Fukuda M, Fukuda K, Andersen C Y, Byskov A G
Fukuda Ladies Clinic, Hyogo, Japan.
Hum Reprod. 1996 Sep;11(9):1958-62. doi: 10.1093/oxfordjournals.humrep.a019524.
Ovulation was studied using vaginosonography in a total of 410 natural cycles of 123 women undergoing infertility treatment [267 intrauterine insemination (IUI) cycles of 103 women and 143 in-vitro fertilization (IVF) cycles of 50 women]. None of the women received ovarian stimulation. Each follicle was measured daily from 14 mm in diameter until formation of corpus luteum or oocyte retrieval. Contralateral ovulation as compared with the preceding cycle occurred in 57% of the 410 cycles. Contralateral ovulations occurred in 72% of cycles with a follicular phase < 13 days. In cycles with a follicular phase of > 14 days, ovulations occurred at random. The length of follicular phase in contralateral ovulation cycles (15.2 +/- 3.2 days) was significantly (P < 0.05) shorter than that of ipsilateral ovulation cycles (15.8 +/- 2.8). During the 57% contralateral ovulations in 143 IVF cycles, the rates of oocyte retrieval (89%), fertilization (69%), cleavage (90%) and embryo transfer (56%) were significantly higher than those of ipsilateral ovulations (69, 51, 64 and 23% respectively). The pregnancy rate of contralateral ovulations (9%) was also higher, though not significantly, than that of ipsilateral ovulations (3%), although the pregnancy rates per transfer were similar (16 and 14% respectively). The total pregnancy rate of both IUI and IVF was higher in contralateral than in ipsilateral ovulation cycles (8.1 and 4.0% respectively). The dominant follicles in contralateral ovulation cycles showed significantly higher oestradiol/androstenedione ratio (P < 0.025) and oestradiol/testosterone + androstenedione ratio (P < 0.025) and lower androstenedione (P < 0.05) than those of ipsilateral ovulation cycles. There was no significant difference in oestradiol, progesterone and testosterone. These results indicate that the dominant follicles in contralateral ovulation cycles are healthier than those of ipsilateral ones. Local intra-ovarian factors, e.g. from the corpus luteum, may negatively affect the health of the dominant follicle and the enclosed oocyte. Therefore contralateral selection of the dominant follicle in the succeeding cycle may favour pre-embryo development. The chance of conceiving during a natural cycle may be affected by the site of ovulation in the preceding cycle.
采用阴道超声检查法，对123名接受不孕症治疗的女性的410个自然周期进行了排卵情况研究[其中包括103名女性的267个宫内人工授精（IUI）周期和50名女性的143个体外受精（IVF）周期]。所有女性均未接受卵巢刺激。从卵泡直径达14毫米开始，每天对每个卵泡进行测量，直至黄体形成或取卵。与前一周期相比，410个周期中有57%发生了对侧排卵。在卵泡期<13天的周期中，72%发生了对侧排卵。在卵泡期>14天的周期中，排卵随机发生。对侧排卵周期的卵泡期长度（15.2±3.2天）显著短于同侧排卵周期（15.8±2.8天）（P<0.05）。在143个IVF周期的57%对侧排卵过程中，取卵率（89%）、受精率（69%）、卵裂率（90%）和胚胎移植率（56%）均显著高于同侧排卵（分别为69%、51%、64%和23%）。对侧排卵的妊娠率（9%）也高于同侧排卵（3%），尽管差异不显著，尽管每次移植的妊娠率相似（分别为16%和14%）。IUI和IVF的总妊娠率在对侧排卵周期中均高于同侧排卵周期（分别为8.1%和4.0%）。对侧排卵周期中的优势卵泡与同侧排卵周期相比，雌二醇/雄烯二酮比值（P<0.025）和雌二醇/睾酮+雄烯二酮比值（P<0.025）显著更高，而雄烯二酮水平更低（P<0.05）。雌二醇、孕酮和睾酮水平无显著差异。这些结果表明，对侧排卵周期中的优势卵泡比同侧排卵周期中的优势卵泡更健康。卵巢局部因素，例如来自黄体的因素，可能会对优势卵泡及其内包裹的卵母细胞的健康产生负面影响。因此，在后续周期中选择对侧的优势卵泡可能有利于胚胎前期发育。自然周期中的受孕机会可能会受到前一周期排卵部位的影响。
