Induction of ovulation with pulsatile subcutaneous administration of menopausal gonadotropin in anovulatory infertile women.

采用脉冲式皮下注射人绝经期促性腺激素(HMG)对无排卵性不孕症患者进行促排卵。128个治疗周期中排卵率为90.6%，26例患者中有16例(18个治疗周期)妊娠。除两个自然中断的妊娠外，所有16个胎儿都是西格尔顿受孕。15.6%的治疗周期观察到卵巢过度刺激。实验二采用促性腺激素释放激素激动剂(GnRHa)联合HMG脉冲式给药诱导多囊卵巢综合征(PCO)患者排卵。给予GnRHa，允许操纵和改变黄体生成素和卵泡刺激素水平，导致黄体生成素/卵泡刺激素比率正常化。这可能会降低卵巢过度刺激的风险。最后一项实验是评估每日激素变化与…无排卵期成功妊娠的临床相关性。生育能力更强的女性。至黄体中期，非妊娠周期的孕酮(P)和雌二醇(E_2)与妊娠周期无显着差异。但妊娠周期黄体中期的P/E_2明显高于非妊娠周期，提示P/E_2比P或E_2的绝对值更能反映着床激素的功能。然而，妊娠周期的发生率与非妊娠周期的发生率相当，提示过早黄体化的发生并不一定对成功妊娠的建立不利。本研究表明，无排卵性不孕症患者脉冲式皮下注射HMG可有效地诱导成功排卵和建立单胎妊娠。较少

The pulsatile subcutaneous administration of human menopausal gonadotropin (hMG) was used for induction of ovulation in patients with anovulatory infertile women. Ovulation was observed in 90.6% of 128 treatment cycles, and 16 (18 treatment cycles) of 26 patients became pregnant. All 16 fetus, excluding two pregnancies interrupted spontaneously, were sigleton conceptions. Ovarian hyperstimulation was observed in 15.6% of treatment cycles. In the second experiment, treatment with a combination of gonadotropin releasing hormone agonist (GnRHa) and pulsatile administration of hMG was used to induce ovulation in patients with polycystic ovary syndrome (PCO). GnRHa administration, permit manipulation and alteration of the levels of LH and FSH, resulting in normalization of the LH/FSH ratio. This may lessen the risk of ovarian hyperstimulation. The final experiment was undertaken to assess the clinical relevance of daily hormonal changes for achieving a successful pregnancy in anovulatory in … More fertile women. Up to the mid-luteal phase progesterone (P) and estradiol (E_2) values in non-pregnant cycles did not differ significantly from those in pregnant cycles. However, the P/E_2 ratio in the mid-luteal phase was significantly greater in pregnant cycles than in the non-pregnant cycles, suggesting that the P/E_2 ratio is a more important indicator of hormonal function for implantation than the absolute levels of either P or E_2. A premature endogenous LH rise and premature luteinization were frequent phenomena in anovulatory infertile women undergoing the pulsatile administration of hMG. However, the incidences in the pregnant cycles were comparable to those in non-pregnant cycles, suggesting that the occurrence of premature luteinization may not necessarily be detrimental to the establishment of successful pregnancy.The present study demonstrate that pulsatile subcutaneous administration of hMG is effective in induction of successful ovulation and establishment of singleton pregnancy in patients with anovulatory infertility. Less