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診斷與治療

輔助生育治療藥物

要提高受孕機會，醫生會按情況處方誘發排卵的藥物，令女士排出多於一顆卵子。誘發排卵的藥物主要有兩類，分別是克羅米芬（俗稱多仔丸）以及促性腺激素。

克羅米芬

克羅米芬為口服誘導排卵藥物。其副作用包括潮熱﹑視力模糊﹑噁心﹑腹脹及頭痛。克羅米芬會抑制雌激素功能，減薄子宮內膜的厚度，令胚胎難以著床。數據顯示，服用克羅米芬而成功受孕的比率只有少於10%^5-8。

促性腺激素

促性腺激素是指含有促卵泡激素（FSH）﹑促黃體激素（LH）及/或人類絨毛性腺激素（hCG）的針劑。療程一般由經期第2天開始，為期7至14天。促性腺激素大致分為人類促性腺激素和基因重組促性腺激素兩種。

	人類促性腺激素	基因重組促性腺激素
來源	天然	基因重組
獲得的卵子數量⁹	合理	大量
獲得的卵子質素¹⁰	較高	較低
成功懷孕機會¹¹	較高	較低
分娩出健康嬰兒機會^12,13	較高	較低
過度刺激卵巢的風險⁹	較低 (因獲得的卵子數量較少)	較高 (因獲得的卵子數量可能太多)

參考資料:

5 Nakamura Y et al 1997. Effects of clomiphene citrate on the endometrial thickness and echogenic pattern of the endometrium. Fertil Steril. 67:256–260.

6 Dehbashi S et al 2003. Effect of clomiphene citrate on endometrium thickness and echogenic patterns. Int J Gynaecol Obstet. 80:49–53.

7 Haritha S et al 2003. Follicular growth, endometrial thickness, and serum estradiol levels in spontaneous and clomiphene citrate-induced cycles. Int J Gynaecol Obstet. 81:287–292.

8 Peeraer K et al 2015. Low-dose human menopausal gonadotrophin versus clomiphene citrate in subfertile couples treated with intrauterine insemination: a randomized controlled trial. Hum Reprod. 30(5):1079-1088.

9 Arce JC et al 2014. The rate of high ovarian response in women identified at risk by a high serum AMH level is influenced by the type of gonadotropin. Gynecol Endocrinol. 30(6):444-50.

10 Smitz J et al 2007. Endocrine profile in serum and follicular fluid differs after ovarian stimulation with HP-hMG or recombinant FSH in IVF patients. Hum Reprod. 22(3):676-87.

11 Platteau P et al 2008. Highly purified HMG versus recombinant FSH for ovarian stimulation in IVF cycles. Reprod Biomed Online. 17(2):190-8.

12 van Wely M et al 2011. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Cochrane Database Syst Rev. (2):CD005354.

13 Bordewijk EM et al 2019. Required amount of rFSH, HP-hMG and HP-FSH to reach a live birth: a systematic review and meta-analysis. Hum Reprod Open. 2019(3):hoz008