摘要
一、黄体生成素（LH）峰及早发LH峰产生机制自然月经中期LH峰的出现是促排卵、恢复卵母细胞减数分裂和卵泡黄素化的关键。LH峰出现机制与排卵前优势卵泡分泌的雌激素高峰正反馈诱发，抑制素A使垂体对促性腺激素释放激素（Gn—RH）的敏感性增强，小卵泡产生的促性腺激素峰平抑因子（gonadotropin surge—attenuating factor，GnSAF）下降有关。
In the late follicular phase of natural normal menstrual cycle, the LH surge is absolutely required for final maturation of the oocytes and initiation of follicular rupture, which generally occurs 36 hours after the LH surge. The premature LH surge is defined as an early and spontaneous LH surge that causes premature luteinization which contributes to poor oocyte maturation and decreased fertilization rates, and also has harmful effects on the endometrium, resulting in lower implantation rates and ham- pered early embryonic development. In the management of premature LH surge, it is not clear when to cancel an IVF cycle if LH rises prematurely before GnRH antagonist administration or whether there is a threshold for LH surge to continue the ovarian stimulation safely, provided that the LH level is brought to a safe range with daily GnRH antagonist injections. The accompanying rise in progesterone levels may guide the physician; however, no definitive cut off value exists for follicular phase progesterone levels that may have a negative effect on implantation. In general, we need an individualized management of premature LH surge. The serum progesterone level on the day of hCG injection may help us to decide to proceed with cycle and embryo transfer or go forward with cryopreservation of available embryos for future use.
出处
《生殖医学杂志》
CAS
2010年第A01期3-5,共3页
Journal of Reproductive Medicine
关键词
LH峰
早发LH峰
过早黄素化
LH surge
Premature LH surge
Premature luteinization
