宫颈评分监测氯菧酚胺诱发排卵的评价

Evaluation of Use of Cervical Score in Monitoring Results of Clomiphene Induction of Ovulation

本文分析33例无排卵患者应用氯菧酚胺治疗76周期中宫项评分(CS)与BBT、卵泡发育及激素参数的关系。19个周期无排卵反应,CS波动,但宫项粘液透明性状不变。57个周期有排卵反应,其中32周期停药后CS渐进增高,最高宫颈评分MCS≥8,卵泡发育好,LH峰后24h内排卵;22周期MCS<8,LH峰后卵泡不消失,形成LUF,激素测定提示停药后睾酮水平明显升高;另三个周期资料不全。结果提示停药后未见药物在宫颈水平的抗雌素效应;睾酮升高可能干扰CS并导致LUF。

Thirty-three anovulatory infertile patients were treated with Clomiphene citrate for 76 cycles. The relationship between cervical score(CS), BBT, follicular growth and hormonal levels was analyzed. Nineteen cycles showed anovulation with cervical mucus persistently presenting a transparent character with a fluctuating score. In 32 cycles, after drug administration, CS increased gradually to a maximum (MCS) of ≥8. Follicles developed well and ovulation occurred within 24 hours after the highest LH levels. In 22 cycles, MCS only reached 3-7, while blood testosterone levels increased significantly after clomiphene treatment. Although midcycle LH rises occurred and post peak progesterone secretion was manifested, follicles did not rupture, indicating the occurrence of LUF. In 3 cycles, data were incomplete. Results indicate that anti-estrogenic effects of clomiphene are usually not directly manifested on cervical mucus secretion as proposed by some authors in the literature. But excessive testosterone secretion may interfere with hormonal interrelationships and give rise to LUF, thus producing identifiable cervical mucus characteristics.