子宫内膜异位症的黄体功能研究

Luteal Function in Patients with Endometriosis

本文通过测定子宫内膜异位症患者黄体期血清雌二醇(E_2)及孕酮(P)的浓度之高低,同时以子宫内膜组织学表现及基础体温(BBT)作对照来研究黄体功能的变化.结果证明了不孕症患者不论轻、中,重度均有黄体功能不足的表现,(血清孕酮(P)平均浓度偏低,孕酮分泌延迟)基础体温升高迟缓,子宫内膜成熟延迟。作者还进一步探讨了其发生机制及与不孕的关系,从而提出了今后治疗处理的措施以提高妊娠率.

Luteal function was studied in 19 cases with endometriosis, infertility being present in 16 cases. Based on previous menstrual cycles, BBT graphs and cervical mucus scores, serum LH concentrations were measured consecutively for 3 days during peri-ovulatory period to define day of LH peak (Do). Meanwhile, serum estradiol (E2) and progesterone (P) levels were determined in early, mid and late luteal phase. Endometrium biopsies were done on 4th and 12th days after BBT rise in 16 cases and dated according to Noyes' criteria. Six normally cycling women with matched age were served as controls.Results: Serum LH peaks were detected in all patients and normal subjects. All data were synchronized by D0, and analyzed. In endometriosis group, mean serum P levels in early, mid-luteal phase and total luteal phase (the sum of 3 values) were significantly lower than those in control group. Five cases (26.3%) showed low P levels during mid-luteal and/or total luteal phase. Delayed endometrJal maturation was observed in 10 of 16 cases (62.5%). Short luteal phase and /or delayed elevation of BBT were shown in 3 of 14 cases (21.4%). Besides. 10 of 12 cases (83.3%) had at least one abnormality in all 3 parameters and 7 cases (58.3%) had two abnormalities. In conclusion, the incidence of luteal phase defect (LPD) is higher in endometriosis group than that in the controls. The mechanisms of LPD and its relationship with infertility were discussed.