超声探查在发现卵泡和诊断排卵中的意义

临床实验室检查(功能诊断试验、子宫内膜组织学检查)结果虽能反映月经周期内激素相互关系的性质,但不是发生排卵的直接证据。动态地测定尿、血浆中促性腺激素和甾体激素的含量,可提供有关排卵及滤泡和黄体功能的情况但须消耗大量材料和一定时间,同时只能在所取得的结果的回顾性分析时确定排卵期。故均非诊断排卵的最佳方法。     

泰国妇女正常月经周期中的激素变化

在月经周期中,黄体生成素(LH)、卵泡刺激素(FSH)和催乳素(PRL)垂体激素在不同种族中已有研究,孕酮(P)及雌二醇(E_2)的曲线型也有报道,没有较大的种族差异。Judd和Yen报告6个妇女的血清睾酮(T)的平均浓度在月经周期的中1/3有明显的增高。Coyotupa报告在整个排卵周期中每天的血清T浓度黄体期比滤泡期持续高些。Dupon等指出在4个妇女正常排卵周期中血浆T浓度在滤泡期和黄体期无明显的差异。在有正常月经的泰国妇女中报导的血清T,PRL和皮质醇,在整个月经周期中每天的浓度波动范围是不     

孕激素ST-1435抑制排卵的浓度依赖机制

在人类女性内分泌的调节由于孕激素的使用而引起依赖剂量的靶器官的改变。在月经中期E_2的阳性反馈是通过孕激素抑制促性腺激素波峰。另外,孕激素通过抑制黄体生成素释放激素(LHRH)的分泌或通过垂体合成和/或促性腺激素释放的直接作用影响促性腺激素的脉冲式分泌。作者在较早的研究中,使用一种新的孕激素ST-1435(19去甲孕酮衍生物),通过血浆中E_2浓度非常低而证实,既使血浆ST-1435浓度比较低也有效的抑制滤泡发生,同时抑制血浆中黄体生成素(LH)增加滤泡刺激素(FSH)浓度。本文进一步研究皮下胶囊释放ST-1435超过一定时期,血浆ST-1435浓度     

青春期发动与性成熟的机理及异常

青春期使于休眠状态的下丘脑-垂体-卵巢轴功能赋活,出现月经周期及第二性征的发育。关于青春期有几种学说。①性激素抑制学说:小儿期下丘脑-垂体轴对雌激素的负反馈反应敏感,相当于成人的1/6～1/15水平的雌激素即可抑制促性腺激素的分泌。②自动的中枢性抑制学说:认为儿童期性腺发育不全,促性腺激素处于抑制期,青春期前期     

生殖的神经内分泌调节和GnRH及其类似物的治疗价值

生殖的正常激素调节是通过下丘脑脉冲式的分泌促性腺激素释放激素(GnRH)以节律性的刺激垂体促性腺激素(GTH)分泌,再进一步对性腺甾体激素和生殖细胞的生成进行调节的。由于GnRH在周围血中的浓度是很低的且半衰期又很短,故很难进行测定。使用直接记录下丘脑分泌的GnRH的频率和振幅,可以正确了解中枢神经系统对垂体-性腺轴的调节情况,但这种操作只能在对垂     

纳络酮对月经周期中内源性吗啡物质调节垂体促性腺激素及催乳素分泌的影响

已有很多证据表明,内源性吗啡物质能通过控制下丘脑GnRH神经元来抑制垂体前叶神经内分泌调节功能。但有关在正常月经周期妇女阻断吗啡受体对垂体促性腺激素影响的研究工作很少,结果不一致,也难以解释。本实验目的在于研究纳络酮这一吗啡受体阻断剂对妇女正常月经周期的卵泡中期和黄体中期FSH、LH和PRL水平的影响。     

自发的和克罗米芬枸橼酸盐诱发排卵的早期妊娠激素分泌

本文研究的目的是评价在月经周期的滤泡期给予克罗米芬枸橼酸盐(CC)是否影响妊娠早期卵巢类固醇的分泌。作者研究了12例21～36岁的孕妇,5例(对照组)在妊娠和研究期,除补充铁剂外,未接受任何药物。另外7例(治疗组)从妊娠周期的第1～5天接受CC,以诱发滤泡发育;每天给药50mg(n=2),100mg(n=3)和150mg(n=2)。通过超声波和黄体生成素测定和/或基础体温的变化     

浅谈黄体酮

正女性内分泌激素包括下丘脑-垂体-卵巢轴系腺体分泌的激素,这些激素通过复杂的刺激和抑制信号协调女性的月经、生育以及全身的健康。下丘脑向垂体门脉系统脉冲式分泌促性腺激素释放激素,刺激垂体前叶合成和释放促卵泡激素和黄体生成素,卵巢在其作用下产生卵泡的发育、成熟和排卵。排卵后卵巢的黄体分泌黄体酮,即孕酮。孕酮作用于体温中枢,可使体温上     

1例注射绒毛膜促性腺激素后严重反应的护理

<正>绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)是促性腺激素药,多用于垂体促性腺激素不足所致的女性无排卵性不孕症和黄体功能不全的治疗。不良反应有:头痛、疲倦、情绪改变、水肿、注射部位疼痛、偶然产生过敏性皮疹[1]。     

在不明原因不孕症的宫腔内人工授精治疗中监测子宫血流

本研究中,61例妇女诊断为不明原因不孕,用其丈夫的精液进行宫腔内人工授精(IUI)。她们的平均年龄为30.5岁(SD3.9,范围在21～39岁)。所有患者经腹腔镜检查均正常,在月经周期第3d和黄体中期分别测定卵泡成熟激素(FSH)和孕酮均正常,同时其丈夫的精液也正常。 行IUI的卵巢刺激方案由单用克罗米芬(CC)或CC加入绝经期促性腺激素(hMG)两种。从月经周期的第4d开始服用CC 100 mg/d连续5 d。在CC加hMG方案中,服CC后,在月经周期的第8 d、第10 d注射hMG 150 IU两次,当主卵泡直径≥18     

Job strain and male fertility

BACKGROUND: Job strain, defined as high job demands and low job control, has not previously been explored as a possible determinant of male fertility. We collected prospective data on job strain among men, and describe the associations with semen quality and probability of conceiving a clinical pregnancy during a menstrual cycle. METHODS: Danish couples (N = 399) who were trying to become pregnant for the first time were followed for up to 6 menstrual periods. All men collected semen samples, and a blood sample was drawn from both partners. Job demand and job control were measured by a self-administered questionnaire at entry, and in each cycle the participants recorded changes in job control or job demand during the previous 30 days. RESULTS: In adjusted analyses, no associations were found between any semen characteristic or sexual hormones and any job strain variable. The odds for pregnancy were not associated with job strain. CONCLUSIONS: Psychologic job strain encountered in normal jobs in Denmark does not seem to affect male reproductive function.     

控制性超促排卵对正常妇女心脏物理学的影响

目的:通过对正常妇女自然周期和控制性超促排卵过程中监测心脏彩超,探讨控制性超促排卵对心脏物理学的影响。方法:选择2005年2月～2008年10月,在青岛市妇女儿童医疗保健中心接受IVF-ET治疗单纯输卵管因素或男方因素的患者48例,采用每例患者促排卵周期和自然周期自身对照,分别于自然周期月经第3天、LH日、降调后月经第3天及HCG日进行内分泌激素和心脏彩超检测。结果:自然周期月经第3天与降调后月经第3天及自然周期LH日与促排周期HCG日的心脏结构各腔室、心室壁厚度、心脏血流动力学、心室顺应性相比较无统计学差异(P0.05)。结论:控制性超促排卵对女性心血管系统从心脏物理学角度没有明显影响,是比较安全的。     

Disorders of ovulation

A regular ovulatory menstrual cycle requires a functional and integrated feedback system involving the hypothalamus, the anterior pituitary and the ovary (Figure 1). In the normal menstrual cycle, periods occur at regular intervals of 21-35 days and bleeding lasts for up to 7 days. Disorders of ovulation usually cause menstrual disturbance and present with irregular periods (oligomenorrhoea) or absent periods (amenorrhoea). Irregular periods with anovulatory cycles are commonest under age 20 and over age 40. Ovulatory disorders account for one-quarter of couples presenting with infertility. Anovulation may be classified by the anatomical location of the defect in the hypothalamo-pituitary-ovarian axis (Figure 2). By focusing on ovarian, hypothalamic and endocrine defects, this article offers an overview of the disorders of ovulation.     

Menstrual irregularities and related plasma hormone levels in multiple sclerosis patients treated with beta interferone

Multiple sclerosis is a chronic inflammatory disease of central nervous system.Women are more susceptible to this disease. One of the obvious clinical complaints in women with multiple sclerosis specially treated with Beta Interferones is menstrual cycle irregularity. The aim of this study was to determine the prevalence of menstrual irregularities and probable changes in blood levels of related hormones (FSH, LH, PRL, TSH, T4, T3) in 58 females with definite MS treated with beta interferones versus 58 healthy women. In comparison to the control group, the patients had higher prevalence of irregular menstruation (P=0.001), oligomenorrhea (p=0.03), abnormal amount of menstrual blood flow (P=0.001), abnormal duration of menstrual flow (P=0.01) and missed period (P=0.04). Mean LH level in patients group was higher than control group (P=0.04). Hyperprolactinemia (>25.5 ng/ml) was more prevalent in patients group. There were not a significant difference in plasma levels of FSH and thyroid hormones between two groups. There were some relations between the type of Beta interferones and the subtype of menstrual irregularities in the patients. In conclusion, the results of this study emphasized the high rate of menstrual problem and changes of related plasma hormone levels in MS patients.     

Menstrual Cycle Changes in Daily Sexual Motivation and Behavior Among Sexually Diverse Cisgender Women

We used a one-month daily diary assessment to measure menstrual cycle-related changes in same-gender and other-gender sexual motivation and behavior in 148 cisgender women (32% lesbian-identified, 35% bisexually identified, and 33% heterosexual-identified). Women with exclusive same-gender orientations reported increased motivation for same-gender sexual contact during the higher-fertility phase of the cycle, but women with exclusive other-gender orientations did not show a parallel increase in other-gender sexual motivation during the higher-fertility phase. Bisexually attracted women showed no phase-related changes in same-gender or other-gender sexual motivation, regardless of whether they generally preferred one gender versus the other. Rates of partnered sexual contact did not increase during the higher-fertility phase. During the 14 midcycle days during which we assayed salivary estrogen and testosterone, we found no significant associations between daily hormones and sexual motivation. However, daily estrogen levels were positively related to sexual behavior among women currently partnered with women, and negatively related to sexual behavior among women currently partnered with men. Our results suggest that traditional evolutionary models of menstrual cycle-related changes in sexual motivation do not adequately reflect the full range of cycle-related changes observed among sexually diverse women.

     

Examination of changes caused by tubal sterilization in ovarian hormone secretion and uterine and ovarian artery blood flow rates

OBJECTIVES: To examine the changes caused by tubal sterilization (TS) in ovarian hormone secretion and uterine and ovarian circulation. DESIGN: Tubal sterilization was performed by minilaparotomy and laparoscopy methods in 36 women. Blood samples were taken for hormonal tests on Preoperative Day 3 (D3) of the menstrual cycle, on Postoperative Days 13-15 (periovulatory period) of the same cycle and on D3 in the 1st and 6th months post-TS. Uterine and ovarian artery blood flow rates of the women were measured on the same days as hormonal tests by transvaginal color Doppler ultrasonography (TVCDUSG). The control group was composed of 15 volunteers in the same age group who preferred the barrier method and who had the same TVCDUSG and hormonal analyses in the same periods. RESULTS: There was a decrease in the uterine and ovarian artery pulsatility index (PI) measurements and an increase in serum luteinizing hormone (LH) and estradiol (E2) values during the periovulatory period as compared with preoperative and postoperative menstrual measurements in all groups. There was no difference between baseline uterine and ovarian artery PI and serum follicle-stimulating hormone, LH and E2 values and those measured on D3 of the menstrual cycle in the 1st and 6th months post-TS. CONCLUSIONS: The 6-month postoperative follow-up of groups that had undergone different TS methods showed no difference in uterine or ovarian artery blood flow rates or ovarian hormone secretion in comparison with baseline values.     

Sexual Fantasies and Viewing Times Across the Menstrual Cycle: A Diary Study

Recent research has revealed that many aspects of female sexuality change across the menstrual cycle. In this study, we examined changes in sexual fantasies and visual sexual interests across the menstrual cycle. A total of 27 single, heterosexual women (M age = 21.5 years) not using hormonal contraceptives answered questions on a web-based diary every day for 30 days about their sexual fantasies and behaviors. Twenty-two of them also completed a viewing time task during three different menstrual cycle phases (follicular, ovulation, and luteal) to assess changes in visual sexual interest. Ovulation status was determined by a self-administered urine test. Results showed that the frequency and arousability of sexual fantasies increased significantly at ovulation. The number of males in the fantasies increased during the most fertile period, with no such change for the number of females. Fantasy content became more female-like during ovulation, focusing more on emotions rather than explicit sexual content. Women displayed a category non-specific pattern of viewing time with regard to target age and gender, regardless of fertility status. Results were discussed in the context of the ovulatory shift hypothesis of female sexuality.     

Psychoendocrinological Assessment of the Menstrual Cycle: The Relationship Between Hormones, Sexuality, and Mood

The role of sex hormones in sexuality and mood across the menstrual cycle was investigated. Twenty-one normal healthy women were followed for one menstrual cycle. Blood samples were taken frequently, and analyzed for estradiol, progesterone, testosterone, androstenedione, dehydroepiandrosterone sulfate, cortisol, and sex hormone-binding globulin. A diary concerning sexual interest and behavior, and different moods, was completed daily. Although the sample was not large, a clear effect of menstrual cycle phase on levels of testosterone and the free testosterone index was demonstrated. In a preliminary screening interview, 11 of the 21 women had reported that they suffered from premenstrual complaints (PC), the other 10 had reported no complaints in the premenstrual phase (NPC). Significant differences between the two groups were established in estradiol and the estradiol–progesterone ratio, with the NPC group having higher levels of both endocrine parameters across different menstrual samples. Psychologically, a cycle effect on tension and sexual interest was demonstrated. The NPC group reported a peak in sexual interest in the premenstrual phase, whereas the PC group reported a peak in the ovulatory phase. There was a difference between the two groups in feelings of fatigue but not in other moods across the menstrual cycle. The study provides further evidence of the importance of androgen levels in women's sexuality and shows again that the relationship between menstrual cycle phase and sexuality is much clearer than between phase and mood.     

Hormonal basis of proceptivity and receptivity in female primates

The role played by steroid hormones in regulating the sexual behavior of female primates is reviewed, with emphasis placed on experiments using nonhuman species. A distinction is made between the effects of hormones on female proceptivity (i.e., behaviors which incite mounting activity in the male) and receptivity (i.e., willingness to accept male mounting attempts). The rationale for distinguishing between proceptivity and receptivity is discussed, and the methods used for measuring each are described. Evidence shows that estrogen of ovarian origin facilitates sexual interaction primarily by stimulating the emission of nonbehavioral cues which increase the female's sexual attractivity (i.e., the value of a female as a sexual stimulant for a male). Evidence is presented suggesting that estrogen may enhance proceptivity by acting on the female's central nervous system; however, there is no clear demonstration that estrogen affects neural mechanisms controlling receptivity. Experiments show that proceptivity and to a lesser extent receptivity are modulated by adrenal androgens, and the possibility is raised that adrenal androgens may act synergistically with estrogen to facilitate sexual behavior. A disruptive effect of progesterone on sexual interaction is described, and evidence is presented suggesting that this effect of progesterone results primarily from a reduction in sexual attractivity caused by the action of the hormone in the female's vagina. Other literature indicates that proceptivity is often maximal at the periovulatory period of the female primate's menstrual cycle whereas cyclic variations in receptivity occur infrequently. Most hormone-dependent changes in sexual interaction associated with the menstrual cycle seem to result from fluctuations in nonbehavioral attributes of female sexual attractivity. The problem of distinguishing between the effects of steroid hormones on proceptivity and receptivity in human females is discussed.This work was supported by a program grant from the Medical Research Council (J. H.) and by a NATO Science Fellowship from the Dutch Organisation for Pure Scientific Research (M. J. B.).     

Serum allopregnanolone levels relate to FSFI score during the menstrual cycle

The aim of this study was to measure serum allopregnanolone levels and other hormones in women who completed the Female Sexual Function Index (FSFI; Rosen et al., 2000) during the follicular or the luteal phase of the menstrual cycle. Twenty-nine women with a regular menstrual cycle completed the FSFI during days 5-7 and days 19-21 of their menstrual cycles. We collected a blood sample on the same days so that we could determine levels of allopregnanolone (AP), dehydroepiandrosterone (DHEA), free testosterone (FreeT), androstenedione (A), and estradiol (E2); we stored serum at--20 degrees C until we assayed it. We performed statistical analyses by parametric and nonparametric comparisons and correlations, as appropriate. We found that the full FSFI score was 23 +/- 11.3 (mean +/- SD; 31% under 95% confidence interval = 18.7) in our study population. We also found a significant positive correlation between serum allopregnanolone levels and each FSFI domain, including full scale score (r = 0.47, p < 0.01), with the exception of pain. Similarly, we found a positive correlation between FreeT and each FSFI domain and full scale score (r = 0.55, p < 0.002). We found no significant correlation among FSFI scores and DHEA, A, or E2 plasma levels. It is interesting to note that FSFI full score was significantly higher (p < 0.04) in women tested in the luteal phase compared to women tested in the follicular phase. Serum allopregnanolone may be relevant to female sexuality directly or by its influence on a woman's general sense of well-being during the menstrual cycle. Further studies are required to test the hypothesis that high serum allopregnanolone levels in the luteal phase play a role in women's attitudes toward self-report questionnaires on sexual function.