延迟排卵与黄体功能缺陷性不孕的关系探讨

Luteal Function after Delayed Ovulation and Corpus LuteumDysfunction Infertility

目的探讨延迟排卵后的黄体功能与卵泡期长的患者不孕的关系。方法对27例卵泡期长(≥20天)的有自发排卵周期的不孕患者进行同一周期黄体中期3次血清孕酮(P)、雌二醇(E2)、催乳素(PRL)的放射免疫测定及黄体后期内膜活检,并观察基础体温(BBT)。以P值<15 ng/mL.和内膜成熟落后≥2天为诊断标准。结果27例中11例有子宫内膜性黄体期缺陷(40.7％),其中有7例(63.6％)P水平正常。所有病例E2、PRL水平均在正常范围。结论延迟排卵周期中子宫内膜黄体期缺陷的发生率高;在那些月经周期延长的不孕症患者中,子宫内膜活检是一个比血清孕酮更好的诊断指标。

Objective To study a relationship between the luteal function after delayed ovulation and corpus luteum dysfunction infertility. Methods Twenty - seven infertile patients presenting spontaneous ovulatory cycle with long follicular phase ( ≥20 days) underwent a luteal function evaluation by basal body temperature (BBT), plasma progesterone (P), estradiol (E2), and prolactin (PRL) determination, and endometrial biopay study. The diagnostic criteria for luteal phase defect (LPD) was mean P level of 3 blood samples taken on three days during midluteal phasma was less than 15 ng/mL and the histological dating of endometrial was two or more days behind. Results An endometrial LPD was detected in 11 patients (40.7% ) although in 7 of them (63.6%) P levels were normal. Conclusion This study shows a high incidence of endometrial LPD among cycles with delayed ovulation and that in cases of LPD related to abnormal folliculogenesis, the endometrium is a better indicator than plasma P.