無排卵周期症に対する系統的臨床内分泌学的研究

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タイトル別名
  • A Clinico-endocrinological Study on a Case of Persistent Anovulation
  • ム ハイラン シュウキショウ ニ タイスル ケイトウテキ リンショウ ナイブン
  • —A Case Report of Hyperstimulation by HMG Administration—
  • HMG負荷試験に際してhyperstimulationをきたした-症例について

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説明

An ovarian wedge resection was performed on a persistent anovulatory case who was mostly suspected of polycystic ovary (PCO) by clinico-endocrinological examinations. Prior to the operation, HMG (150 IU/day for 5 days) and HCG (10000 IU) were administered consecutively, and daily fluctuations of plasma estradiol (E2), estrone (E1), progesterone (P), 17α-hydroxyprogesterone (17α-P) and 20a-dihydroprogesterone (20α-P) were analysed simultaneously using specific radioimmunoassay during administration and postoperative periods. Ovarian specimen obtained at laparotomy was also studied histologically. Plasma E2 level initially showed a significant increase (after 300 IU of HMG), while marked elevation of plasma P and 17α-P levels were detected after HCG injection. Both ovaries had enlarged to goose-egg size with many cysts at laparotomy, but no finding suggesting ovulation was identified. Histological examinations revealed a remarkable proliferation as well as hypertrophy of both granulosa and theca interna cells, and characteristic features of luteinization were observed in both groups of cells. It was indicated that massive progestins can be secreted by non-ovulated but luteinized follicles if a certain kind of ovary is intensively stimulated by exogenous gonadotropin. As spontaneous ovulation occurred after the operation, wedge resection seems to be effective in this case

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