• Clinical and Experimental Reproductive Medicine
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• v.18 no.1
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• pp.107-111
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• 1991

The testicular volume measured by a Prader orchidometer was compared with sperm count in semen, the levels of serum FSH, LH, testosterone, prolactin, estradiol and progesterone in 59 nonobstructive infertile men. 1. The causes of infertility were primary hypogonadisms in 50 patients (35 unknown, 9 Klinefelter syndromes, 6 varicocels) and secondary hypogonadism in 9 (5 isolated FSH deficiencies, 1 hyperprolactinerriia, 3 pituitary hypogonadisms). 2. Decreased levels of serum FSH (less than 4 mIU/ml) did not correlate with testis volume but increased level of serum FSH (more than 20 mIU/ml) were mostly noted in the testis less than 10ml. 3. Decreased level of serum testosterone (less than 3 ng/ml) were distinguishably noted in the atrophied testis less than 5 ml. 4. There was no correlation between the testicular volume and the levels of serum prolactin, estradiol, and progesterone. Coclusively, testicular volume less than 11 ml suggests poor spermatogenesis, but normal testicular volume dose not nessarily rule out poor spermatogenesis. Function of Leydig cell is relatively well preserved in atrophied testis of 5 to 10 ml comparing with that of seminiferous tubule.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.4
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• pp.315-324
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• 2005

Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.1
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• pp.63-70
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• 2009

Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13${\sim}$14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13${\sim}$14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.

• Journal of Embryo Transfer
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• v.17 no.2
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• pp.123-128
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• 2002

The present study aimed at determining the effective dose of Folltropin, a follicle timulating hormone (FSH), on superovulation in indigenous cows of Bangladesh. Fifteen regularly cycling 5～7 years old dry cows, weighing 200～250 kg with 2.5～3.0 body condition scores (BCS) were divided into three groups (n＝5). Individual groups were superovulated with 100, 200 or 300 mg of Folltropin per animal. The superovulation treatment was initiated at Day 10 or Day 11 of the estrous cycle (Day 0＝day of estrus). Alfaprostol (6 mg) was injected to each cow 72 h after the initiation of superovulation treatment to induce eestrus. After confirming standing estrus, the cows were inseminated 2～3 times, 12 h apart, depending on the duration of estrus. At Day 6 or Day 7, individual horns of the uterus were flushed with 150～200 $m\ell$ of phosphate buffered saline supplemented with BSA (0.2％), penicillin (100 IU／$m\ell$) and streptomycin (100 $\mu\textrm{g}$／$m\ell$) using a two-way foley catheter. The embryos were concentrated, removing the excess medium through an embryo filter, and identified under a stereomicroscope. The identified embryos were collected, washed four times, evaluated and graded as excellent, good, fair or poor. The excellent, good and fair embryos were considered as transferable quality embryos. The mean (range). numbers of embryos collected vs. transferable quality embryos far 100, 200 and 300 mg of Folltropin were 4.5 (1～10) vs. 3.5 (1～8); 2.5 (1～4) vs. 1 (0～2) and 0.0 (0～0) vs. 0.0 (0～0), respectively, Folltropin at a dose of 100 or 200 mg produced suitable ovarian stimulation for superovulation in indigenous zebu cows of Bangladesh. A dose of 300 mg or more Folltropin consistently caused preovulatory corpora lutea formation in the ovaries and resulted in zero embryo recovery.

• Journal of Embryo Transfer
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• v.5 no.2
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• pp.1-10
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• 1990

The individual difference of superovulatory responses and inferior embryo quality in superovulated cattle may cause disturbances in the endocrine profile, follicular steroidogenesis, nuclear maturation of nocyte, fertilization and cleavage of embryos. However, the reasons why those disturbances are occurred were not understood. The methods of the improvement of superovulatory response and embryo production were the use of anti-PMSG if PMSG used, pure FSH or controlled FSH-LH inducer, priming dose of gonadotropin in the first few day of the estrous cycle and GnRH or analogue. However, all of the above methods were not reduced the individual differences but improved embryo production We must continue the fundamental studies to understand the mechanism.

• Reproductive and Developmental Biology
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• v.31 no.3
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• pp.199-205
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• 2007

The present study was carried out to assess the effect of superovulation response and efficiency of embryo production induced with injection of FSH dissolved in polyethylene glycol (PEG) in Hanwoo. Eighty-eight cows were divided into four groups. In group 1, cattle were intramuscularly treated with twice-daily administration of 50mg FSH for 4 days. Group 2 and 3 were subcutaneously single injection of 400mg and 200mg FSH dissolved in 30% PEG, respectively. Group 4 were subcutaneously single injection of 200 mg FSH dissolved in 30% PEG at 7 day after CIDR insertion. The number of corpus luteum (CL) in group 2 resulted in significantly (p<0.05) higher compared to group 1, 3 and 4 (18.5 vs. 11.2, 13.1 and 13.9, respectively). However, the number of total ova $(7.9{\sim}10.4)$, transferable embryos $(3.7{\sim}4.7)$, degenerate embryos $(1.9{\sim}3.5)$ and unfertilized ova $(1.8{\sim}2.7)$ did not differ among treatment groups. No difference was observed in pregnancy rate after transferring the recovered embryos among groups $(36.0{\sim}50.0%)$. In addition, blood progesterone concentrations at embryo recovery did not differ among all groups. In conclusion, although no differences were observed in the number of total ova, transferable embryos and pregnancy rate after transfer, a single injection of reduced dose of FSH (200mg FSH) at 7 day after CIDR insertion is more practical for superovulation treatments than frequent injection because of reduction of stress in Hanwoo and decreases of cost and laber.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.5
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• pp.595-599
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• 2000

Fine wool sheep (n=18) maintained in a tropical environment were allocated to three treatment groups. Estrus was induced with two injections of $PGF_{2{\alpha}}$ (10 mg. im) at 10 days interval. Superovulation treatment started 2 days prior to the second injection of $PGF_{2{\alpha}}$. Each ewe was treated with a total dose of 25 units FSH (Super-OV) i.m. every 12 hover 3 days; Group 2 were also injected i.m. with 200 IU PMSG at the first injection of FSH; Group 3 was treated as in Group 2 and also with GnRH ($4{\mu}g$ Buserelin) at the onset of estrus. The ewes in estrus were mated with a fertile ram. Ovarian examination and recovery of embryo and ova were performed at laparoscopy and laparotomy on day 3 or 4 after mating. Data for onset of estrus, duration of estrus, number of corpora lutea (CL), number of unnovulated large follicle (LF), embryo recovery rate, embryo quality and fertilization recorded for the 3 groups. Ewes in the Group 1 set in estrus later (p<0.05; $50.0{\pm}7.29h$) than the ewes in Group 2 ($24.5{\pm}3.58$) and 3 ($32.5{\pm}3.58h$). The duration of estrus, ovarian size and ovarian response (number of CL and LF) did not differ significantly (p>0.05) among the 3 groups. The proportion of ewes with a superovulatory response (${\geq}2$ CL) was the lowest (50%) in Group 1 treated with FSH alone but ova/embryo recovery (100%) and fertilization (100%) was significantly (p<0.05) higher than Group 2 (58.3 and 85.7%, respectively) and Group 3 (48.6 and 50%, respectively). It is concluded that in tropical fine wool sheep, there is no difference in the 3 treatments for yield of good quality embryos but ovarian response and ovulation rate increased on additional use of PMSG and GnRH respectively to FSH alone.

• Development and Reproduction
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• v.16 no.4
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• pp.295-300
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• 2012

Manganese ($Mn^{2+}$) is a trace element that is essential for normal physiology, and is predominantly obtained from food. Several lines of evidence, however, demonstrated that overexposure to $MnCl_2$ exerts serious neurotoxicity, immunotoxicity and developmental toxicity, particularly in male. The present study aimed to evaluate the effect of 0, 1.0, 3.3, and 10 mg/kg/day doses of $MnCl_2$ on the reproductive organs in the immature female rats. Rats (PND 22; S.D. strain) were exposed to $MnCl_2$ ($MnCl_2{\cdot}4H_2O$) dissolved in drinking water for 2 weeks. The animals were sacrificed on PND 35, then the tissues were immediately removed and weighed. Histological studies were performed using the uteri tissue samples. Serum LH and FSH levels were measured with the specific ELISA kits. Body weights of the experimental group animals were not significantly different from those of control group animals. However, ovarian tissue weights in 1 mg and 3.3 mg $MnCl_2$ dose groups were significantly lower than those of control animals (p<0.05 and p<0.01, respectively). Uterine tissue weights of 3.3 mg dose $MnCl_2$ groups were significantly lower than those of control animals (p<0.01), while the 1 mg $MnCl_2$ dose and 10 mg $MnCl_2$ dose failed to induce any change in uterine weight. Similarly, only 3.3 mg $MnCl_2$ dose could induce the significant decrease in the oviduct weight compared to the control group (p<0.05). Non-reproductive tissues such as adrenal and kidney failed to respond to all doses of $MnCl_2$ exposure. The uterine histology revealed that the $MnCl_2$ exposure could affect the myometrial cell proliferation particularly in 3.3 mg dose and 10mg dose group. Serum FSH levels were significantly decreased in 1mg $MnCl_2$ dose and 10 $MnCl_2$ mg groups (p<0.05 and p<0.01, respectively). In contrast, treatment with 1 mg $MnCl_2$ dose induced a significant increment of serum LH level (p<0.05). The present study demonstrated that $MnCl_2$ exposure is capable of inducing abnormal development of reproductive tissues, at least to some extent, and altered gonadotropin secretions in immature female rats. Combined with the well-defined actions of this metal on GnRH and prolactin secretion, one can suggest the $Mn^{2+}$ might be a potential environmental mediator which is involved in the female pubertal process.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.3
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• pp.225-233
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• 2001

Objective : To evaluate the efficacy of low-dose aspirin on IVF outcome and endometrium in patients undergoing IVF-ET. Materials and Methods : From February, 2001 to Jun, 2001, 60 infertile patients were randomly divided into study group (28 cycles) and control group (32 cycles). The study group received a daily oral dose of 25 mg of aspirin for at least 2 weeks from first visiting day. Controlled ovarian hyperstimulation was initiated in all patients with the GnRH agonist starting in the midluteal phase of the previous cycle. Results: There were no significant differences in age of the patients, basal serum E2, LH, FSH level and endometrial thickness among two groups. There were no statistically significant differences between the study group and the control group respectively in dosage ($26.5{\pm}4.8$ vs $26.2{\pm}5.3$ amples) and duration ($10.4{\pm}4.2$ vs $9.8{\pm}5.3$ days) of gonadotropin administration, serum E2 level on the hCG administration day ($1823{\pm}342$ vs $1854{\pm}543$), LH ($14.5{\pm}2.7$ vs $14.8{\pm}3.1$), FSH ($16.7{\pm}3.4$ vs $18.3{\pm}4.7$), the number of follicles > 15 mm ($13.2{\pm}6.3$ vs $12.8{\pm}5.9$), the number of oocytes retrieved ($9.2{\pm}2.4$ vs $8.4{\pm}1.7$), the number of embryos transferred ($4.7{\pm}2.0$ vs $4.7{\pm}2.0$), fertilization rate (68.4% vs 64.5%), implantation rate (21.3% vs 17.6%), and clinical pregnancy rate (28.4% vs 26.2%). The endometrial thickness and the percentage of endometrial trilaminar pattern on hCG day were significantly higher in study group than control group ($12.9{\pm}3.7mm$ vs $10.4{\pm}2.8mm$, 78.3% vs 64.5%). Conclusion: Many reports suggest that low-dose aspirin improve ovarian response, implantation rate, fertilization rate, implantation rate, and pregnancy rate by increasing the blood flow, but we couldn't prove the significant effect of low-dose aspirin on the IVF outcome except on endometrium. This may be affected by dose of aspirin, duration, and number of patients studied. This trial is small, so our results highlight the need for a large randomized controlled trial to identify the effect of low-dose as pirin on IVF-ET outcome.

• International Journal of Industrial Entomology and Biomaterials
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• v.5 no.1
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• pp.109-122
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• 2002

The purpose of this investigation is to evaluate the effects of the Nuegra on enhancement of the masculine and physical activities in general through measuring changes of the testosterone, FSH and subjective symptoms like fatigue, insomnia, urinary stream, muscular weakness, libido and erectile dysfunction. Total 168 male subjects were enrolled from 12 urology, internal medicine clinics and general practitioner, During the 6-week investigational period, 2 capsules of Nuegra were given to the subjects right after meal for 4 weeks, and 1 capsule of Nuegra was added each time in subjects with no or minimal effect. Testoster-one and FSH levels were measured at first visit and last visit, for evaluating masculine activities. To avoid bias and standardize the test results, only one clinic was assigned as a central lab, and all blood samples were transferred. General information and subjective symptoms were evaluated at first visit and at 2 weeks interval, week 2, 4 and 6 using VAS (Visual Analogue Scale). The mean age of the subjects were 51.8${\pm}$8.2 years old (range: 36.1-82.1). Based on the subjects who were tested on testosterone and FSH levels at day l and week 6, the means were 4.4${\pm}$1.4 nmol/L (range: 2.6-7.7), 8.6${\pm}$9.6 mIU/mL (range: 0.3-40.4), respectively at day 1. At week 6, the results were 4.9 ${\pm}$1.6 (2.6-8.9 range), 9.4${\pm}$13.1 (1.0-53.9 range), respectively. Marginally significant difference between pre-dose and post-dose was present. Statistically significant differences were revealed in general assessment for subjective symptoms, fatigue, insomnia, erectile dysfunction, etc. In fatigue, response rates were 39.6, 65.4 and 76.4% at week 2, 4 and 6, respectively (P < 0.0001). Response vates for erectile dysfunction were 13.4, 41.2 and 72.7% at week 2, 4, and 6 (P < 0.0001), respectively, Response rates for libido were 13.6, 51.6 and 73.5% at week 2, 4, and 6 (P < 0.0001), respectively. For urinary stream response rates were 26.9, 44.7 and 66.8% at week 2, 4, and 6 (P < 0.0001), respectively. VAS for muscular weakness did not show significant results that response rates were 40, 60 and 80% at week 2, 4, and 6 from 8.2 (P ＝ 0.24), respectively. Response rates for insomnia were 50, 60, 100% at week 2, 4, and 6 (P < 0.0001), respectively. The results shows that Nuegra tends to enhance masculine activities including libido, erectile dysfunction and urinary stream and also effective for improving general conditions especially insomnia, muscular weakness and fatigue. In conclusion, this investigation has demonstrated that Nuegra does not only have tendency to increase masculine activities through increased secretion of the testosterone and FSH but also improve general conditions such as erectile dysfunction, libido, fatigue and muscular power.