153例雌激素冲击诱导排卵和受孕

High dose estradiol-induced ovulation and pregnancy in 153 cases.

目的探讨一次性大剂量雌二醇冲击诱导排卵和受孕的效果。方法１５３例卵巢无排卵或黄体功能不健的内分泌失调不孕症，对其中７１例月经周期基本正常者，于月经第８～１１天一次性肌肉注射苯甲酸雌二醇１０ｍｇ，８２例周期４０天以上、体内雌激素水平偏低者，于月经第５天起服克罗米芬５０ｍｇ，每日一次，连服５天，己烯雌酚０２５ｍｇ，每日一次，连服１０天，Ｂ超提示生长卵泡直径达０８ｃｍ左右时，再肌肉注射苯甲酸雌二醇１０ｍｇ。结果１５３例共治疗２６７月经周期，排卵１８６次，用药排卵率为６９７％；１５３例中７９例受孕，总受孕率为５１６％，排卵周期受孕率为４２５％（７９／１８６）。结论大剂量雌二醇可促垂体Ｇｎ的合成，下丘脑ＧｎＲＨ的释放增加了垂体细胞对ＧｎＲＨ敏感性，释放ＬＨ，形成峰值，促成熟卵泡排卵，提高了受孕率。

Objective:To discuss the effects of induced ovulation and pregnancy by single high dose estrodiol.Methods:153 cases of infertile women with non-ovulation and corpus luteum insufficiency were treated.71 of them with normal menstrual cycle were injected i.m. with single dose estradiol benzoate 10mg in day 8～11 of the cycle .The other 82 cases with menstrual cycle more than 40 days,whose estrogen levels were lower in the blood,were treated with clomiphene 50 mg,qd.for 5 days and diethylstibestrol 0.25mg,qd.for 10 days from day 5 of the cycle,and estradiol benzoate 10mg was injected i.m.when follicular diameters became larger than 0.8cm.Results:186 times of ovulation were induced in 267 treated menstrual cycles of the 153 cases(ovulation rate 69.7%).79 women got pregnant in the 153 cases(pregnancy rate 51.6%).The rate of pregnancy in ovulatory cycles was 42.5%(79/186).Conclusion:High dose estradiol could promote the synthesis of gonadotropin in pituitary gland and the release of GnRH in hypothalamus.It could increase the sensitivity of pituitary cells to GnRH,which induced the surge of LH,promoted ovulation,and elevated the rate of pregnancy. \ \