Clinical and Experimental Reproductive Medicine

  • 제29권2호
  • /
  • Pages.91-96
  • /
  • 2002
  • /
  • 2233-8233(pISSN)
  • /
  • 2233-8241(eISSN)
대한생식의학회 (The Korean Society for Reproductive Medicine)
권호 표지

불임 환자와 반복자연유산 환자에서 황체형성호르몬에 대한 연구

A Study of Luteinizing Hormone in Patients with Infertility and Recurrent Spontaneous Abortion

  • 남윤성 (포천중문 의과대학 산부인과학교실) ;
  • 조용선 (포천중문 의과대학 산부인과학교실) ;
  • 이우식 (포천중문 의과대학 산부인과학교실) ;
  • 김남근 (포천중문 의과대학 임상의학연구소) ;
  • 김세현 (포천중문 의과대학 임상의학연구소) ;
  • 차광렬 (포천중문 의과대학 산부인과학교실)
  • Nam, Yoon-Sung (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University) ;
  • Cho, Yong-Seon (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University) ;
  • Lee, Woo-Sik (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University) ;
  • Kim, Nam-Keun (Institute for Clinical Research, College of Medicine, Pocheon CHA University) ;
  • Kim, Se-Hyun (Institute for Clinical Research, College of Medicine, Pocheon CHA University) ;
  • Cha, Kwang-Yul (Department of Obstetrics and Gynecology, College of Medicine, Pocheon CHA University)
  • 발행 : 2002.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : To evaluate luteinizing hormone (LH) in patients with infertility and recurrent spontaneous abortion. Material and Method: LH was tested by solid phase immunoradiometric assay based on monoclonal and polyclonal anti-LH antibodies. Results: Of 100 infertile patients, the number of less than 5 mIU/ml, 5$\sim$10 mIU/ml, greater than 10 mIU/ml in LH level was 67 (67%), 22 (22%), 11 (11%), respectively. Of 100 patients with recurrent spontaneous abortion, the number of less than 5 mIU/ml, 5$\sim$10 mIU/ml, greater than 10 mIU/ml in LH level was 79 (79%), 18 (18%), 3 (3%), respectively. There was a significant difference between patients with infertility and recurrent spontaneous abortion only in the group with LH level greater than 10 mIU/ml (p=.0325). Conclusions: High LH in the follicular phase is known to decrease pregnancy rate and increase abortion rate. But in this study the incidence of high LH in patients with recurrent spontaneous abortion was low. On the contrary, there was a significant increase of LH in infertile patients. So recurrent spontaneous abortion does not seem to be related to high LH level.

키워드

참고문헌

  1. Homburg R, Eshel A, Armar NA. One hundred pregnancies after treatment with pulsatile luteinizing hormone releasing hormone to induce ovulation. Br Med J 1989; 298: 809-12 https://doi.org/10.1136/bmj.298.6676.809
  2. Homburg R, Armar NA, Eshel A, Adams J, Jacobs HS. Influence of serum luteinizing hormone concentrations on ovulation, conception, and early pregnancy loss in polycystic ovary syndrome. Br Med J 1988; 297: 1024-6 https://doi.org/10.1136/bmj.297.6655.1024
  3. Homburg R, Jacobs HS. Etiology of miscarriage in polycystic ovary syndrome. Fertil Steril 1989; 51: 196-7 https://doi.org/10.1016/S0015-0282(16)60457-0
  4. Regan L, Owen EJ, Jacobs HS. Hypersecretion of luteinizing hormone, infertility, and miscarriage. Lancet 1990; 336: 1141-4 https://doi.org/10.1016/0140-6736(90)92765-A
  5. Shoham Z, Borenstein R, Lunenfeld B, Pariente C. Hormonal profiles following clomiphene citrate therapy in conception and non-conception cycles. Clin Endocrinol 1990; 33: 271-8 https://doi.org/10.1111/j.1365-2265.1990.tb00491.x
  6. Howles CM, Macamee MC, Edwards RG, Goswamy R, Steptoe Pc. Effect of high tonic luteinizing hormone on outcome of in-vitro fertilization. Lancet 1986; 2: 521-2
  7. Punnonen R, Heinonen PK, Ashom R, Kujansuu E, Vilja P, Tuohimaa P. Spontaneous luteinizing hormone surge and cleavage of in-vitro fertilized embryos. Fertil Steril 1998; 49: 479-82
  8. Stanger JD, Yovich JL. Reduced in-vitro fertilization of human oocytes from patients with raised basal LH levels during the follicular phase. Br J Obstet Gynaecol 1985; 92: 385-93 https://doi.org/10.1111/j.1471-0528.1985.tb01113.x
  9. Gysler M, March CM, Mishell DR, Bailey EJ. A decade's experience with an individualized clomiphene treatment regimen including its effect on a postcoital test. Fertil Steril 1982; 37: 161-7 https://doi.org/10.1016/S0015-0282(16)46033-4
  10. Tsafiri A, Pomerantz SH. Oocyte maturation inhibitor. Clin Endocrinol Metab 1986; 15: 157-70 https://doi.org/10.1016/S0300-595X(86)80047-0
  11. Guerrero R, Rojas OI. Spontaneous abortion and aging of human ova and spermatozoa. N Engl J Med 1975; 293: 573-5 https://doi.org/10.1056/NEJM197509182931202
  12. Hunter RHF, Cook B, Baker TG. Dissociation of response to injected gonadotropin between the graafian follicle and oocyte in pigs. Nature (London) 1976; 260: 156-8 https://doi.org/10.1038/260156a0
  13. Sagle M, Bishop K, Ridley N, Alexander FM, Michel M, Bonney RC, et al. Recurrent early miscarriage and polycystic ovaries. Br Med J 1988; 297: 1027-8 https://doi.org/10.1136/bmj.297.6655.1027
  14. Filicori M, Flamigni C, Meriggiola MC, Ferrari L, Michelacci L, Campaniello E, et al. Endocrine response determines the clinical outcome of pulsatile gonadotropin-releasing hormone ovulation induction in different ovulatory disorders. J Clin Endocrinol Metab 1991; 72: 965-72 https://doi.org/10.1210/jcem-72-5-965
  15. Hombrug R, Eshel A, Kilborn J, Adams J, Jacobs HS. Combined luteinizing hormone analogue and exogenous gonadotropins for the treatment of infertility associated with polycystic ovaries. Hum Reprod 1990; 5: 32-5 https://doi.org/10.1093/oxfordjournals.humrep.a137035
  16. Johnson P, Pearce JM. Recurrent spontaneous abortion and polycystic ovarian disease: comparison of two regimens to induce ovulation. Br Med J 1990; 300: 154-6 https://doi.org/10.1136/bmj.300.6718.154
  17. Balen AH, Conway GS, Kaltas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995; 10: 2107-11 https://doi.org/10.1093/oxfordjournals.humrep.a136243
  18. Bonney RC, Frank S. The endocrinology of implantation and early pregnancy. Bailliere's Clin Endocrinol Metab 1990; 4: 207-31 https://doi.org/10.1016/S0950-351X(05)80048-5
  19. Polson DW, Chanda M, Bedi S, Troup S, Lieberman B. The effect of serum luteinizing hormone concentrations on success rates of frozen embryo replacement into natural cycles. Br Congr Obstet Gynecol 1992 abstr 152
  20. Hamilton-Fairley D, Kiddy D, Watson H, Paterson C, Franks S. Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotropin. Br J Obstet Gynecol 1992; 99: 128-31 https://doi.org/10.1111/j.1471-0528.1992.tb14470.x
  21. Buckler HM, McLachlan RI, MacLachlan VB, Healy DL, Burger HG. Serum inhibin levels in poly-cystic ovary syndrome: basal levels and response to luteinising hormone-releasing hormone agonist and exogenous gonadotrophin administration. J Clin Endocrinol Metab 1988;66: 798-803 https://doi.org/10.1210/jcem-66-4-798
  22. Sopelak VM, Hodgen GD. Blockade of the estrogen-induced luteinising hormone surge in monkeys: a nonsteroidal, antigenic factor in porcine follicular fluid. Fertil Steril 1984; 41: 108-13 https://doi.org/10.1016/S0015-0282(16)47550-3
  23. Messinis IE, Templeton A, Baird DT. Endogenous luteinising hormone surge during superovulation induction with sequential use of clomiphene citrate and pulsatile human menopausal gonadotrophin. J Clin Endocrinol Metab 1985; 61: 1076-80 https://doi.org/10.1210/jcem-61-6-1076
  24. Balen AH, Jacobs HS. Gonadotrophin surge attenuating factor: a missing link in the control of LH secretion? Clin Endocrinol 1991; 35: 399-402
  25. Homburg R, Eshel A, Kilborn J, Jacobs HS. Combined luteinising hormone releasing hormone analogue and exogenous gonadotrophins for the treatment of infertility associated with polycystic ovaries. Hum Reprod 1990; 5: 32-5 https://doi.org/10.1093/oxfordjournals.humrep.a137035
  26. Jacobs HS. Polycystic ovaries and polycystic ovary syndrome. Gynecol Endocrinol 1987; 1: 113-31 https://doi.org/10.3109/09513598709082702
  27. Balen AH, Tan SL, MacDougall J, Jacobs HS. Miscarriage rates following in vitro fertilization are increased in women with polycystic ovaries and reduced by pituitary desensitization with buserelin. Hum Reprod 1993; 8: 959-64 https://doi.org/10.1093/oxfordjournals.humrep.a138174
  28. Fleming R, Jamieson ME, Hamilton MP, Black WP, Macnaughton MC, Coutts JR. The use of GnRH analogues in combination with exogenous gonadotropins in infertile women. Acta Endocrinol (Suppl) 1988; 288:77-84
  29. Abdalla HI, Ahuja KK, Leonard T, Morris NN, Honour JW, Jacobs HS. Comparative trial of luteinising hormone releasing hormone analogue / HMG and clomiphene citrate / HMG in an assisted conception programme. Fertil Steril 1990; 53:473-8 https://doi.org/10.1016/S0015-0282(16)53343-3
  30. Tan SL, Waterstone J, Waren M, Parsons J. A prospective randomized study of the optimum timing of human chorionic gonadotropin administration after pituitary desensitization in vitro fertilisaiton. Fertil Steril 1992; 57: 1259-64 https://doi.org/10.1016/S0015-0282(16)55084-5