Management of women with polycystic ovary syndrome who experienced premature luteinization during clomiphene citrate treatment

被引:18
作者
Lidor, AL [1 ]
Goldenberg, M
Cohen, SB
Seidman, DS
Mashiach, S
Rabinovici, J
机构
[1] Chaim Sheba Med Ctr, Dept Obstet & Gynecol, Reprod Med & Infertil Clin, IL-52621 Ramat Gan, Israel
[2] Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel
关键词
premature luteinization; polycystic ovary syndrome; gonadotropin-releasing hormone agonist;
D O I
10.1016/S0015-0282(00)01499-0
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine the preferred treatment modality in patients with PCOS who experienced premature luteinization during CC treatment. Design: Prospective randomized study. Setting: Tertiary medical center. Patients: Twenty-two infertile women with PCOS demonstrating premature luteinization during at least two consecutive CC cycles. Interventions: Randomized induction of ovulation either with FSH alone or with GnRH agonist combined with FSH for a single treatment cycle. Main Outcome Measures: Premature luteinization was defined as serum progesterone >1.5 ng/mL before hCG administration. Results: Premature luteinization occurred in eight of the 10 patients (80%) in group A and in two of the 12 patients in group B (16.6%). This result corresponds to the higher mean (+/-SD) progesterone level present in group A patients as compared to those in group B (2.0 +/- 1.2 ng/mL vs. 1.2 +/- 0.6 ng/mL, P=0.03). No pregnancies were achieved in group A, whereas the pregnancy rate per cycle observed in group B was 33.3% (4/12). On the day of hCG administration, the maximum mean (+/-SD) estradiol level was significantly lower (P<0.0001) in group A (210.6 +/- 37.9 pg/mL) than in group B (600.3 +/- 253.8 pg/mL). The treatment duration and the number of FSH ampules used did not differ between the groups. Conclusions: Pituitary desensitization with GnRH analog in combination with FSH is superior to FSH-only treatment in PCOS patients who demonstrate premature luteinization during CC treatment. (Fertil Steril (R) 2000;74:749-52. (C) 2000 by American Society for Reproductive Medicine.).
引用
收藏
页码:749 / 752
页数:4
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