排卵。两剂方案在持续LH释放方面比一剂方案更有效。在没有黄体期支持的情况下，黄体期P值和黄体期持续时间均低于通常使用促性腺激素人绒毛膜促性腺激素（hCG）治疗时的情况。
在没有激素支持的情况下，hMG启动后用GnRH-a诱导排卵会产生不可接受的黄体期周期。
