PDF(Pubmed)
Abstract：
To determine and compare metabolite content using magnetic resonance spectroscopy (MRS) of growing follicles in patients with polycystic ovary syndrome (PCOS) receiving recombinant follicle stimulating hormone (rFSH), clomiphene citrate (CC) or aromatase inhibitor (AI) for ovarian stimulation.
Thirty patients diagnosed with PCOS and infertility and scheduled for ovarian stimulation were divided by therapy, rFSH/CC/AI, into three equal groups. Five fertile cases were designated as the control group. When the follicle diameters reached 16-18 mm in each group, patients underwent MRS and the metabolite content of a dominant follicle was analyzed. N-acetylaspartate, lactate (Lac), creatine (Cr), and choline (Cho) metabolite levels in parts per million were measured in the spectra.
A ~three-fold decrease in dominant follicle Cho content was found in patients receiving CC compared to control subjects. Similarly, the dominant follicle Cho intensities of patients given rFSH and AI were noted to be significantly higher than those who received CC. Only dominant follicle Lac levels of the patients who received CC were found to be significantly higher than the other groups. Cr peak intensities of patients receiving CC were found to be approximately three times less than control subjects. Cr signal intensity was significantly higher in patients receiving rFSH or AI than in patients receiving CC. While two patients became pregnant in the CC group, three patients in the AI group and five patients in the rFSH group became pregnant. The main metabolites detected in patients who conceived in each group were Cho and Cr. In cases who could not conceive, while Lac and lipid signals increased, Cho and Cr signals decreased.
Unlike CC, ovarian stimulation with rFSH or AI does not alter dominant follicle metabolite content. The developmental capacity of a growing egg may be determined non-invasively with MRS.
Thirty patients diagnosed with PCOS and infertility and scheduled for ovarian stimulation were divided by therapy, rFSH/CC/AI, into three equal groups. Five fertile cases were designated as the control group. When the follicle diameters reached 16-18 mm in each group, patients underwent MRS and the metabolite content of a dominant follicle was analyzed. N-acetylaspartate, lactate (Lac), creatine (Cr), and choline (Cho) metabolite levels in parts per million were measured in the spectra.
A ~three-fold decrease in dominant follicle Cho content was found in patients receiving CC compared to control subjects. Similarly, the dominant follicle Cho intensities of patients given rFSH and AI were noted to be significantly higher than those who received CC. Only dominant follicle Lac levels of the patients who received CC were found to be significantly higher than the other groups. Cr peak intensities of patients receiving CC were found to be approximately three times less than control subjects. Cr signal intensity was significantly higher in patients receiving rFSH or AI than in patients receiving CC. While two patients became pregnant in the CC group, three patients in the AI group and five patients in the rFSH group became pregnant. The main metabolites detected in patients who conceived in each group were Cho and Cr. In cases who could not conceive, while Lac and lipid signals increased, Cho and Cr signals decreased.
Unlike CC, ovarian stimulation with rFSH or AI does not alter dominant follicle metabolite content. The developmental capacity of a growing egg may be determined non-invasively with MRS.
摘要：
使用磁共振波谱（MRS）测定和比较接受重组卵泡刺激素（rFSH）的多囊卵巢综合征（PCOS）患者生长卵泡的代谢物含量。柠檬酸氯米芬（CC）或芳香化酶抑制剂（AI）用于卵巢刺激。
30例诊断为PCOS和不孕症并计划进行卵巢刺激的患者通过治疗进行分组，rFSH/CC/AI,分成三个相等的组。将5例可育病例指定为对照组。当每组卵泡直径达到16-18毫米时，患者接受了MRS,并分析了优势卵泡的代谢物含量.N-乙酰天冬氨酸,乳酸（Lac），肌酸(Cr),和胆碱(Cho)代谢物水平在光谱中测量,单位为百万分之一。
与对照受试者相比,在接受CC的患者中发现优势卵泡Cho含量降低了3倍。同样，rFSH和AI患者的优势卵泡Cho强度显著高于CC患者.发现接受CC的患者中只有优势卵泡Lac水平显着高于其他组。发现接受CC的患者的Cr峰强度比对照受试者低约三倍。接受rFSH或AI的患者的Cr信号强度明显高于接受CC的患者。虽然CC组中有两名患者怀孕，AI组3例患者和rFSH组5例患者怀孕.在每组受孕的患者中检测到的主要代谢产物是Cho和Cr。在无法怀孕的情况下，而Lac和脂质信号增加，Cho和Cr信号降低。
与CC不同，用rFSH或AI刺激卵巢不会改变优势卵泡代谢物含量。可以使用MRS非侵入性地确定正在生长的卵的发育能力。
30例诊断为PCOS和不孕症并计划进行卵巢刺激的患者通过治疗进行分组，rFSH/CC/AI,分成三个相等的组。将5例可育病例指定为对照组。当每组卵泡直径达到16-18毫米时，患者接受了MRS,并分析了优势卵泡的代谢物含量.N-乙酰天冬氨酸,乳酸（Lac），肌酸(Cr),和胆碱(Cho)代谢物水平在光谱中测量,单位为百万分之一。
与对照受试者相比,在接受CC的患者中发现优势卵泡Cho含量降低了3倍。同样，rFSH和AI患者的优势卵泡Cho强度显著高于CC患者.发现接受CC的患者中只有优势卵泡Lac水平显着高于其他组。发现接受CC的患者的Cr峰强度比对照受试者低约三倍。接受rFSH或AI的患者的Cr信号强度明显高于接受CC的患者。虽然CC组中有两名患者怀孕，AI组3例患者和rFSH组5例患者怀孕.在每组受孕的患者中检测到的主要代谢产物是Cho和Cr。在无法怀孕的情况下，而Lac和脂质信号增加，Cho和Cr信号降低。
与CC不同，用rFSH或AI刺激卵巢不会改变优势卵泡代谢物含量。可以使用MRS非侵入性地确定正在生长的卵的发育能力。
