Deaton J L, Bauguess P, Huffman C S, Miller K A
Section on Reproductive Endocrinology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157-1067, USA.
J Assist Reprod Genet. 1996 May;13(5):390-4. doi: 10.1007/BF02066170.
Our purpose was to determine the pituitary response to minidose follicular-phase GnRHa and see if a second flare can be achieved.
A prospective, consecutive series of 12 couples with tubal-factor infertility underwent 14 cycles of minidose GnRHa. Women were given a 25- or 50-migrograms dose of leuprolide acetate (LA) on cycle days 2 and 5. On cycle days 3 and 4 no LA was given but 2 ampoules of pure follicle stimulating hormone (FSH) was administered. Beginning day 6, a combination of LA and FSH was administered.
Following a dose of only 25 micrograms of LA on cycle day 2, mean FSH, LH, and E2 levels were significantly elevated over the baseline levels. Following no LA on cycle day 3 or 4, a repeat dose of 25 micrograms LA caused a second flare of LH and E2 on cycle day 6. Of the 14 cycles, 6 were canceled because of poor stimulation. Two of the eight patients who underwent retrieval delivered a live birth.
This is the first study to examine both the pituitary response and the recovery time from minidose follicular-phase GnRHa. An extremely small dose of LA is needed to cause a pituitary flare of gonadotropins. Following a flare from 25 micrograms of LA on cycle day 2, the pituitary is able to recover and respond with a repeat flare on cycle day 5.
我们的目的是确定垂体对小剂量卵泡期促性腺激素释放激素激动剂（GnRHa）的反应，并观察是否能实现第二次促性腺激素高峰。
对12对输卵管因素不孕症夫妇进行前瞻性、连续系列研究，共进行14个小剂量GnRHa周期。在月经周期第2天和第5天，给女性注射25或50微克的醋酸亮丙瑞林（LA）。在月经周期第3天和第4天不注射LA，但注射2支纯卵泡刺激素（FSH）。从第6天开始，联合注射LA和FSH。
在月经周期第2天仅注射25微克LA后，平均FSH、LH和E2水平显著高于基线水平。在月经周期第3天或第4天未注射LA后，重复注射25微克LA会在月经周期第6天引起LH和E2的第二次高峰。在14个周期中，6个周期因刺激不佳而取消。8例接受取卵的患者中有2例活产。
这是第一项研究垂体对小剂量卵泡期GnRHa的反应以及恢复时间的研究。只需极少量的LA就能引起促性腺激素的垂体高峰。在月经周期第2天注射25微克LA出现高峰后，垂体能够恢复，并在月经周期第5天再次出现高峰。
