• Title/Summary/Keyword: 과배란 유도

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Superovulation-Oocyte and Uterine Function (과배란-난자 및 자궁기능)

  • 문영석
    • Korean Journal of Animal Reproduction
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    • v.20 no.4
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    • pp.379-384
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    • 1997
  • Superovulation with exogenous gonadotropins creates a spectrum of pre or periovulatory hormonal changes with subsequent detrimental effects on oocyte quality, fertilization, embryo development, implantation and maintenance of pregnancy. Our recent study determined potential roles for insulin-like growth factor-1 (IGF-1) in uterine environment regulation and preimplant tation in the rat. The evidence indicates that IGF-l may play an important role in the main tenance of a receptive uterine environment for embryonic development and the regulation of decidualization. Embryonic loss and failure of implantations following superovulation may be partially attributed to disturbances in uterine IGF-l action as observed in this study. We investigated the effects of superovulatory doses of gonadotropins on frequency of chromosomal a abnormalities of mouse embryos. Chromosome a analysis of mouse zygotes and 8- to 16-cell stage embryos from spontaneously ovulated, 5, 10, and l 15 lU pregnant mare serum gonadotropin (PMSG) superovulated mice was carried out. Aneuploidy, polyploidy and structural chrom- osomal abnormalities were detected among the four groups. However, only polyploidy was correlated with superovulation. In 10 and 15 IV PMSG treated groups, the rate of polypoidy was 2.9% and 10.5%, respectively. Furthermore, there was a dose reponse relationship between the PMSG dose and the incidence of embryonic p polyploidy (P

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Clinical Efficacy of Clomiphene Citrate and Letrozole Combined with Gonadotropins for Superovulation in Patients with Clomiphene-Induced Thin Endometrium (클로미펜에 얇은 자궁내막을 보이는 환자에서 성선자극호르몬 병합 과배란유도시 클로미펜과 레트로졸의 임상적 효용성)

  • Lee, Eun-Joo;Park, Hyun-Jong;Yang, Hyo-In;Lee, Kyung-Eun;Seo, Seok-Kyo;Kim, Hye-Yeon;Cho, Si-Hyun;Choi, Young-Sik;Lee, Byung-Seok;Park, Ki-Hyun;Cho, Dong-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.111-119
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    • 2009
  • Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

Effects of Aromatase Inhibitor on Reproductive Hormone Profiles and Ovulation Induction (방향화효소억제제의 생식호르몬 분비와 배란유도에 대한 효과)

  • Kim, Sook-Hyun;Kim, Jeong-Ah;Park, Joon-Cheol;Bae, Jin-Gon;Shin, So-Jin;Kwon, Sang-Hoon;Cho, Chi-Heum;Yoon, Sung-Do;Cha, Soon-Do;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.143-153
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    • 2008
  • Objective: To investigate the effects of aromatase inhibitor on reproductive hormone profiles and evaluate it's ovulation inducing capability in anovulatory infertile women. Methods: We quantified the blood levels of reproductive hormones from 30 healthy normal cycling women in natural cycle (control) and letrozole medicated cycle (study). LH, FSH, estradiol, testosterone, DHEA-S were quantified on third, 11th, 21th day in both cycles, and on 21th day, progesterone was added. Sixth anovulatory infertile women received either letrozole or clomiphene citrate for ovulation induction (n=30 in each groups). We compared the clinical parameters such as ovulation rate, pregnancy rate, the day of LH surge, number of follicles and endometrial thickness, cervical mucus amount, spinnbarkeit, mean diameter of follicles on the day of LH surge. Results: Letrozole had no effect on the LH, FSH, estradiol, DHEA-S secretion but there were significant increase in testosterone level on day 11 and progesterone level on day 21 in letrozole medicated cycle compared than control cycle ($0.40{\pm}0.16$ vs $0.28{\pm}0.11\;ng/ml$, p=0.002, $18.18{\pm}13.07$ vs $8.38{\pm}7.64\;ng/ml$, p=0.001, respectively). In comparison between letrozole and clomiphene groups, there were no significant difference in ovulation rate, pregnancy rate, number of mature follicle, mean diameter of follicles, but showed earlier LH surge, thicker endometrium, more cervical mucus, and higher spinnbarkeit in letrozole group ($12.12{\pm}2.46$ vs $14.52{\pm}3.18$ days, p=0.006, $10.48{\pm}1.23$ vs $8.52{\pm}0.93\;mm$, p=0.000, $2.04{\pm}0.61$ vs $1.57{\pm}0.59$, p=0.012, $6.00{\pm}1.12$ vs $4.95{\pm}1.61\;cm$, p=0.003, respectively). Conclusion: Letrozole may augment folliculogenesis and improve the endometrial condition for implantation in normal cycling women. Ovulation efficacy of letrozole in anovulatory women was comparable to clomiphene citrate and letrozole may be more physiological in ovulation induction.

Relationship between FSH Receptor Genotype and Clinical Outcomes of IVF-ET in Infertile Korean Women (한국 불임 여성에서 난포자극호르몬 수용체 유전자형과 체외수정 및 배아이식술 임상 결과와의 관련성)

  • Moon, Mi-Hye;Choi, Hye-Won;Kim, Min-Jee;Lee, Hyoung-Song;Cha, Sun-Hwa;Song, In-Ok;Koong, Mi-Kyoung;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.1
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    • pp.69-76
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    • 2008
  • Objective: The purposes of this study were to determine the distribution of follicle-stimulating hormone receptor (FSHR) genotypes in infertile Korean women and to evaluate the relationship between FSHR genotypes and clinical outcomes of IVF-ET cycles. Methods: Genomic DNA was extracted from peripheral blood in 1, 020 of infertile Korean women. Genotypes of FSHR at Thr307Ala (T/A) and Asn680Ser (N/S) were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Clinical outcomes related to the genotypes of FSHR were evaluated in IVF-ET cycles (n=302) with controlled ovarian hyperstimulation (COH) of infertile women under 40 years old. Results: In a population of 1, 020 infertile Korean women, the frequency of TT/NN, TA/NS and AA/SS for the major variant Thr307Ala and Asn680Ser was 44.80%, 41.96% and 10.49%, respectively. There was no significant difference in characteristics of ovarian response and clinical pregnancy rate among the major genotypes of FSHR in IVF-ET cycles with COH. However, implantation rate of AA/SS patients was significantly higher than that of TT/NN patients (24.5% vs 15.7%, p<0.05). Conclusion: This study showed that FSHR genotype was not directly associated with ovarian response in IVF-ET cycles with COH. The relationship between clinical outcomes and FSHR genotypes of patients should be substantiated by further studies.

Pregnancy and Implantation Rates Related to Serum Estradiol Concentrations of Controlled Ovarian Hyperstimulation in Fresh IVF-ET and Frozen-thawed ET Cycles (과배란 유도에서의 혈중 에스트라디올 농도에 따른 신선주기와 동결-융해 배아이식 주기에서의 임신율과 착상율)

  • Kim, Myo-Kyung;Choi, Su-Jin;Choi, Hye-Won;Bang, Kyoung-Hee;Kim, Hye-Ok;Yang, Kwang-Moon;Koong, Mi-Kyoung;Jun, Jong-Young;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.197-205
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    • 2007
  • Objective: This study evaluated the pregnancy and implantation rates in fresh IVF-ET cycles or frozen-thawed ET (F-ET) cycles based on serum estradiol concentrations of controlled ovarian hyperstimulation (COH). Methods: Clinical outcomes of 1,565 cycles of fresh IVF-ET with COH and 670 cycles of F-ET were retrospectively analyzed. Serum estradiol levels on the day of human chorionic gonadotropin (hCG) administration were categorized into Group-A (1,000$\sim$2,000 pg/ml), Group-B (2,000$\sim$3,000 pg/ml), Group-C (3,000$\sim$4,000 pg/ml) and Group-D (> 4,000 pg/ml). Clinical pregnancy (CPR), implantation (IR) and delivery rates (DR) were compared among four groups subdivided into younger (< 35 years) and older ($\geq$ 35 years) women. Statistical analysis was performed by Student's t-test and chi-square test. Results: Overall clinical outcomes with fresh IVF-ET and F-ET cycles were similar: 41.2% vs 44.8% of CPR, 18.8% vs 19.6% of JR, and 33.2% vs 34.5% of DR, respectively. There were no significant differences in the clinical outcomes of all four groups between fresh IVF-ET and F-ET cycles of younger women according to the estradiol levels. However, the clinical outcomes of F-ET cycles of older women in Group-D were significantly higher than those of fresh IVF-ET cycles (51.3% vs 25.0% of CPR*, 18.6% vs 9.9% of IR and 33.3% vs 19.4% of DR;* p<0.05). Conclusion: Our results demonstrated that supraphysiological levels of estradiol during COH in fresh IVF-ET cycles of older women ($\geq$ 35 years) may be detrimental to implantation environments of endometrium and clinical outcomes, which could be improved by F-ET cycles.

In vitro Effects of Hormaonal Teatment on Induced Maturation and Ovulation in the Sea bass, Lateolabrax japonicus (호르몬 처리 (in vitro 실험)에 의한 농어, Lateolabrax japonicus의 난성숙과 배란유도)

  • 백혜자;김형배;안철민;명정인
    • Journal of Aquaculture
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    • v.11 no.1
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    • pp.119-124
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    • 1998
  • The relative effectiveness of C21-steroids and human chorionic gonadotropin(HCG) on maturation and ovulatin was investigated in vitro using the isolated oocytes or ovarian fragments from the sea bass, Lateolabrax japonicus. ${\alpha}$-hydroxy, 20${\beta}$-dihydroprogesterone(17${\alpha}$20${\beta}$OHP : 5, 50, 500, 1000ng/ml), 17${\alpha}$-hydroxy, 20${\alpha}$-dihydroprogesterone(17${\alpha}$20${\alpha}$OHP : 5, 50, 500, 1000ng/ml) and HCG (5, 50, 500IU/ml) were effective in inducing oocyte maturation, GVM (germinal vesicle migration) or GVBD(germinal vesicle breakdown), compared to control except 17${\alpha}$20${\beta}$OHP and 17${\alpha}$20${\alpha}$OHP at 5ng/ml. 17${\alpha}$20${\beta}$OHP showed the greatest effect on oocyte maturation at 50ng/ml. A combination of 17${\alpha}$20${\beta}$OHP(50ng/ml) and HCG(500IU/ml) led to a significant increase (p<0.05) in GVBD when compared with 17${\alpha}$20${\beta}$OHP or HCG alone. These findings suggest that the two in combination acts synergistically to induce GVBD. 17${\alpha}$20${\beta}$OHP (1~1000ng/ml) and HCG(1~500IU/ml) also induced ovulation in ovarian fragments at all concentrations used ; more effective at lower concentrations(1~50ng/ml or IU/ml). It was shown that HCG was more potent in inducting ovulatin than 17${\alpha}$20${\beta}$OHP.

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