Study on the assesment of effective and safe protocols in ovulation induction by gonadotropin therapy

为了评价促性腺激素诱导排卵的有效性和安全性，我们研究了3种促排卵方案：（1）常规FSH方案（FSH治疗），（2）低剂量FSH治疗（LD-FSH治疗）和（3）FSH和脉冲式GnRH序贯治疗（FSH-促性腺激素释放激素治疗）2例患者组下丘脑无排卵（HA）和多囊卵巢综合征（PCOS）。GnRH治疗组与FSH治疗组相比无显著性差异，而LD-FSH治疗组的持续时间较长。平均卵泡数为FSH组>LD-FSH组>GSH-GnRH组。FSH-GnRH联合治疗HA组和PCOS组每个治疗周期的单个卵泡生成率分别为70%和50%，3组间排卵率和排卵率无显著性差异。LD-FSH和FSH-GnRH联合治疗未观察到多胎妊娠。促排卵综合征（OHSS）发生率FSH治疗>LD-FSH治疗>GSH-GnRH治疗。LD-FSH方案治疗PCOS患者，其疗程较长，不良反应发生率较FSH-GnRH方案高，可减少促性腺激素治疗的副作用，减少多胎妊娠和OHSS的发生，是一种安全有效的促性腺激素治疗方案。本研究的结论是，LD-FSH治疗是低风险无排卵患者的合适促性腺激素治疗方案，而FSH-GnRH治疗是高危患者的最佳方案。

To assess the effective and safe protocols in ovulation induction by gonadotropin therapy, we studied on 3 protocols, (1) conventional FSH therapy (FSH therapy), (2) low dose FSH therapy (LD-FSH therapy) and (3) sequential FSH and pulsatile GnRH treatment (FSH-GnRH treatment) for 2 patient group with hypothalamic anovulation (HA) and Polycystic ovary syndrome (PCOS).The mean treatment period in FSH-GnRH therapy is not changed with that of FSH therapy, but that of LD-FSH therapy is longer than other groups. The mean numbers of follicles are FSH therapy >LD-FSH thepy>GSH-GnRH therapy. The incidences of single folliculogenesis per treatment cycle by FSH-GnRH therapy were 70% in HA and 50% in PCOS.No significant differences were observed among 3 groups in the incidences of oulation and pregnency. We did not observe multiple pregnancy in LD-FSH therapy and FSH-GnRH therapy. The incidences of ovarian stimulation syndrome (OHSS) were FSH therapy>LD-FSH thepy>GSH-GnRH therapy. Especially, that in FSH-GnRH therapy was significantly lower than those in other groupsThese data suggested that LD-FSH therapy is a effective and safe protocol of gonadotropin therapy because it reduces the side effects of gonadotropin therapy, multiple pregnancy and OHSS.However, treatment periods is longer and the incidences of side effects in PCOS patients were higher than those in FSH-GnRH therapy. On the other hand, FSH-GnRH therapy is best protocol of gonadotropin treatment for reducing side effects.In conclusion of this study, LD-FSH therapy is a suitable protocol of gonadotropin treatment for low risk anovulation as HA, and FSH-GnRH therapy is best protocol for high risk patients.