• Clinical and Experimental Reproductive Medicine
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• v.14 no.1
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• pp.7-17
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• 1987

It appears that a major determinant of the success of in vitro fertilization is the selection of the optimal follicle containing an oocyte capable of being fertilized and producing a normal pregnancy. However, the hormonal basis of oocyte maturation is not well substantiated by the as yet available informations. It has been suggested that prolactin(PRL) may stimulate the formation of an oocyte maturation inhibitor and thus inhibit the maturation of oocyte. During the hyperstimulated menstrual cycles serum estradiol($E_2$) levels are markedly elevated, and it seems justified to assume that serum prolactin levels may be elevated since estrogens are potent stimulators of prolactin secretion. This study was carried out to ascertain the effect of the elevated serum estradiol levels on the serum prolactin levels in women undergoing ovarian hyperstimulation with either hMG and/or clomiphene citrate. Serum estradiol and prolactin profiles were measured from third menatrual cycle day to ovulation or ovum aspiration day in 11 normal menstruating women and 30 women who underwent an in vitro fertilization procedure with ovarian hyperstimulation by hMG, clomiphene citrate/hMG, clomiphene citrate. Ovum aspiration was performed 36 hours after hCG administration. The day of ovum aspiration or ovulation was designated Day 0. Serum estradiol levels increased progressively during the follicular phase and this rise peaked on Day-1 at a mean concentration of 1,204${\pm}$189.0pg/ml in Group II(hMG), 1,194${\pm}$167.9pg/ml in Group III(clomiphene citrate/hMG), 1,035${\pm}$195.1pg/ml in Group IV(clomiphene citrate) respectively and on Day -2 of 336${\pm}$34.5pg/ml in Group I(normal control). The elevated estradiol levels fen rapidly after ovulation or ovum aspiration. Serum estradiol values of hyperstimulated groups(Group II, III, IV) were significantly higher than that of control group(Group I) from Day -6 to Day +1, but there was no significant difference of estradiol values among the hyperstimulated groups. Serum prolactin levels increased and peaked on Day +1 at a mean concentration of 60.8${\pm}$14.4ng/ml in Group II, 34.2${\pm}$7.0ng/ml in Group III, 30.1${\pm}$5.7ng/ml in Group IV respectively, but no significant elevation was observed in Group I. Levels of estradiol and prolactin can be positively and significantly correlated in the hyperstimulated groups. However, the increase of serum prolactin levels in hMG group was significantly higher than those in clomiphene citrate/hMG or clomiphene citrate group.

• Clinical and Experimental Reproductive Medicine
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• v.18 no.2
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• pp.201-208
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• 1991

Recently the application of gonadotropin-releasing hormone (GnRH) agonist to superovulation in previous poor responders has resulted in the improved outcomes after in vitro fertilization (IVF) outcome. However, poor responders with poor estradiol $(E_2)$ rise or single dominant follicle are a particularly challenging group. Recent reports have also shown that patients with higher basal serum follicle stimulating hormone (FSH) level, result in poorer ovarian response and lower pregnancy rate. Analysis of the differences of superovulation outcomes according to the different protocols of GnRH agonist, long (L, n = 18) and short (S, n = 16) protocols, in patients with high basal FSH levels (>20mIU/ml) were undertaken at Seoul National University Hospital from June to October 1990. The administration of GnRH agonist was begun on day 21 of the cycle in long protocol, and on day 2 in short protocol. Ages of patients and husbands, basal FSH and luteinizing hormone (LH) levels and FSH/LH ratio did not differ significantly. Types and causes of infertility were evenly distributed. Whereas the duration of stimulation and the amounts of gonadotropins administered were significantly reduced in short protocol, the numbers of oocytes retrieved and cleaved, the cleavage rate and the number of embryos transferred were higher in long protocol without statistical signifieance. The pregnancy rate per ET was 16.7% (2/12) in short protocol, and 17.6% (3/17) in long protocol. These data suggest that both protocols result in the similar superovulation outcomes in patients with higher basal serum FSH levels.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.4
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• pp.163-168
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• 2015

Objective: To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods: In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results: Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (${\geq}2$) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion: Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids.

• Korean Journal of Veterinary Research
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• v.35 no.1
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• pp.169-177
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• 1995

This study was carried out to investigate the effect, range of practice, and propriety for diagnosis of early non-pregnancies and reproductive disorders by dairy cows' milk progesterone analysis used EIA-kit of home products. The results were summarized as follows : 1. During 2 to 6 months after artificial insemination, the results of milk progesterone measurement by Home-kit and Auto ELISA reader-kit with pregnant dairy cows(152 heads) certified by rectal palpation were revealed, in Home-kit, 145 heads(95.4%) of positive reaction, 7 heads(4.6%) of quasi-positive, and 0 heads(0%) of negative among 152 heads and, in Auto ELISA reader-kit, 152 heads(100%) of positive reaction among 152 heads. 2. During 19 to 22 days after artificial insemination, the results of milk progesterone measurement by Home-kit, and thereafrer during 50 to 90 days after that, the results of pregnant test by rectal palpation were summarized as follows : 147 heads(82.1%) among 179 heads of positive reaction by Home-kit and 5 heads(31.3%) among 16 heads of quasi-positive were revealed pregnant cows by rectal palpation, and 42 heads(100%) among 42 heads of negative were non-pregnant. 3. During 19 to 22 days after artificial insemination, the results of milk progesterone measurement by Auto ELISA reader-kit, and thereafrer during 50 to 90 days after that, the results of pregnant test by rectal palpation were summarized as follows : 146 heads(86.9%) among 168 heads of positive reaction by Auto ELISA reader-kit and 6 heads(28.6%) among 21 heads of quasi-positive were revealed pregnant cows by rectal palpation, and 48 heads (100%) among 48 heads of negative were non-pregnant. 4. For the accuracy of the rectal palpation, Home-kit and Auto ELISA reader-kit were used in the cows of ovarian diseases. The results were following : in the cows of reproductive disorders expected negative milk progesterone, the accuracies of rectal palpation were the same 75.5%(40 heads among 53 heads) by Home-kit and Auto ELISA reader-kit, and in the cows of reproductive disorders expected positive milk progesterone, the accuracies of rectal palpation were 82.6%(19 heads among 23 heads) and 91.3%(21 heads among 23 heads) by Home-kit and Auto ELISA reader-kit, respectively, and the general accuracies of rectal palpation were 77.6%(59 heads among 76 heads) and 80.3%(61 heads among 76 heads) by Home-kit and Auto ELISA reader-kit, respectively.

• Clinical and Experimental Reproductive Medicine
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• v.40 no.3
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• pp.131-134
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• 2013

Objective: To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI. Methods: One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared. Results: Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010). Conclusion: The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.3
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• pp.419-432
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• 1999

Objective: To establish the evaluation system of the quality of oocytes on the basis of the incidence of cumulus cells apoptosis, to investigate the relationships beween the incidence of cumulus cells and the outcomes of IVF-ET. Method: Thirth-four cycles undergoing controlled ovarian hyperstimulation for IVF-ET with tubal infertility (23 cycles) or unexplained infertility (11 cycles) were included in this study. Cumulus cell masses surrounding mature oocyte and co-culture of embryos with autologous cumulus cells during IVF-ET process. The incidence of apoptosis in cumulus cells was assessed by apoptosis detection kit fluorescein. The effect of co-culture using cumulus cells and the incidence of cumulus cells apoptosis. Results: The results were as follows: 1. The incidence of apoptosis in cumulus cells markedly increased in patients aged 40 or over, while the fertilization rate was greatly decreased in those age group. 2. Apoptosis in cumulus cells was found in both the fertilized oocytes and unfertilized oocytes, but the incidence of apoptosis was higher in unfertilized oocytes. 3. There is no clear correlation between apoptosis in cumulus cells and the number of oocytes retrieved. However, the incidence of apoptosis was increased when the number of oocytes retrieved was 5 and fewer in comparison with $6{\sim}10$. 4. Embryo grade was significantly affected by the incidence of apoptosis in cumulus cells. 5. Pregnancy rate of IVF-ET per cycle was 29.4%, and the pregnant group had the higher fertilization rate and a significantly lower incidence of apoptosis in cumulus cells compared with the nonpregnant group. 6. When cumulus cells were used as helper cells in the co-culture of the embryo, in vitro activity of cumulus cells based on morphological change and proliferation did not influence the quality of embryo, but was closely associated with the implantation rate and pregnancy rate, which was enhanced when morphological changes and proliferation of cumulus cells was more active. 7. This difference in the outcome of IVF-ET according to in vitro activity of cumulus cells used for co-cultue was not associated with the incidence of apoptosis in cumulus cells; but rather had likely relations with the different secretion pattern of protein, which may be an embryo trophic factor by cumulus cells. Conclusion: These results suggest that the incidence of apoptosis in cumulus cells can be used in predicting oocyte qualities and the outcomes of IVF-ET. And the effect of co-culture largely depends on the in vitro activity of cumulus cells as well.

• Asian-Australasian Journal of Animal Sciences
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• v.16 no.7
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• pp.1071-1086
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• 2003

Reproductive biotechnologies continue to be developed for genetic improvement of both river and swamp buffalo. Although artificial insemination using frozen semen emerged some decades back, there are still considerable limitations. The major problem appears to be the lack of efficient methods for estrus detection and timely insemination. Controlled breeding experiments in the buffalo had been limited and similar to those applied in cattle. Studies on multiple ovulation and embryo transfer are essentially a replica of those in cattle, however with inherent problems such as lower number of primordial follicles on the buffalo ovary, poor fertility and seasonality of reproduction, lower population of antral follicles at all stages of the estrous cycle, poor endocrine status and a high incidence of deep atresia in ovarian follicles, the response in terms of transferable embryo recovery has remained low with 0.51 to 3.0 per donor and pregnancy rates between 15 to 30%. In vitro production of buffalo embryos is a valid alternative to recovery of embryos by superovulation. This aspect received considerable attention during the past decade, however the proportion of embryos that develops to the blastocyst stage is still around 25-30% and hence the in vitro culture procedures need substantial improvement. Embryo cryopreservation procedures for direct transfer post thaw need to be developed for bubaline embryos. Nuclear transfer and embryo cloning is a technique that has received attention in various species during recent years and can be of immense value in buffaloes as they have a low rate of embryo recoveries by both in vitro and in vivo procedures. Gender pre-selection, genome analysis, gene mapping and gene transfer are a few of the techniques that have been studied to a limited extent during recent years and are likely to be included in future studies on buffaloes. Very recently, reproductive biotechnologies have been applied to feral buffaloes as well, but the results obtained so far are modest. When fully exploited they can play an important role in the preservation of endangered species.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.4
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• pp.181-186
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• 2017

With advances in the methods of cancer treatment used in modern medicine, the number of breast cancer survivors has been consistently rising. As the number of women who wish to become pregnant after being diagnosed with breast cancer increases, it is necessary to consider fertility preservation in these patients. However, medical doctors may be unaware of the importance of fertility preservation among cancer patients because most patients do not share their concerns about fertility with their doctors. Considering the time spent choosing and undergoing treatment, an early referral to a reproductive specialist is the best way to prevent a delay in cancer treatment. Since it is not easy to make decisions on matters related to cancer diagnosis and fertility, patients should be provided with enough time for decision-making, and to allow for this, an early referral will provide patients with sufficient time to choose an appropriate method of fertility preservation. The currently available options of fertility preservation for patients with breast cancer include cryopreservation of embryos, oocytes, and ovarian tissue and gonadotropin-releasing hormone agonist treatment before and during chemotherapy. An appropriate method of fertility preservation must be selected through consultations between individual patients and health professionals and analyses of the pros and cons of different options.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.4
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• pp.178-188
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• 2019

Objective: To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis. Methods: A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (-)GH group) and 809 patients with good prognosis (as control, (-)Adj (Good) group). Results: The poor-prognosis women were significantly older, with a lower ovarian reserve than the (-)Adj (Good) group, and demonstrated lower chances of CP (p< 0.005) and LB (p< 0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (-)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p< 0.028). This was further confirmed in age-matched analyses. Conclusion: The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.

• Korean Journal of Veterinary Research
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• v.15 no.2
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• pp.181-185
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• 1975

The experiment was carried out to determine the concentrations of total calcium and inorganic phosphorus of thirty rera obtained from pregnant Holitein cows, six sera from normal non-pregnant cows with one month after delivery, six sera from cows with ovarian cyst and six sera from heifer of sixteen months old. The changes of total calcium and inorganic phosphorus were observed on the 2nd, 4th, 6th, 8th, and l0th month of gestation. The results obtained in this work were summarized as follows: 1. The mean values of total serum calcium obtained from the pregnant group were $9.59{\pm}0.34mg/100ml$, from the non-pregnant group $10.23{\pm}0.47mg/100ml$, from the infertility grou $10.37{\pm}0.27mg/100ml$, and from the heifer group $10.07{\pm}0.20mg/ml$. The change of total serum calcium values in the pregnant group revealed the tendency of decrease as gestation progresses and the lowest value appeared on the sixth month. The mean value of total serum calcium in the pregnant group was lower than those of the other groups, but the differences were not statistically significant. 2. The mean values of serum inorganic phosphorus obtained from the pregnant group were $5.82{\pm}0.31mg/100ml$, from the non-pregnant group $5.92{\pm}0.44mg/100ml$, from the infertility group $5.80{\pm}0.49mg/100ml$, and from the heifer group $5.10{\pm}0.32mg/100ml$. The change during pregnancy showed a slight fall and the lowest value appeared on the sixth month. The differences of serum inorganic phosphorus values between the pregnant group and the other adult groups were not significant, but these adult groups showed a significantly higher value than that of heifer group (p<0.05).