生长激素在多囊卵巢综合征促排卵中的作用

目的　探讨生长激素(GH)在多囊卵巢综合征(PCOS)患者促排卵中的作用。方法　测定130例PCOS患者(PCOS组)及107例正常妇女(对照组)的血中生殖激素及GH和胰岛素样生长因子Ⅱ(IGF-Ⅱ)的基础水平,并应用GH辅助促排卵方案治疗7例对人绝经期促性腺激素(hMG)反应不良的PCOS患者,观察疗效。结果　PCOS患者血中GH水平明显降低,肥胖者更为明显,非肥胖与肥胖者分别为(2.50±1.33)μg/L及(1.04±0.47)μg/L,而对照组肥胖与非肥胖者分别为(2.95±1.49)μg/L、（5.30±2.26）μg/L（P均<0.05）;PCOS组肥胖者IGF-Ⅱ水平为（136±27）nmol/L,高于非肥胖者的（123±20）nmol/L,两者比较,差异有显著性（P<0.05）。应用GH辅助促排卵治疗,可以明显减少hMG用量1～12支,缩短hMG刺激时间3～12d,增加优势卵泡的数量。结论　PCOS患者存在GH分泌障碍,应用GH辅助促排卵可以提高排卵率。

Effect of growth hormone on the outcome of ovulation induction in patients with polycystic ovary syndrome

OBJECTIVE: To study the effect of growth hormone (GH) on the outcome of ovulation induction in patients with polycystic ovary syndrome (PCOS). METHODS: We examined serum sex hormone, GH and insulin like growth factor-II (IGF-II) basal levels by radioimmunoassay in 130 PCOS patients and 107 normal women. In addition, we observed the effect of GH on the outcome of ovulation induction in 7 poor responders to human menopausal gonadotropin (hMG) treatment. RESULTS: The mean serum GH level is (2.50 +/- 1.33) micrograms/L and (1.04 +/- 0.47) micrograms/L respectively in nonobese and obese PCOS patients which were significantly lower than those in controls [(5.30 +/- 2.26) micrograms/L, (2.95 +/- 1.49) micrograms/L respectively, P < 0.05]. The mean serum IGF-II level is (136 +/- 27) nmol/L in the obese PCOS patients, significantly greater than those in nonobese PCOS and controls (P < 0.05). When we used GH with hMG in 7 poor responders, the total amount of hMG required decreased from 1 to 12 amples and the duration of treatment shortened as compared with hMG alone. CONCLUSION: There is abnormal GH secretion in patients with PCOS, GH may improve the outcome of ovulation induction by gonadotropin.