激发排卵的方法和机理

The methods and mechanism of trigger ovulation

排卵是女性生殖周期的中心，激发排卵则在辅助生育中具有重要的作用。生理状态下，黄体生成素（LH）在卵子的发生过程和卵巢的激素生成中发挥重要的生物学作用。在前期卵泡发育过程中LH能够维持卵泡的生长和发育，而且如果卵泡仅在卵泡刺激素的作用下，缺少LH的保护，卵泡将会出现结构及卵母细胞的退化。LH不但能促进卵泡的生长，而且还能促进卵子的成熟，LH峰触发卵母细胞的减数分裂恢复和卵泡细胞的黄素化，使原来较紧密的卵丘复合体的颗粒细胞变得较为分散，并促使卵细晌壁改蛮导致卵泡破裂和排卵发牛。

Injection of chorionic gonadotrophin （hCG） at the right time can make up for the absence of luteinizing hormone（LH） surge. It also contributes to ovulation and luteal formation. During ovary hyperstimulation in assisted reproductive technology （ART） treatment, observation of follicle development and urinary LH changes closely, as well as usage of hCG timely, can help to improve ovulation rate and embryo quality. One of the most important factors of ART success is that the best suitable dosage and right injection time of hCG are chosen to trigger ovulation. If the patient has risk factors for ovarian hyperstimulation syndrome （OHSS）, it is necessary to reduce the dose of hCG, select the GnRH-a or recombinant human LH and other medicine for triggering ovulation. Treatment protocol should be individualized. The different way to trigger ovulation should be chosen in the different ovulation failure state.