Shalev E, Geslevich Y, Matilsky M, Ben-Ami M
Department of Obstetrics and Gynecology, Central Emek Hospital, Afula, Israel.
Hum Reprod. 1995 Oct;10(10):2541-4. doi: 10.1093/oxfordjournals.humrep.a135741.
The objective of this study was to compare hormonal response, luteal phase adequacy and pregnancy and abortion rates in patients randomized to receive human chorionic gonadotrophin (HCG) or gonadotrophin-releasing hormone agonist (GnRHa) during ovulation cycles stimulated by clomiphene citrate. Anovulatory patients received either one s.c. dose of tryptorelin (0.1 mg; n = 104) or one i.m. dose of HCG (10,000 IU; n = 106) after clomiphene citrate stimulation had induced enlarged ovarian follicles (> 17 mm in diameter). A short-lived, transitory increase in serum luteinizing hormone (98 +/- 9 IU/l) and follicle-stimulating hormone (30 +/- 5 IU/l) concentrations was measured at 12 h following the injection of GnRHa, and these concentrations returned to baseline levels by 36 h post-injection. Midluteal progesterone concentrations were similar in both groups (> 10 ng/ml), and the mean luteal phase duration was also not significantly different (13 days). There were no significant differences in the mean number of pregnancies (12.0 versus 12.6% per cycle) and the abortion rate (18.2 versus 12.5%) between the GnRHa- and HCG-treated groups respectively. There were no complications related to treatment in either group. The results show that a relatively low dose of GnRHa can be used in place of HCG to induce ovulation in clomiphene citrate-treated patients.
本研究的目的是比较在枸橼酸氯米芬刺激的排卵周期中，随机接受人绒毛膜促性腺激素（HCG）或促性腺激素释放激素激动剂（GnRHa）的患者的激素反应、黄体期充足情况以及妊娠和流产率。无排卵患者在枸橼酸氯米芬刺激诱导卵巢卵泡增大（直径>17mm）后，接受一次皮下注射曲普瑞林（0.1mg；n = 104）或一次肌肉注射HCG（10,000IU；n = 106）。注射GnRHa后12小时，血清黄体生成素（98±9IU/l）和卵泡刺激素（30±5IU/l）浓度出现短暂、一过性升高，且这些浓度在注射后36小时恢复至基线水平。两组的黄体中期孕酮浓度相似（>10ng/ml），平均黄体期持续时间也无显著差异（13天）。GnRHa治疗组和HCG治疗组的平均妊娠率（分别为每周期12.0%对12.6%）和流产率（分别为18.2%对12.5%）均无显著差异。两组均无与治疗相关的并发症。结果表明，较低剂量的GnRHa可用于替代HCG，以诱导枸橼酸氯米芬治疗患者排卵。
