Development of safe and convenient ovulation induction

不孕妇女使用促性腺激素诱导排卵需要每天去医院注射，并且与多胎妊娠高度相关。我们开发并评价了新的促排卵方法：FSH脉冲促性腺激素释放激素(F-G)、慢性小剂量FSH自身注射(LD-F)和克罗米芬-二甲双胺(CL-Met)。研究设计在所有研究中都是前瞻性、随机化和交叉的。我们比较了F-G和LD-F在10例PCOS患者中的疗效和安全性。LD-F方案：每日注射FSH，剂量为75IU，治疗14天后增加，以防卵泡不发育。F-G方案：每日注射FSH，剂量为150IU，当卵泡直径达到11 mm时，改为脉冲式GnRH。这两种治疗方法都同样有效。F-G组平均每个周期住院天数(8.8±1.3天)明显短于LD-F组(17.7±6.6天)(P&lt；0.01)。对3例无排卵的患者采用自体注射(SI)或住院(AH)的方法进行LD-F。两种治疗周期均达到单次排卵，未见不良反应。卵泡成熟总天数SI组为6.0±1.0天，AH组为17.7±8.0天(p=0.067)。我们比较了氯化蛋氨酸和氯化蛋氨酸对5例耐氯米芬(100 Mg)的多囊卵巢综合征患者的疗效和安全性。克罗米芬150 mg/d，二甲双胍750 mg/d(第5天至卵泡成熟)。1/4的氯液和4/5的氯-蛋氨酸有排卵。所有周期均实现单次排卵。2例单胎氯-蛋氨酸妊娠。结论：所有新方法对不孕症患者都是安全和综合的方法。

Ovulation induction using gonadotropin for infertile women requires daily attendance to hospital for injection, and is highly associated with multiple pregnancies. We developed and evaluated new method to induce ovulation: FSH-pulsatile GnRH(F-G), chronic low-dose FSH self-injection(LD-F) and clomiphene-metformine(Cl-Met). Study designs were prospective randomized and cross over in all investigations.1. F-GWe compared efficacy and safety between F-G and LD-F in 10 PCOS patients. Schedule of LD-F: Daily injection of FSH was started with a dose of 75 IU and increased after 14 days treatment in case no follicle developed.Schedule of F-G: Daily injection of FSH was started with a dose of 150 IU and switched to pulsatile GnRH administration when follicle reached 11mm. Both treatments were equally effective. Total day of attendance to hospital per cycle was significantly shorter in F-G(8.8± 1.3 days, mean±SE) than in LD-F(17.7± 6.6) (P<0.01).2. LD-F by self-injectionLD-F was performed by self-injection(SI) or by attendance to hospital(AH) to 3 anovulatory patients. All cycles of both treatment achieved single ovulation, and no side effect was observed. Total days of attendance to follicular maturation were 6.0 ±1.0 clays in SI and 17.7± 8.0 days in AH (p=0.067).3. Cl-MetWe compared efficacy and safety between Cl and Cl-Met in 5 clomiphene (100mg)-resistant women with PCOS. Dose of clomiphene was 150 mg/day and dose of metformin was 750 mg/day(day5 to follicular maturation). One out of 4 in Cl, and 4 out of 5 in Cl-Met showed ovulation. All cycles achieved single ovulations. Pregnancies were achieved in 2 of Cl-Met(singletons).In conclusion, all of new methods were safe and comprehensive methods for infertile patients.