Recurrent spontaneous abortion and polycystic ovarian disease: comparison of two regimens to induce ovulation.
Recurrent spontaneous abortion and polycystic ovarian disease: comparison of two regimens to induce ovulation.
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复发性自然流产和多囊卵巢病：两种诱导排卵方案的比较。
DOI：
10.1136/bmj.300.6718.154
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发表时间：
1990
影响因子：
--
通讯作者：
Pam Johnson
中科院分区：
文献类型：
--
作者：
Pam Johnson
目的：确定诱导排卵前垂体抑制是否能降低多囊卵巢疾病和原发性复发性自然流产妇女的自然流产率。设计：封闭、随机、顺序试验。两组女性通过抛硬币的方式被分配到不同的治疗方案。背景：为复发性自然流产妇女提供的跨区域诊所。对象：42例多囊卵巢疾病和原发性复发性自然流产的妇女。干预措施：用克罗米芬或用布瑟林抑制垂体诱导排卵，然后用纯促卵泡激素。主要结局指标：对特定治疗的偏好被记录。当一组女性中有一名成功怀孕（定义为妊娠超过12周），另一名自然流产时，会出现优先选择；优先考虑导致成功怀孕的治疗。结果：20名服用克罗米芬的妇女中有11名发生了自然流产，而20名垂体抑制的妇女中有2名发生了自然流产。有11人喜欢布瑟林，2人喜欢克罗米芬。在7对夫妇中，两名女性都成功怀孕。其中一对因为其中一名妇女没有怀孕而被丢弃。黄体生成素浓度与卵泡直径之比可能是自然流产的诊断指标。结论：诱导排卵前垂体抑制可显著降低多囊卵巢疾病和原发性复发性自然流产妇女的自然流产风险。
OBJECTIVE--To determine whether pituitary suppression before induction of ovulation reduces the rate of spontaneous abortion in women with polycystic ovarian disease and primary recurrent spontaneous abortions. DESIGN--Closed, randomised, sequential trial. Pairs of women were allocated to each treatment by the toss of a coin. SETTING--Supraregional clinic for women who had had recurrent spontaneous abortions. SUBJECTS--Forty two women with polycystic ovarian disease and primary recurrent spontaneous abortions. INTERVENTIONS--Ovulation was induced by clomiphene or pituitary suppression with buserelin followed by pure follicle stimulating hormone. MAIN OUTCOME MEASURES--Preference for a particular treatment was noted. A preference occurred when one woman in a pair had a successful pregnancy (defined as one of over 12 weeks' gestation) and one had a spontaneous abortion; the preference was for the treatment resulting in the successful pregnancy. RESULTS--Spontaneous abortions occurred in 11 of 20 women given clomiphene compared with two of 20 who had pituitary suppression. Eleven preferences were found for buserelin and two for clomiphene. In seven pairs both women had successful pregnancies. One pair was discarded because one of the women did not become pregnant. The ratio of luteinising hormone concentration to follicular diameter was found to be a possible diagnostic indicator of spontaneous abortion. CONCLUSION--Pituitary suppression before induction of ovulation significantly reduces the risk of spontaneous abortion in women with polycystic ovarian disease and primary recurrent spontaneous abortions.