• Title/Summary/Keyword: 과배란 유도

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A Comparative Study of Stimulation Protocols in IVF/ET Program (IVF/ET Program에 있어서 과배란 유도 방법에 대한 비교 연구)

  • Whang, In-Gu;Kim, Sun-Haeng;Rha, Jung-Yol;Ku, Pyong-Sahm
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.2
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    • pp.211-220
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    • 1989
  • The aim of this study was to compare the response and their outcome of superovulation induction protocol in IVF-ET program. One hundued seventy seven infertile women were stimulated by FSH/hMG(group I, N=128), clomiphene citrate/hMG(group II, N=51), and hMG(group III, N=18) for the purpose of ovulation induction. The results were as follows; 1. The mean ages of patients were $31.9{\pm}3.8$ in group I, $30.6{\pm}3.3$ in group II, and $29.3{\pm}2.5$ in group III. 2. The day of hCG administration was $11.1{\pm}1.8$ in group I, $12.1{\pm}2.0$ in group II, and $13.7{\pm}6.8$ in group III. The hCG administration day of group III was significantly delayed compared with that of group I (p<0.001). 3. The terminal E2 pattern in group II was different from those of group I and III, but there was no significant difference. 4. The mean numbers of mature eggs aspirated were $5.5{\pm}3.8$ in group I, $5.0{\pm}3.3$ in group II, and $5.6{\pm}5.4$ in group III. There was no significant differences in the mean numbers of mature eggs retrieved among the three groups. 5. The fertilization rate of eggs was significantly higher in group II (67.9%) than that of group I (52.2%)(p<0.001). 6. The cleavage rate of group I (67.0%) was significantly lower than those of group II (93.2%) and group III (95.8%) (p<0.0001). 7. The mean numbers of embryos transfered were $3.3{\pm}1.4$ in group I, $3.1{\pm}1.3$ in group II, and $3.2{\pm}1.6$ in group III and the ET rate was 69.0% in group I, 77.3% in group II, and 100% in group III. There was significant difference in ET rate between group I and group III (p<0.005). 8. The pregnancy rates per OPU cycle or ET cycle were not significantly different among the three groups, but delivered and ongoing pregnancy rates were significantly different between group I (36.8%) and group II (p<88.8%) (p<0.05).

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Response of Repeated Cycle of Ovulation Induction in Human in Vitro Fretilization and Gamete Intra-Fallopian Transfer (인간난자 체외수정 및 생식자 난관내이식술의 반복주기에서 과배란유도반응에 관한 연구)

  • Shin, Yong-Duk;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.14 no.2
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    • pp.101-108
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    • 1987
  • In order to evaluate the consistency of the serum estradiol pattern and response and to determine the influence of number of ovary on them in repeat cycles in the same patient, 57 cycles in 24 patients who underwent in Vitro Fertilization-Embryo Transfer or Gamete Intrafallopian Transfer in Seoul National University Hospital. The patients were stimulated by follicular stimulating hormone and human menopausal gonadotropin and classified as high(${\geqq}$400 pg/ml) and low(<400 pg/ml) response group according to preovulatory estradiol concentration and classified as three estradiol patterns (A,G.B) according to Jones criteria. Seventeen(89.5%) of 19 patients in when a high response to ovulation induction in their first cycle showed a high response. 40%(2/5) of the second ovulation induction cycle were low response in the patient whose first cycle resulted resulted in a low response. Serum estradiol pattern in the first ovulation induction cycle tended to be repeated in the second cycle. Women with high response tended to be more likely to have A and G patterns and less likely to have a cancellation than those with low response. One-ovary patients were at higher risk for inadequate ovulation induction response.

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Studies on the Superovulation and Collection of microinjectable Embryos in Korean Native Goats (Capra hircus aegagrus) (한국 재래산양에서의 과배란유기와 외래유전자 주입에 적합한 수정란의 회수에 관한 연구)

  • ;;Igor Goldman
    • Korean Journal of Animal Reproduction
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    • v.21 no.4
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    • pp.373-379
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    • 1997
  • This study was carried out to determine the hormone treatment scheme for an efficient superovulation and optimal recovery time for obtaining pronuclear embryos suitable for DNA injection in Korean native goats. For a superovulation, FSH(5.6mg) was given over four days in twice daily injections with (FSH/hCG group) or without(FSH group) hCG(100 IU) co-injection at the time of 7th FSH injection. Estrus cycle was synchronized by norgestomet ear-implantation for 11 days and its removal at the time of 6th FSH injection. Among the treated goats, the percentage of ovulated goats, which were examined at 70 to 76 h following implant removal, was greater in FSH/hCG group than in FSH group (100% vs 36.4%) but there was no significant difference in the mean numbers of ovulation points and fertilization rates between the two groups. To optimize hCG treatment scheme and recovery time, we injected hCG at the time of 7th (FSH/hCGa) or 8th(FSH/hCGb) FSH injection and then examined the developmental stage of the embryos recovered at different times after implant removal. In FSH/hCGa group, significant portions(31 to 44%) were beyond 1-cell stage, which was non-injectable, irrespective of their recovery time. However, in FSH/hCGb group recovered at 70 to 76 h after implant removal, great portions(69%) were fertilized and most of them(96.6%) were injectable 1-cell stage. Considering together the fertilization rate and developmental stage of recovered embryos, it is recommendable to administrate hCG at the time of final 8th FSH injection and collect the embryos at 70 to 76 h after implant removal to obtain injectable embryos as many as possible in Korean native goats.

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Effect of LH Bioactivity on Fertilization and Cleavage Rates of Mature Oocytes in Hyperstimulation Cycles for IVF-ET (과배란유도시 난포기 LH의 생물학적 활성이 성숙난자의 수정율 및 난할율에 미치는 영향에 관한 연구)

  • Moon, Shin-Yong;Kim, Seok-Hyun;Hwang, Tae-Young;Shin, Chang-Jae;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.18 no.1
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    • pp.13-21
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    • 1991
  • To investigate the factors that affect the fertilization and cleavage rates of mature oocytes, 44 patients undergoing controlled ovarian hyperstimulation(COH) with FSH/hMG/hCG regimen for IVF - ET were analyzed. During follicular phase, serum LH levels were measured by radioimmunoassay and bioassay. Based on the mean follicular immunoactive LH(i-LH) and bioactive LH(b-LH) levels, patients were divided into 3 groups, respectively. There were no significant differences in basal serum FSH levels on menstrual cycle day 3, serum estradiol($E_2$) and progesterone ($P_4$) levels on the day of hCG administration, and the numbers of follicles aspirated and oocytes retrieved among groups. In relation to the mean follicular i-LH levels, the fertilization and cleavage rates of mature oocytes did not show a significant difference among groups. However, in groups with higher mean follicular b-LH levels, the fertilization and cleavage rates were reduced significantly. During late follicular phase, day-to-day variance in b-LH levels was not significant, but there was a significant difference among groups. There was no significant correlation between serum P. and b-LH levels. These data suggest that the fertilization and cleavage rates of mature oocytes are adversely affected by the raised mean follicular b-LH levels, and monitoring of serum b-LH levels is more useful in COH when compared with i-LH. It appears that the reduced rates are not due to the attenuated endogenous LH surge.

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초기 배아의 분리할구에서 중기 염색체상 획득 방법에 대한 연구: 염색체 변이로 인한 착상전 유전자 진단에서 보인자와 정상 핵형 구분을 위한 연구

  • 임천규;전진현;민동미;변혜경;김진영;궁미경;강인수
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2002.11a
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    • pp.105-105
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    • 2002
  • 염색체의 구조적 이상으로 인한 습관성 유산과 기형아의 출산을 예방하기 위해 착상전 배아에서 할구를 분석하여 정상적인 핵형을 가진 배아만을 이식하는 착상전 유전자 진단 (preimplantation genetic diagnosis, PGD)의 성공적인 임상 적용이 보고되고 있으며, 그 적용 범위가 확대되고 있다. 그러나 일반적인 간기의 핵상을 이용한 PGD에서는 형광직접보합법 probe의 제약으로 보인자와 정상적인 핵형을 구분할 수 없는 단점이 있다. 따라서 본 연구에서는 보다 정확한 PGD를 위해 생쥐 배아를 이용하여 분리한 할구에서 중기 염색체상을 획득하기 위해 미세소관 (microtubule) 형성 저해제를 처리하였으며, 이를 통해 확립된 방법을 인간의 PGD에 적용하고자 하였다. 과배란이 유도된 ICR 생쥐에서 4- 또는 8-세포기 배아를 수획하여 colcemid, nocodazole, vinblastine을 각각 0.1, 0.5, 1.0, 5.0$\mu$M을 처리하고, hoechst 33342로 염색하여 핵상을 관찰하여 최적의 농도를 결정하였다. 또한 각 미세소관 형성 저해제를 혼합 처리하여 가장 높은 중기 염색체상을 획득할 수 있는 혼합 처리를 결정하였다. 이렇게 결정된 혼합 처리 방법을 인간의 체외 수정 및 배아 이식술에서 획득된 3PN 배아에 처리하여 중기 염색체를 획득하였다. Colcemid, nocodazole, vinblastine 모두 1 $\mu$M이 최적 농도임을 확인할 수 있었다 (각각 96.3%, 92.0%, 98,4%). 미세소관 형성저해제를 혼합 처리하였을 경우 nocodazole과 vinblastine (각각 1$\mu$M)을 혼합 처리했을 때 중기 염색체 획득률(97.3%)이 가장 높았다. 인간의 3PN 배아에 1$\mu$M의 nocodazole과 vinblastine을 혼합 처리한 후, 113개의 할구를 분석하여 44개(38.9%)의 할구에서 중기 염색체를 확인할 수 있었다. 본 실험 결과를 통해 중기 염색체를 획득하기 위하여 미세소관 형성 저해제를 처리하는 방법은 생쥐의 배아에서는 효과적이지만, 인간의 배아에서는 그 효율이 다소 낮음을 알 수 있었다. 그러나 이 방법을 개선하여 인간의 할구에서 중기 염색체의 획득률을 높이고, 이를 염색체의 구조적 이상에 대한 착상전 유전자 진단에 적용한다면, 보인자와 정상의 핵상을 구분하여 정상의 핵상만을 갖는 배아의 이식을 통하여 더욱 정확한 착상전 유전자 진단을 시행할 수 있으리라 사료된다.

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A Study for Clinical Efficacy of GnRH Antagonist (Cetrorelix) Minimal Stimulation Protocol in Assisted Reproductive Techniques for Polycystic Ovaian Syndrome (다낭성 난소증후군의 과배란유도시 GnRH Antagonist (Cetrorelix)를 병합한 Minimal Stimulation Protocol의 임상적 유용성에 관한 연구)

  • Park, Sung-Dae;Lee, Sang-Hoon
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.4
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    • pp.251-258
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    • 2002
  • Objective : The aim of this study was to evaluate the outcomes of the GnRH antagonist (Cetrotide) minimal stimulation protocol comparing with GnRH agonist combined long step down stimulation protocol in PCOS patients. Materials and Method: From Apr 2001 to May 2002, 22 patients (22 cycles) were performed in controlled ovarian hyperstimulation using by GnRH antagonist and GnRH agonist for PCOS patients. GnRH antagonist (Cetrotide) combined minimal stimulation protocol was administered in 10 patients (10 cycles, Study Group) and GnRH agonist long step down stimulation protocol was administered in 12 patients (12 cycles, Control Group). We compared the pregnancy rate/cycle, total FSH (A)/cycle, Retrieved oocyte/cycle, the incidence of ovarian hyperstimulation syndrome, multiple pregnancy rate between the two groups. Student-t test were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: Group of GnRH antagonist (Cetrorelix) minimal stimulation protocol produced fewer oocytes (6.4 versus 16.3 oocytes/cycle) using a lower dose of FSH (22.2 versus 36.1 Ample/cycle) and none developed OHSS and multiple pregnancy. Although the trends were in favour of the GnRH antagonist (Cetrorelix) protocol, the differences did not reach statistical significance. This was probably due to small sample size. Conclusion: The use of GnRH antagonist reduce the risk of ovarian hyperstimulation and multiple pregnancy. We suggest that GnRH antagonist might be alternative controlled ovarian hyperstimulation method, especially in PCOS patients who will be ovarian high response.

Neuroendocrine Control of Pituitary Gonadotropin Release (뇌하수체(腦下垂體) 성선자극(性腺刺戟)호르몬 분비(分泌)의 신경내분비적(神經內分泌的) 조절(調節))

  • Ryu, Kyung-Za
    • Clinical and Experimental Reproductive Medicine
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    • v.7 no.1_2
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    • pp.3-10
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    • 1980
  • Pituitary gonadotropes, as target cells, exhibit cyclic changes in terms of LH and FSH release in synchrony with the estradiol levels. The ultimate release is determined by the relative size of the two pools of gonadotropins, which is regulated by the two controllers: LH-RH and estradiol. LH-RH appears to serve as a primary drive on the gonadotrope, stimulating gonadotropin synthesis, storage, and release. Estradiol amplifies the action of LH-RH and induces the development of a self-priming effect of LH-RH except that it impedes LH-RH mediated gonadotropin release. Negative and positive feedback action of estradiol is revealed to operate by different mechanisms. The pituitary capacity increases severalfold from early to late follicular phase, which is considered to be prerequisite for the development of mid-cycle surge. CNS-hypothalamic dopamine, norepinephrine, and prostaglandins, as well as LH-RH, are involved in the negative and positive feedback effects of estradiol. The possible mechanisms in the triggering of LH-RH release for the initiation of midcycle LH-RH surge are considered.

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Effects of GnRH Agonist Used for Ovarian Hyperstimulation in Human IVF-ET on the Apoptosis of Preovulatory Follicular Cells (인간 체외수정 및 배아이식에 있어서 과배란 유도 과정에 사용한 GnRH Agonist가 배란 전 난포내 과립 세포의 세포자연사에 미치는 영향)

  • Yang, Hyun-Won;Kwon, Hyuck-Chan;Hwang, Kyung-Joo;Park, Jong-Min;Oh, Kie-Suk;Yoon, Yong-Dal
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.55-65
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    • 1999
  • There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-eosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged $11.09{\pm}8.75\;and\;10.33{\pm}4.53$ per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental rate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.

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A Study of the Changes of Breast Uptake in Menstrual Cycle on 18F-FDG PET/CT (월경 주기에 따른 18F-FDG PET/CT에서 유방 섭취 변화에 관한 고찰)

  • Tak, Yeojin;Park, Min Soo;Lee, Juyoung;Park, Hoon-Hee
    • Journal of radiological science and technology
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    • v.38 no.1
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    • pp.31-38
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    • 2015
  • $^{18}F-FDG$ PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; however, there have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on $^{18}F-FDG$ PET/CT. 160 females ($34{\pm}3.5$ years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used a s PET/CT. We analyzed SUVs on accumulated region on breast, and 3 nuclear medicine specialists did the Blind test. SUVs on the Breast were flow phase ($1.64{\pm}0.25$), proliferative phase ($0.93{\pm}0.28$), ovulatory phase ($1.66{\pm}0.26$) and secretory phase ($1.77{\pm}0.28$). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast's uptake was equal to lung (Grade I); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

Effects of Cortisol on the Steroidogenesis and the Apoptosis of Human Granulosa-Lutein Cells (Cortisol이 사람 과립-황체화 세포의 스테로이드 생성과 세포자연사에 미치는 영향)

  • Kim, Jin-Hee;Yang, Hyun-Won
    • Development and Reproduction
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    • v.13 no.4
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    • pp.329-339
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    • 2009
  • Cortisol is present in high concentration in the ovary and its receptor is expressed in the ovarian cells. Moreover, cortisol is known to have a role in steroid synthesis and cell metabolism in human granulosa and lutein cells. However, little is known of the role of cortisol presenting in high concentration in the follicles after LH surge on the granulosa-lutein cells. Therefore, the this study we evaluated the apoptosis and the production of progesterone $(P_4)$ and estradiol $(E_2)$ in the granulosa-lutein cells that are obtained during oocyte-retrieval after treatment with 5, 50, and $500{\mu}g/m\ell$ cortisol and 1 IU/$m\ell$ FSH. Results of DNA fragment analysis and TUNEL assay demonstrated that DNA fragmentation and the rate of apoptotic cells were increased in a dose-dependent manner showing a significant increase in 50 and $500{\mu}g/m\ell$ cortisol treated cells. We found, however, that FSH did not suppress the apoptosis of the cells induced by cortisol. In the results of chemiluminescence assay for $P_4$ and $E_2$, $P_4$ production was decreased by cortisol treatment, whereas $E_2$ was not changed. We also demonstrated that FSH did not inhibit the suppressive effect of GnRH on $P_4$ production as the result of apoptosis. The present study suggests that cortisol of high concentration could cause the apoptosis of human granulosa-lutein cells by suppressing the production of $P_4$. However, we need more studies to elucidate the mechanism by which cortisol induces apoptosis in human granulosa-lutein cells in view of the fact that our results are inconsistent with previous reported data.

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