Vermeiden J P, Roseboom T J, Goverde A J, Suchartwatnachai C, Schoute E, Braat D D, Schats R
IVF Centre, Department of Obstetrics and Gynaecology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Hum Reprod. 1997 Jul;12(7):1399-402. doi: 10.1093/humrep/12.7.1399.
In the spontaneous menstrual cycle, the mid-cycle gonadotrophin surge causes maturation of the cumulus-oocyte complex, mucification of cumulus cells and expansion of the cumulus oophorus, resumption of meiosis and maturation of the cytoplasm of the oocyte. Whether this is an effect purely of luteinizing hormone (LH) or whether follicle stimulating hormone (FSH) also plays a role is unknown. The effect of an artificially induced FSH surge at the time of human chorionic gonadotrophin (HCG) injection on maturation of the cumulus-oocyte complex was investigated in a prospective randomized double-blind trial. Twelve patients underwent controlled ovarian hyperstimulation [long gonadotrophin-releasing hormone agonist (GnRHa)/human menopausal gonadotrophin (HMG) protocol] for in-vitro fertilization (IVF) treatment. At the time of HCG administration, six patients received a bolus injection of FSH (450 IU i.m.); the other six patients received a placebo. The peak plasma concentrations of FSH of the experimental group were compared with the peak values of FSH obtained at the mid-cycle gonadotrophin surge of the natural cycle of a group of 12 volunteers to validate the bolus injection of FSH. Maturation of the cumulus-oocyte complex was quantified by measuring the expansion of the cumulus, by the fertilization rate and the implantation rate. The quality of the embryos was scored according the average morphology score. The bolus injection of FSH mimicked the mid-cycle gonadotrophin surge. The mean peak value of FSH (12.9 IU/l) in the experimental group was fully comparable with the mean peak value of FSH (10.0 IU/l) of the mid-cycle gonadotrophin surge in the natural cycle. No effect of a bolus injection of FSH on the maturation of the cumulus-oocyte complex or any other outcome variable was found. It is not advantageous to combine the final HCG injection with a bolus injection of FSH in GnRHa/HMG stimulated cycles.
在自然月经周期中，周期中期促性腺激素峰可使卵丘 - 卵母细胞复合体成熟、卵丘细胞黏液化及卵丘扩张、减数分裂恢复和卵母细胞细胞质成熟。这纯粹是黄体生成素（LH）的作用，还是卵泡刺激素（FSH）也发挥作用尚不清楚。在一项前瞻性随机双盲试验中，研究了人绒毛膜促性腺激素（HCG）注射时人工诱导的FSH峰对卵丘 - 卵母细胞复合体成熟的影响。12例患者接受控制性卵巢过度刺激（长效促性腺激素释放激素激动剂（GnRHa）/人绝经期促性腺激素（HMG）方案）用于体外受精（IVF）治疗。在给予HCG时，6例患者接受FSH静脉推注（450 IU，肌肉注射）；另外6例患者接受安慰剂。将实验组FSH的血浆峰值浓度与一组12名志愿者自然周期中周期中期促性腺激素峰时获得的FSH峰值进行比较，以验证FSH静脉推注。通过测量卵丘扩张、受精率和着床率来量化卵丘 - 卵母细胞复合体的成熟度。根据平均形态学评分对胚胎质量进行评分。FSH静脉推注模拟了周期中期促性腺激素峰。实验组FSH的平均峰值（12.9 IU/L）与自然周期中周期中期促性腺激素峰时FSH的平均峰值（10.0 IU/L）完全可比。未发现FSH静脉推注对卵丘 - 卵母细胞复合体成熟或任何其他结局变量有影响。在GnRHa/HMG刺激周期中，将最终的HCG注射与FSH静脉推注联合使用并无益处。
