HORMONAL PROFILES AND FOLLICULAR-GROWTH IN CYCLES WITH IMMINENT OVARIAN HYPERSTIMULATION

被引:6
作者
KUSHNIR, O [1 ]
BENRAFAEL, Z [1 ]
SHALEV, J [1 ]
LIPITZ, S [1 ]
BIDER, D [1 ]
MASHIACH, S [1 ]
BLANKSTEIN, J [1 ]
机构
[1] CHAIM SHEBA MED CTR,DEPT OBSTET & GYNAECOL,IL-52621 TEL HASHOMER,ISRAEL
关键词
HORMONAL PROFILES; OVARIAN HYPERSTIMULATION SYNDROME;
D O I
10.1093/oxfordjournals.humrep.a137402
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Ovarian hyperstimulation syndrome is a common and serious complication of human menopausal gonadotrophin/human chorionic gonadotrophin treatment. We evaluated the changes in the pituitary and ovarian hormone profiles and ultrasonographic follicular regression in 12 patients in whom human menopausal gonadotrophin was discontinued due to 'imminent' ovarian hyperstimulation. Following discontinuation, three distinct periods were ovserved: (i) days 1-2, the levels of oestradiol, testosterone and prolactin, and the total number of follicles continued to rise; (ii) days 3-6, the levels of oestradiol, testosterone and prolactin declined sharply and the total number of follicles was reduced significantly, while the large and medium sized follicles continued to increase. Levels of follicle-stimulating hormone and luteinizing hormone gradually declined to reach their lowest levels by days 5-6 and then increased. (iii) Thereafter the number of follicles and steroid output declined to early follicular phase levels. We conclude that discontinuation of human menopausal gonadotrophin and withholding human chorionic gonadotrophin in cycles with laboratory signs of 'imminent' ovarian hyperstimulation syndrome, allows regression of the ovarian ultrasonographic finding and prevents the development of clinical symptoms. However, if rescue of the cycle is attempted, human chorionic gonadotrophin should be given during the first 4 days after discontinuation of stimulation.
引用
收藏
页码:665 / 669
页数:5
相关论文
共 17 条
[1]  
Ben-Rafael Z., Mastroianni L., Strauss G.F., Flickinger G.L., Differences in ovarian stimulation in human menopausal gonadotropin- treated women may be related to follicle stimulating hormone accumulation, Fertil. Sterii, 46, pp. 586-592, (1986)
[2]  
Bergquist C., Nillius S.J., Wide L., Human gonadotropin therapy. I. Serum estradiol and progesterone patterns during conceptual cycles, Fertil. Sterii, 39, pp. 761-765, (1983)
[3]  
Bider D., Menashe Y., Oelsner G., Serr D.M., Mashiach S., Ben-Rafael Z., Ovarian hyperstimulation syndrome due to exogenous gonadotropin administration, Acta Obstet. Gynecol. Scand, 68, pp. 511-514, (1989)
[4]  
Blankstein J., Shalev J., Saadon T., Kukia E.E., Rabinovici J., Pariente C., Lunenfeld B., Serr D.M., Mashiach S., Ovarian hyperstimulation syndrome: Prediction by number and size of preovulatory ovarian follicles, Fertil. Sterii, 47, pp. 597-602, (1987)
[5]  
Channing C.P., Gagliano P., Tanabe K., Fortuny A., Cortes-Prieto J., Demonstration of a gradient in inhibiting activity, estrogen, progesterone, and D4-androstendione in follicular fluid, ovarian vein blood, and peripheral blood of normal women, Fertil. Sterii, 43, pp. 142-145, (1985)
[6]  
Ferrareti A.P., Garcia J.E., Acosta A.A., Jones G.S., Serum luteinizing hormone during ovulation induction with human menopausal gonadotropin for in vitro fertilization in normally menstruating women, Fertil. Steril, 40, pp. 742-747, (1983)
[7]  
Haning R.V., Austin C.W., Carison I.H., Kuzma D.L., Shapiro S.S., Zweibel W.J., Plasma estradiol is superior to ultrasound and urinary estradiol glucuronide as a predictor of ovarian hyperstimulation during induction of ovulation with menotropins, Fertil. Steril, 40, pp. 31-36, (1983)
[8]  
Knobil E., The neuroendocrine control of the menstrual cycle, Reg. Prog. Horm. Res, 36, pp. 53-88, (1980)
[9]  
McGarrigle H., Radwanska E., Lihe V., Swyer G., The monitoring of gonadotropin therapy by plasma oestradiol and progesterone determinations, J. Obstet. Gynaecol. Br. Commonw, 81, (1974)
[10]  
Rabau E., David A., Serr D.M., Mashiach S., Lunenfeld B., Human menopausal gonadotropins for anovulation and sterility, Am, J. Obstet. Gynecol, 98, pp. 92-98, (1967)