Roozenburg B J, van Dessel H J, Evers J L, Bots R S
Department of Obstetrics and Gynaecology, St Elisabeth Hospital, Tilburg, The Netherlands.
Hum Reprod. 1997 Aug;12(8):1720-2. doi: 10.1093/humrep/12.8.1720.
Patients suffering from normogonadotrophic anovulation and infertility are initially treated with clomiphene citrate. Those who do not respond to clomiphene citrate usually receive gonadotrophin treatment which is labour-intensive, expensive, and associated with an increased risk of multiple pregnancies and ovarian hyperstimulation syndrome. We treated 22 patients with clomiphene resistant normogonadotrophic anovulation with naltrexone (an opioid receptor blocker) alone or naltrexone in combination with an antioestrogen. In 19 patients ovulation and resumption of a regular menstrual cycle was achieved and in 12 out of 19 a singleton pregnancy was observed. In conclusion, ovulation can be induced successfully using naltrexone alone or naltrexone in combination with an anti-oestrogen in clomiphene citrate resistant anovulatory patients. Compared to gonadotrophin induction of ovulation, this method is safe, simple and inexpensive.
患有正常促性腺激素性无排卵和不孕症的患者最初用枸橼酸氯米芬治疗。那些对枸橼酸氯米芬无反应的患者通常接受促性腺激素治疗，这种治疗劳动强度大、费用高，且与多胎妊娠和卵巢过度刺激综合征风险增加有关。我们用纳曲酮（一种阿片受体阻滞剂）单独或与抗雌激素联合治疗了22例对氯米芬耐药的正常促性腺激素性无排卵患者。19例患者实现了排卵并恢复了规律月经周期，其中12例观察到单胎妊娠。总之，在枸橼酸氯米芬抵抗的无排卵患者中，单独使用纳曲酮或纳曲酮与抗雌激素联合可成功诱导排卵。与促性腺激素诱导排卵相比，该方法安全、简单且便宜。
