• Clinical and Experimental Reproductive Medicine
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• 제42권4호
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• pp.149-155
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• 2015

Objective: The goal of this study was to investigate the relationship between serum progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration and the pregnancy rate among women undergoing controlled ovarian stimulation for in vitro fertilization (IVF) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) using a flexible antagonist protocol. Methods: This prospective study included 200 IVF and ICSI-ET cycles in which a flexible antagonist protocol was used. The patients were divided into five distinct groups according to their serum P4 levels at the time of hCG administration (0.80, 0.85, 0.90, 0.95, and 1.00 ng/mL). The clinical pregnancy rate (CPR) was calculated for each P4 interval. Statistically significant differences were observed at a serum P4 level of 0.9 ng/mL. These data suggest that a serum P4 concentration of 0.9 ng/mL may represent the optimal threshold level for defining premature luteinization (PL) based on the presence of a significant negative impact on the CPR. Results: The CPR for each round of ET was significantly lower in the PL group defined using this threshold (25.8% vs. 41.8%; p=0.019), and the number of oocytes retrieved was significantly higher than in the non-PL group ($17.3{\pm}7.2$ vs. $11.0{\pm}7.2$; p=0.001). Elevated serum P4 levels on the day of hCG administration were associated with a reduced CPR, despite the retrieval of many oocytes. Conclusion: Measuring serum P4 values at the time of hCG administration is necessary in order to determine the optimal strategy for embryo transfer.

• Clinical and Experimental Reproductive Medicine
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• 제31권2호
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• pp.83-94
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• 2004

Objective: To investigate whether GnRH-agonist (GnRH-Ag) using in IVF-ET affects apoptosis of human granulosa-luteal cells and expression of peripheral benzodiazepine receptor (PBR) protein involved in the apoptosis of the cells. Methods: Granulosa-luteal cells obtained during oocyte retrieval were cultured and treated with $10^{-5}M$ GnRH-Ag. Apoptosis of the cells by the treatment was confirmed using DNA fragmentation analysis 24 h after culture. The presence of PBR protein within the cells was examined by immunofluorescence staining and the expression of the protein was analyzed by Western blotting. In addition, it was measured for progesterone and nitric oxide (NO) produced by granulosa-luteal cells after GnRH-Ag treatment. To evaluate the relationship between NO production and PBR expression, sodium nitroprusside (SNP) as a NO donor was added in media and investigated the expression of PBR protein by Western blotting. Results: Apoptosis increased in the granulosa-luteal cells 24 h after GnRH-Ag treatment, whereas the expression of PBR protein significantly decreased. Furthermore, the production of progesterone and nitric oxide (NO) by the cells significantly fell from 12 h after the treatment. In the results of Western blotting after SNP treatment, the expression of PBR protein increased in the treatment with SNP alone to the granulosa-luteal cells, but was suppressed in the treatment with GnRH-Ag and SNP. Additionally, the staining result of PBR protein in the cells showed the even distribution of it through the cell. Conclusion: These results demonstrate that GnRH-Ag treatment induces apoptosis, decreasing expression of PBR protein and NO production in human granulosa-luteal cells. The present study suggests that one of the apoptosis mechanism of human granulosa-luteal cells by GnRH-Ag might be a signal transduction pathway via NO and PBR.

• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.203-210
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• 1995

Many oocytes fail to fertilize and cleave in vitro and many embryos transferred back to uterus fail to implant or maintain implantation. Chromosomal abnormalities in the male and female gametes may contribute to this loss. The higher incidence of meiotic chromosomal abnormalities bas been found in oocytes than in sperm. The wide range of incidence of chromosomal abnormalities in unfertilized oocytes has been reported in human IVF program (26-63%). However, factors affecting chromosomal abnormalities are not well understood. The present study has been conducted to investigate effects of the method for ovarian hyperstimulation, women's age, and the number of oocytes retrieved per patients on the incidence of numerical chromosomal abnormalities. Five hundred eighty four unfertilized metaphase II oocytes were subjected to chromosomal analysis. Included unfertilized oocytes were from 220 patients (mean $age=32.7{\pm}3.0$) and three hundred thirty oocytes were legible for analysis. Two hundred fourty five oocytes out of 330 (73.3%) were normal, while 38 (11.5%) were hyperploidy, 35 (10.6%) were hypoploidy, and 12 (3.6%) were diploidy. Significant difference in chromosomal abnormalities was not found between two patient groups stimulated by follicular stimulating hormone/human menopausal gonadotrophin (FSH/HMG) (25.9%) and gonadotrophin-releasing hormone agonist/follicular stimulating hormone/human menopausal gonadotrophin (GnRHa/FSH/HMG) (28%). There was a tendency of increasing chromosomal abnormalities in unfertilized oocytes from older patients (<30 yrs: 20.3%, 30-34yrs: 26.9%, >34 yrs: 35.3%). The number of oocytes retrieved per patient had no effect the incidence of chromosomal abnormalities (1-5: 31. 4%, 6-10: 29.8%, 11-15: 28.6%, > 15: 16.5%). These results from the present study suggest that the chromosomal abnormalities observed in the unfertilized oocytes has not affected by the stimulation methods, patient's age, and the number of oocytes retrieved per patients.

• Clinical and Experimental Reproductive Medicine
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• 제24권2호
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• pp.267-271
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• 1997

Apoptosis, programmed cell death, is posulated to occur in granulosa cells in ovarian follicular atresia. bcl-2 gene serves as protector from apoptosis and, thus, is associated with increased cell survival. TRPM-2 gene expression has been implicated as a trigger of apoptosis in rat prostate, uterus and mammary gland. Our objective was to determine if bcl-2 and TRPM-2 are expressed in luteinized human GC and, therefore, have regulatory functions for apoptosis in GC. Human GC were obtained via oocyte retrival from the infertile patients stimulated with exogeneous gonadotropins while undergoing IVF. GC were isolated from follicular fluid using Percoll gradient centrifugation. The GC were further purified with anti-CD45 magnetic beads to remove contaminating WBC's. RT-PCR were performed to analyze the mRNA expression of bcl-2 and TRPM-2 in the GC. The PCR primers were designed to amplify a 195 bp fragment of bcl-2 and a 174 bp fragment of TRPM-2. The PCR products were electrophoresed on 4% agarose gel. Three separate experiments indicated that both bcl-2 and TRPM-2 are concurrently expressed in human GC. We cultured granulosa cells with FSH (1 ng/ml) for 1 day to investigate the relative changes of TRPM-2 mRNA level with RNAse protection assay. When we cultured GC with serum free medium for 1 day TRPM-2 mRNA level increased with 1.3 fold, however it was decreased 0.64 fold with FSH. Therefore we conclude that bcl-2 and TRPM-2 are concurrently expressed and that the interaction of their products may be involved in GC apoptosis. And TRPM-2 may be regulated with FSH.

• 한국발생생물학회지:발생과생식
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• 제7권1호
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• pp.49-56
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• 2003

높은 농도로 투여된 성선자극호르몬 분비호르몬 이성체(GnRH-Ag)는 성선자극호르몬의 분비를 억제시키고 난소의 기능을 억제하는 하는 것으로 보고되고 있다. 그러나 체외수정 및 배아이식 시술과정에서 과배란 유도를 위해 다량의 GnRH-Ag를 사용하고 있으며, 이는 progesterone을 보충해 주어야 하는 황체기 결함을 유발시킨다. 본 실험의 목적은 이러한 황체기 결함을 유발시키는 원인을 알아보고자 사람 과배란 유도 과정과 비슷하게 생쥐에 GnRH-Ag와 PMSG를 투여하고 난소내 세 포자연사와 호르몬 합성 의 변화를 조사하고자 하였다. GnRH-Ag과 생리 식염수를 PMSG 투여 전 48시간부터 투여 후 48시간까지 12시간 간격으로 10$\mu$g씩 주사한 후 난소와 혈액을 채취하였다. 결과로서 난소의 무게는 GnRH-Ag만을 투여한 군에서 다른 두 실험군(PMSG 투여군, PMSC + CnRH-Ag 투여군)에 비해 유의하게 감소하였다. GnRH-Ag 투여군에서 난소내 강소형성전 난포의 비율은 증가한 반면, PMSC + GnRH-Ag투여군에서는 강소형성 난포의 비율은 감소하였고 황체의 비율은 증가하였다. 한편 난소내 세포자연사를 보이는 난포의 비율은 GnRH-Ag 투여군에서 PMSG 투여군에 비해 두배 이상 증가한 것을 알 수 있었고, 이러한 증가는 PMSC를 함께 투여함으로서 감소하는 것을 알 수 있었다. 혈청내 estradiol과 progesterone의 농도는 GnRH-Ag 투여군에서 다른 두군에 비해 유의하게 감소하였다. 그러나 GnRH-Ag와 함께 PMSG를 투여 한 경우 estradiol 농도는 PMSG 투여군 수준까지 완전히 회복되었으나, progesterone농도는 완전히 회복되지 않았다. 결론적으로 체외수정 및 배아이식 과정에서 사용되는 GnRH-Ag는 난소내 세포자연사를 유발하고 호르몬 합성을 억제시켜 황체기 결함을 유발시킬 수 있으며, 이를 막기 위해 적절한 progesterone 보충이 필요한 것으로 사료된다.

• 한국발생생물학회지:발생과생식
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• 제13권4호
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• pp.353-362
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• 2009

GnRH는 국부적으로 난소에서 합성되며, 난소내 과립 및 황체세포에 직접적으로 작용하여 난소의 기능을 조절하는 것으로 알려져 있으며, 특히, GnRH는 난소내 과립-황체화 세포의 세포자연사를 유도하는 것으로 보고하고 있다. 그러나 GnRH에 의한 세포자연사가 FSH에 의해 회복될 수 있는지는 명확히 밝혀져 있지 않다. 따라서 본 실험에서 난자 채취시 획득한 사람 과립-황체화 세포를 배양한 후 5, 50, 100 ng/$m\ell$ GnRH와 1 IU/$m\ell$ FSH를 처리하고 세포의 세포자연사 여부와 분비된 progesterone$(P_4)$과 estradiol$(E_2)$ 양의 변화를 조사하였다. DNA 분절화 분석과 TUNEL 방법으로 세포자연사를 평가한 결과, GnRH는 농도 의존적으로 과립-황체화 세포의 세포자연사를 증가시켰고, 특히 100 ng/$m\ell$ GnRH을 처리한 군에서 유의한 차이를 보이며 세포자연사 비율이 증가하였다. 또한 GnRH에 의한 세포자연사의 증가는 FSH에 의해 억제되는 것을 확인할 수 있었다. 화학발광면역 측정법을 이용하여 배양내 $P_4$와 $E_2$의 양을 측정한 결과, GnRH을 처리한 후 $E_2$의 양은 변화가 없었던 반면 $P_4$의 양은 감소하였다. 이러한 GnRH의 $P_4$ 합성 억제 효과는 세포자연사 결과 마찬가지로 FSH에 의해 회복되는 것을 확인할 수 있었다. 이상의 결과는 체외수정 및 배아이식 시술시 사용되고 있는 GnRH 작용제가 난소의 기능을 억제시킬 수 있을 것으로 보이나, 다량으로 투여되는 FSH에 의해 회복될 수 있음을 보여주고 있다. 이러한 실험 결과는 난소에 대한 GnRH의 생리적 기전을 이해하고 향후 새로운 과배란 유도 방법을 개발하는데 필요한 기초 자료로 사용될 수 있을 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제37권4호
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• pp.329-338
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• 2010

목적: 본 연구에서는 10개 이하의 2PN 접합자를 얻은 환자군에서 전핵 단계 배아의 동결보관이 누적 분만율을 증가시키는 지를 살펴보고자 하였다. 연구방법: 2003년 1월부터 2007년 12월까지 제일병원 아이소망센터를 내원하여 과배란 유도에 의해 체외수정 및 배아이식술을 시행한 주기를 후향적으로 비교 분석하였다. 본 연구에서는 일반적 체외수정법 또는 세포질내 정자주입술을 이용하여 수정을 시도한 후 20~22시간에 8개의 수정란을 확인하거나, 또는 전핵이 1개만 보이는 접합자와 발달지연 배아를 포함하여 수정란이 10개 미만인 138주기의 체외수정 및 배아이식 주기를 대상으로 분석하였다. 분석대상을 두 군으로 나누었으며 그룹 I (n=86)은 배아의 동결 없이 모든 수정란을 배양하여 3일째 이식한 군으로 하였으며, 그룹 II (n=52)는 전핵 시기에 일부 수정란을 동결하고 나머지를 배양하여 3일째 이식한 군으로 분류하였다. 두 군간 신선배아 이식주기와 그 다음 동결-해동 이식주기 후의 임상적 임신율과 누적 임신율을 각각 비교하였다. 결과: 비교 대상군 사이에 여성의 평균 나이, 획득 난자의 수 및 수정란의 수에서는 통계적 차이를 보이지 않았다. 배양된 배아의 수는 그룹 II ($5.2{\pm}0.5$)가 그룹 I $8.4{\pm}0.7$)에 비하여 유의하게 적었다 (p<0.01). 또한 이식한 배아의 수 역시 그룹 II ($3.3{\pm}0.6$)가 그룹 I ($3.6{\pm}0.6$)에 비하여 통계적으로 유의하게 적었다 (p<0.01). 신선주기 배아이식에서 ${\beta}$-hCG 양성을 보인 환자 수와 분만을 한 환자의 수는 그룹 I이 그룹 II에 비하여 약간 높은 양상을 보였다 (51.2 vs. 46.2% and 41.9 vs. 34.6%). 동결-해동 배아이식 후 누적 분만율을 비교하였을 때 그룹 I (48.8%)과 그룹 II (50.0%)에서 통계적으로 유의한 차이를 관찰할 수 없었다. 결론: 적은 수의 수정란을 얻은 환자군에서 일부 전핵 단계에서의 동결보관이 누적 분만율을 향상 시키는 효과를 확인할 수 없었다. 그러나 일부 수정란의 동결보관은 해당 신선주기에서 임신에 실패하였을 경우 환자에게 추가적인 배아이식 기회를 제공해 줄 수 있는 장점을 가지고 있는 것으로 생각된다.

• Clinical and Experimental Reproductive Medicine
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• 제44권2호
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• pp.63-72
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• 2017

Objective: Hyperstimulation methods are broadly used for in vitro fertilization (IVF) in patients with infertility; however, the side effects associated with these therapies, such as ovarian hyperstimulation syndrome (OHSS), have not been well studied. N-glycoproteomes are subproteomes used for the remote sensing of ovarian stimulation in follicular growth. Glycoproteomic variation in human follicular fluid (hFF) has not been evaluated. In this study, we aimed to identify and quantify the glycoproteomes and N-glycoproteins (N-GPs) in natural and stimulated hFF using label-free nano-liquid chromatography/electrospray ionization-quad time-of-flight mass spectrometry. Methods: For profiling of the total proteome and glycoproteome, pooled protein samples from natural and stimulated hFF samples were selectively isolated using hydrazide chemistry to obtain the total proteomes and glycoproteomes. N-GPs were validated by the consensus sequence N-X-S/T (92.2% specificity for the N-glycomotif at p<0.05). All data were compared between natural versus hyperstimulated hFF samples. Results: We detected 41 and 44 N-GPs in the natural and stimulated hFF samples, respectively. Importantly, we identified 11 N-GPs with greater than two-fold upregulation in stimulated hFF samples compared to natural hFF samples. We also validated the novel N-GPs thyroxine-binding globulin, vitamin D-binding protein, and complement proteins C3 and C9. Conclusion: We identified and classified N-GPs in hFF to improve our understanding of follicular physiology in patients requiring assisted reproduction. Our results provided important insights into the prevention of hyperstimulation side effects, such as OHSS.

• Reproductive and Developmental Biology
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• 제33권2호
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• pp.93-98
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• 2009

In this study, bovine Dnmt1 cDNA was sequenced and detected Dnmt1 mRNA level in bovine tissues by northern blot, methylation pattern of genome by southern blot, specific localization of Dnmt1 in mouse and bovine preimplantation embryos by immunocytostaining and Dnmt1 protein level in ovary and testis by western blot. Bovine Dnmt1 cDNA sequence showed more homology with that of human than mouse and rat. The RNA level of Dnmt1 was 10 times higher expression in placenta than other tissues. This indicates that placenta was hypermethylated compared to others organs. The genomic DNA could not be cut by a specific restriction enzyme (HpaII) in placenta, lung and liver of bovine. It suggests that Dnmt1 in some somatic cells was already methylated. Dnmt1, which has the antibody epitope 1316~1616, was distributed in nucleus and cytoplasm including the stage of pronuclear stage and maturation of oocyte and gradually weaken to blastocyst stage compare to negative. In addition, Dnmt1 was strongly expressed in tetraploid embryo and cloned 8-cell than IVF 8-cell. An aberrant pattern of DNA methylation in cloned embryo may be abnormal development of fetus, embryonic lethality and placenta dysfunction. The somatic specific band (190kDa) was appeared in ovary and testis, but oocyte specific band (175kDa) was not. Further investigations are necessary to understand the complex links between the methyltransferases and the transcriptional activity of genes in the cloned bovine tissues.

• Clinical and Experimental Reproductive Medicine
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• 제24권3호
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• pp.319-324
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• 1997

Despite the direct placement of sperm within the oocyte, fertilization failure still occurs after ICSI. This study was accomplished to analyze the chromosomes in oocytes failed to fertilize after ICSI comparing to oocytes failed to fertilize by conventional in vitro insemination. Seventy-four ICSI cycles and 122 conventional IVF cycles were included in analysis. Included unfertilized oocytes were from 74 patients (mean age = $32.7{\pm}3.7$). Ninety-three oocytes were informative and 83 oocytes were legible for cytogenetic analysis. Sixty-two oocytes out of 83 (74.7%) had normal chroruosomes, while 15 (18.1%) were hypoploidy, 6 (7.2%) were hyperploidy. Eighteen oocytes out of 93 (17.6%) were premature chromosome condensation (PCC). Two hundred ninety-four unfertilized oocytes after conventional insemination were subjected to chromosomal analysis and 180 oocytes were legible for analysis. One hundred thirty-two oocytes out of 180 (73.3%) were normal, while 22 (12.2%) were hypoploidy, 20 (11.1%) were hyperploidy, and 6 (3.3%) were polyploidy. Twenty-two oocytes (12.2%) were PCC. There was no difference in chromosomes between oocytes that failed to fertilize after ICSI or conventional insemination. High PCC rates in fertilization-failed oocytes suggest that oocytes maturity is another important factor in achieving successful fertilization.