控制性超排卵中低LH的发生及其结局与特殊类型病例LH添加治疗

The occurrence and consequence of low LH level in controlled ovarian stimulation and the supplementation of LH in certain patients

在女性的卵巢周期中，卵泡的正常发育是由垂体分泌的卵泡刺激素（FSH）和黄体生成素（LH）两种激素控制的，两者对于正常卵泡雌二醇（E2）的生物合成均有重要作用，也就是所谓的“两种细胞，两种促性腺激素”学说，即FSH刺激卵泡发育，LH结合于卵泡膜细胞上的受体，激发雄激素前体从膜细胞转移至颗粒细胞，

In ＂two-cell, two-gonadotropin＂ theory, folliculargenesis and steroidogenesis are controlled by follicle stimulating hormone （FSH） and luteinizing hormone （LH）. Balash and Fabregues proposed the concept of ＂LH window＂, outside which LH may be impotent or deleterious. The LH level may be suppressed too much by GnRH-a down-regulation in controlled ovarian stimulation, which could decrease the number of retrieved oocytes, the fertilization rate, implantation rate, and pregnancy rate. The supplementation of exogenous LH would be beneficial in this kind of circumstance. In some patients with normal LH levels but slow or low response to FSH, including those older patients （〉35 years old） or those with polymorphism of LH receptor, the supplementation of exogenous LH is also needed. The dose of LH supplemented is not yet determined, but 75 IU 150 IU is recommended.