排卵诱导
Ovulation induction uses hormonal therapy to stimulate egg development and release, or ovulation. 从历史上看, these drugs were designed to induce ovulation in women who did not ovulate on their own — typically women with irregular 月经周期s. 目标是产生一个健康的卵子.
The second use of ovulation induction was to increase the number of eggs reaching maturity in a single cycle, 增加受孕的机会. The initial agents for this treatment — used first for in vitro fertilization (IVF) and only later for simpler treatments — were injectable medications. 这些药物会增加多胎妊娠的风险, 卵巢过度刺激, 增加了成本和时间.
最近, 在90年代中期, evidence developed to suggest there may be an advantage to treating even ovulatory women with fertility medications. These women with "unexplained infertility" may have subtle defects in ovulation, 药物可以诱导两到三个卵子成熟, 而不是只有一个. This treatment therefore improves the quality and quantity of the ovulation, 从而提高怀孕率.
In ovulatory women, ovulation induction is always combined with intrauterine insemination. Ovulation induction should progress only after a complete and thorough evaluation. 所有潜在的荷尔蒙失调, 比如甲状腺功能障碍, should be treated before resorting to ovulation induction with fertility drugs.
The following common fertility drugs are used for ovulation induction.
柠檬酸克罗米芬(西拉芬和克罗米芬)
Clomiphene citrate is an oral medication that induces ovulation by blocking estrogen receptors. This artificial anti-estrogen effect makes your body believe that estrogen levels are low, which stimulates the production of more follicle stimulating hormone (FSH). Clomiphene citrate acts as a fertility agent in women by inducing superovulation — the release of multiple eggs in a given 月经周期.
Some form of monitoring is necessary while taking clomiphene citrate. 这种监视可能包括 超声波, blood estrogen levels, and urinary leutinizing hormone (LH) testing.
For unexplained infertility, clomiphene citrate is prescribed with 宫内人工授精. When used for ovulation induction in women who do not ovulate, IUI is not necessary.
人绝经期促性腺激素(Pergonal, Humegon和Repronex)
Human menopausal gonadotropin (hMG) is a medication that is composed of follicle stimulating hormone (FSH) and leutinizing hormone (LH). It is used to stimulate egg development in women who do not ovulate spontaneously or who ovulate extremely irregularly, or to increase the number of eggs developed in a single cycle in women who already ovulate. 由于不同病人的反应不同, 不推荐固定的给药方案. 每个患者周期必须个体化. However, it is generally thought to be a stronger superovulation agent than oral medications.
This fertility medication can be used with both 宫内人工授精 and in vitro fertilization (IVF).
对卵巢反应进行某种形式的监测是必要的. 结合血液雌激素测量(E2)和 ultrasound 这是目前最好的方法吗. 监测可将并发症的风险降到最低.
Human menopausal gonadotropin is available only in injectable form. Self-administered injection techniques are taught in a special class given by the nursing staff at the 加州大学旧金山分校生殖健康中心.
促卵泡激素(Follistim/Gonal-F, Bravelle)
FSH medications are used to stimulate the recruitment and development of multiple eggs in women during an ovulation induction cycle. FSH products may be used alone or in combination with human menopausal gonadotropin (hMG) to induce superovulation.
由于不同病人的反应不同, 不推荐固定的给药方案. 每个患者周期必须个体化,与 ultrasound 检查和血液雌激素水平测试评估卵巢反应. 监测可将并发症的风险降到最低.
卵泡刺激素只能以注射形式提供. Self-administered injection techniques are taught in a special class given by the nursing staff at the 加州大学旧金山分校生殖健康中心.
人绒毛膜促性腺激素(Profasi, Pregnyl, Ovidrel)
Human chorionic gonadotropin (hCG) is a natural hormone that helps with the final maturation of the eggs and triggers the ovaries to release the mature eggs (ovulation). It also stimulates the corpus luteum to secrete progesterone to prepare the lining of the uterus for implantation of the fertilized egg. 排卵通常发生在服用促性腺激素36小时后.
这种药是自行注射的. Self-administered injection techniques are taught in a special class given by the nursing staff at the 加州大学旧金山分校生殖健康中心.
Leuprolide (Lupron)和合成促性腺激素(FSH/LH)抑制剂
Lupron suppresses the brain's secretion of leutinizing hormone (LH) and follicle stimulating hormone (FSH). Therefore, it is used in preparation for cycles of treatment with ovulation induction drugs, 如外源性hMG-LH/FSH和/或FSH. It improves the recruitment of follicles by preventing the recruitment of a dominant follicle for the next 月经周期. Lupron enables the ovaries to respond with the recruitment of multiple follicles since in most cases it's possible to override the selection of a single dominant follicle. 它还通过阻止LH释放来防止早泄.
为了确认苯丙酮治疗的有效性,我 ultrasound is performed before the ovarian stimulation is begun and a blood estrogen level (E2) test may be required. Lupron also may be used to stimulate FSH if it is used early in the 月经周期. This property of the drug is helpful in patients expected to respond poorly.
卢普隆是一种可注射的形式. Self-administered injection techniques are taught in a special class given by the nursing staff at the 加州大学旧金山分校生殖健康中心.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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