预测排卵日期的新方法

用三氯化铁试液滴定妇女晨尿所消耗的体积变化来预测排卵。由6名妇女进行了81个月经周期的试验。在月经周期的中期(即排卵的±2天之内),三氯化铁试液体积会出现一个峰值,此峰值与尿的LH峰值相吻合。本方法与基础体温的测定及阴道粘液变化的观察结合使用,能有效地确定月经周期的排卵期。本方法也可应用于动物排卵的测定。     

尿促黄体生成激素半定量试纸在90例不孕妇女排卵监测中的应用

[背景]探讨尿促黄体生成激素(LH)半定量试纸在不孕妇女排卵监测中的应用价值.[病例报告]选择90例自然月经周期不孕妇女,同时应用B型超声仪及尿LH半定量试纸监测排卵,并进行比较分析.阴道B型超声波检查中监测出排卵周期的62例均在尿LH峰形成后的48 h内排卵;监测无排卵周期的10例未发现尿LH的周期变化;18例卵泡黄素化不破裂周期者的尿LH曲线呈缓慢上升及下降,无陡峭的峰值.[讨论]尿LH半定量试纸测定对监测卵泡生长及预测排卵有应用价值.     

B超在不孕症中监测卵泡发育的临床价值

目的：探讨B超在不孕症监测中应用的临床价值。方法：采取50例不孕症妇女的121个月经周期进行B超、尿LH峰值、宫颈黏液评分及基础体温监测排卵。结果：121个月经周期的监测中发现尿LH出现峰值为116,准确率为96％,且与超声监测提示的时间基本一致。结论：尿LH峰值对排卵预测有很好的准确性,和B超监测相结合,可简便而迅速、准确地预测排卵,从而指导计划生育,掌握受孕时机并探讨各项指标的相关性及临床价值。     

无排卵月经周期血及腹腔液中β—EP,L—EK,SS的含量变化

本文用放射免疫法测定了有排卵月经周期及无排卵月经周期各２４例妇女的血浆及腹腔液中β－内啡肽，亮氨酸脑啡肽和生长抑素的含量。结果显示：无排卵月经周期的妇女ＬＨ峰值前后血浆、腹腔液β－ＥＰ含量及腹腔液中Ｌ－ＥＫ含量均显著高于有排卵月经周期妇女，无排卵月经周期中期的β－ＥＰ含量升高提示可能参与调控ＬＨ的分泌，抑制排卵前ＬＨ峰，阻断排卵，本文为神经肽类药物以抑制ＬＨ峰，阻断排卵，控制生育，提供一的理论参数     

经二维腔内超声监测排卵400例

目的探讨二维腔内超声加上自查阴道分泌物,尿LH试纸等综合指标监测不同月经周期的卵泡发育情况及排卵时间,以提高预测排卵时间的准确率.方法 对400例24-60天不同月经周期的育龄不孕妇女采用月经周期倒计时法,即下个月经周期前第20天开始超声监测卵泡发育情况.结果 月经周期规律组和不规律组的排卵时间距下个月经周期的时间均相对恒定,排卵时间为下个月月经周期前第15-18天.腔内超声加上尿LH试纸、基础体温、宫颈评分及自察阴道分泌物等综合指标监测排卵时间准确率高达100%.结论 二维腔内超声结合其他方法监测不同月经周期的卵泡发育,较为准确地确定了排卵的时间范围,提高了预测排卵时间的准确率.     

无排卵月经周期血及腹腔液中β－EP，L－EK，SS的含量变化

本文用放射免疫法测定了有排卵月经周期及无排卵月经周期各２４例妇女的血浆及腹腔液中β－内啡肽（β－ＥＮ，亮氨酸脑啡肽（Ｌ－ＥＫ）和生长抑素（ＳＳ）的含量。结果显示：无排卵月经周期的妇女ＬＨ峰值前后血浆、腹腔液β－ＥＰ含量及腹腔液中Ｌ－ＥＫ含量均显著高于有排卵月经周期妇女，无排卵月经周期中期的β－ＥＰ含量显著升高提示可能参与调控ＬＨ的分泌，抑制排卵前ＬＨ峰，阻断排卵，本文为神经肽类药物以抑制ＬＨ峰，阻断排卵，控制生育，提供一定的理论参数。     

尿LH快速测定结合宫颈粘液评分预测排卵

对６０例无明显盆腔病变的不孕妇女，在预计排卵前２￣３ｄ开始测尿ＬＨ及宫颈粘液评分，连续４￣６次，其中２０例同时作血ＬＨ含量测定。结果显示：血ＬＨ峰值与尿ＬＨ阳性符合率为８１．９％；血ＬＨ无峰值与尿ＬＨ阴性符合率为８８．９％。宫颈粘液评分值与尿ＬＨ（＋）呈正相关，与尿ＬＨ（－）呈负相关。经ｕ检验，可以ＣＳ７分作为有无排卵的分界线，因此认为尿ＬＨ测定结合宫颈粘液评分，为预测排卵的有效简介方法。     

规则月经周期妇女早期尿黄体生成素峰值频率及其对冻融胚胎植入的影响

目的:确定早期尿黄体生成素(LH)峰值频率及其对具有规则月经周期妇女妊娠率的影响。设计:回顾性队列研究。机构:私立医学院辅助生殖技术项目。患者:对具有规则月经周期妇女进行冻融胚胎移植(ET)。干预:应用放射免疫试剂盒检测规则月经周期妇女冻融胚胎植入后尿LH峰值。主要观察指标:早期尿LH峰值与妊娠结局。结果:188例规则月经周期妇女中88例(46.8%)具有早期尿LH峰,其中33例(37%)具有多个早期LH峰。不论有无早期LH峰,每例行ET治疗的患者妊娠率相似。结论:规则月经周期妇女大部分出现早期尿LH峰,且对冻融胚胎植入的结局无影响。规则…     

尿孕酮酶免法对健康妇女无排卵月经周期的研究

目的 实验观察３８名健康妇女连续２～３个月经周期中无排卵所出现的频率。方法 收集每日第１次晨尿,用酶联免疫法分别测定孕酮在尿中的代谢产物３－葡萄糖苷酸孕二醇（ｐｒｅｇｎａｎｅｌｉｏｌ－３－ｇｌｕｃｕｒｏｎｉｄｅ,ＰｄＧ）、卵泡刺激素（ＦＳＨ）以及肌酐（ｃｒｅａｔｉｎｔｉｎｅ,Ｃｒ）。结果 发现无排卵人数所出现的频率为７．９０％,无排卵周期发生的频率为７．６９％。无排卵周期与正常排卵周期相比,ＦＳＨ     

B超检测排卵的应用

目的:比较阴道B超与尿促黄体生成素试纸(LH)结合测定预测不孕症妇女排卵时间,探讨不孕症妇女排卵预测方法。方法:阴道B超结合LH试纸测定不孕妇女排卵时间,比较LH试纸测定与B超检测的吻合度。结果:①经B超监测,能够成功排卵者43例,占64.2%,共64个周期,占64%;无排卵型17例,占35.8%;②阴道B超检测准确率为98.7%。尿LH试纸检测阳性组中51.7%在24 h内发现排卵,89.6%在48 h内排卵,91.4%在72 h内排卵。阳性组与可疑阳性组,在血LH值及排卵时间上比较,差异有统计学意义(P<0.05),而卵泡平均直径则无变化。表明可疑阳性组在卵泡检测时也具有一定的意义。结论:B超联合尿促黄体生成素试纸测定对监测卵泡生长及预测排卵时间是一个简单易行、准确可靠的方法。连续的尿LH试纸测定更能动态的反映卵泡生长并准确预测排卵时间。     

阴道超声结合尿LH试纸监测卵泡发育及排卵在不孕症诊疗中的价值

目的：探讨阴道超声（Transvaginal ultrasonography,TVS）结合尿黄体生成素（LH）试纸监测卵泡发育、排卵时间及掌握促／超排卵时机在不孕症妇女诊疗中的意义。方法：TVS结合尿LH试纸测定54个自然月经周期（A组）、37个克罗米芬（CC）周期（B组）和21个绝经期促性腺激素（HMG）周期（c组）的卵泡生长、尿LH峰、排卵、子宫内膜情况。比较3组卵泡生长速度、优势卵泡数、排卵时间、过早LH峰和LUF（黄素化未破裂卵泡）发生率、尿LH试纸预测排卵的准确性。结果：B组和C组的卵泡生长速度明显快于A组（P〈0.01）。B组与C组的优势卵泡数均高于A组（P〈0.01）。比较3组卵泡生长速度,B组与C组明显快于A组（P〈0.01）。优势卵泡数：B组与C组的优势卵泡数均高于A组（P〈0.01）。C组排卵日子宫内膜厚度高于A组和B组（P〈0.01）。C组LUF周期发生率为16.67％,高于A组和B组（P〈0.01）。尿LH试纸测定阳性结果的排卵率为91％（95／105）。B组与C组周期过早LH峰发生率为12.8％。尿LH峰后100％在48h内排卵。结论：TVS联合尿LH试纸测定对监测卵泡生长及预测排卵是一个简单易行、准确可靠的方法。     

累积计算法测定双相基础体温对排卵日的评估

用基础体温BBT和B超监测排卵对72名月经周期正常妇女的100个月经周期预测排卵。其中48个周期做了LH峰值测定。以累积统计法微机测定BBT升高的第一天(估计排卵日);用B超监测卵泡破裂作为排卵日(D-O)。比较BBT升高的第一天与D-O的关系:结果表明BBT升高第一日波动在D-1到D+3范围内占83%周期。如在BBT升高后的5天作为避孕期,则避孕可靠性复盖了83%周期。如对需用BBT作指导避孕的对象进行选择,累积分析法的可靠性更会提高。     

Ovulation prediction in cattle by rapid measurement of plasma LH and by laparoscopic observation

The last hours of intrafollicular maturation are important to preserve the potential of oocytes for fertilization and development. To collect mature oocytes it is consequently essential to predict accurately the time of ovulation. Therefore we have modified a regular and specific plasma LH radioimmunoassay to a convenient assay providing reliable results within four to five hours. Using this technique we have been able to detect the LH peak with a delay small enough to predict the moment of ovulation; then we have been able to observe and photograph ovulation. The antigen-antibody reaction takes place during a two hour incubation at 37 degrees C. The immune complex is precipitated by addition of a rabbit anti-gamma-globulin and incubation at 22 degrees C for 30 minutes. The variation between fast and regular assays is lower than 15%. From a study of 25 cycles in 12 animals we suggest intervals of approximately 27 hours between the beginning of the LH peak and ovulation and of about 17 hours between the end of the peak and ovulation. Intervals between the beginning of heat and ovulation appear irregular and cannot be used with certainty as a reference point to predict ovulation. Five ovulations were observed closely and in the five cases, the formation of an apex was noted Our results clearly show that with the technique mentioned above we can predict rapidly and precisely bovine ovulation.     

叶天士通补奇经治疗崩漏特色

能补奇经是叶天士治疗奇经虚证的大法，用于治疗奇经虚损之崩漏，以补益奇经和宣通脉络相结合，补肝肾，益因，固阳明，调阴阳，佐以辛润能络，苦辛芳香，宣通气血，以补为主，以通为用，动静相随，祛旧生新，止血塞流，培本复旧，足为临床高速卵巢内分泌，促进排卵，调整月经周期效法。     

促排卵验方联合枸橼酸氯米芬片辨治肾虚血瘀型排卵障碍性不孕症患者的临床研究

目的观察促排卵验方联合枸橼酸氯米芬片辨治肾虚血瘀型排卵障碍性不孕症患者的临床效果。方法选择于我院就诊的肾虚血瘀型排卵障碍性不孕症患者90例为对象,随机分为对照组和观察组各45例。对照组口服枸橼酸氯米芬片,观察组则加用促排卵验方内服。对比两组治疗的妊娠率;记录基础体温BBT及激素水平变化;于排卵期监测子宫内膜厚度、优势卵泡直径及成熟卵泡个数。结果观察组的妊娠率高达68.9%,与对照组37.8%的妊娠率相比显著升高(P0.05);观察组的BBT改善优于对照组,其BBT正常率高达82.2%,显著高于对照组的46.7%(P0.05);观察组经治疗后血清雌二醇(E_2)、黄体生成激素(LH)、促卵泡激素(FSH)水平显著高于对照组(P0.05);观察组经治疗后其子宫内膜厚于对照组,优势卵泡直径较对照组明显增大,成熟卵泡个数较对照组明显增多(P0.05)。结论促排卵验方联合枸橼酸氯米芬片治疗肾虚血瘀型排卵障碍性不孕症疗效肯定,其能显著改善BBT,提高激素水平,促进子宫内膜的发育及卵子的成熟、排出,值得临床推广运用。     

Changes in serum FSH, LH and ovarian follicular growth during electroacupuncture for induction of ovulation

Changes in serum FSH, LH and follicular sizes were observed in chronically anovulatory patients during electroacupuncture treatment (EAT) for induction of ovulation. 7 cases were diagnosed as PCOD, 3 as dysfunctional uterine bleeding, and 1 as hypogonadotropic amenorrhea. Among them 8 cases complained of infertility for 2.7 years on average. Ovulation was confirmed by pregnancy or the combination of biphasic BBT and ultrasonographic evidence. During one cycle with 3-day EAT on acupoints Ren 3, 4, Extra 16 and Sp 6, ovulation resulted in 5 patients (ovulatory group) and among the 5 cases, 3 of 4 infertile cases became pregnant. The other 5 cases remained in anovulation (anovulatory group); of them 3 cases got biphasic BBT, but no typical ovulatory signs were found on ultrasonography; 2 cases remained in monophasic BBT. Serum FSH, LH values were elevated in ovulatory group, and FSH pulsatile frequency increased significantly during EAT (from 2.10 +/- 0.42/4h to 3.70 +/- 1.64/4h), but not in anovulatory group. No apparent changes were found in serum LH pulsatile frequency and pulsatile amplitudes of FSH and LH in this study. In ovulatory group diameters of ovarian follicles increased markedly, while diameters of anovulatory group stopped to grow at 14-16 mm. It is suggested that ovulation may be induced by EAT via a regulation on hypothalamic-pituitary function leading to normal secretion of FSH and LH.     

THE PREDICTION OF OVULATION

The authors present their work on the prediction of ovulation in forty-five women with normal menstrual cycles for a total of 72 cycles by several indices, including ultrasonography, BBT graph, cervical mucus and mittelschmerz, LH peak values were also determined for reference in 20 cases ( 20 cycles ), Results are as follows:     

不孕妇女卵泡发育及排卵的阴道超声监测

目的了解不孕妇女卵泡发育及排卵情况.方法用阴道检查超声仪监测38例患133个月经周期,同时观察基础体温和宫颈粘液结晶.结果133个周期中,有排卵17例65个周期,占48.87%,无排卵21例68个周期,占51.13%.卵泡发育情况的超声图像表现可分为5类:正常排卵型、排卵延缓型、无卵泡发育型、无优势卵泡形成型、黄素化卵泡不破裂型.结论阴道超声监测卵泡发育和排卵准确、直观,并同步观察基础体温和宫颈粘液是最佳诊断方法,对不孕症患的临床诊断和疗效观察起到了非常重要的作用.     

TCM treatment of luteal phase defect--an analysis of 60 cases

Sixty cases of infertility due to luteal phase defect were treated with herbs to tonify the kidney and regulate the menstrual cycle. After the treatment, the hyperthermal phase score of basal body temperature (BBT) was markedly increased (P less than 0.05), the hyperthermal phase 7-8 days after ovulation improved (P less than 0.001), the transitional period of BBT remarkably shortened, and the pregnancy rate in 32 uncomplicated cases of luteal phase defect was 56%. The close relationship between luteal phase defect and the kidney deficiency syndrome in TCM was discussed. The key points of the treatment included coordination of yin and yang, regulation of qi and blood, and combination of tonification with reduction.