• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.261-268
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• 2005

Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.

• 한국발생생물학회지:발생과생식
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• 제28권1호
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• pp.1-12
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• 2024

Gonadotropin-releasing hormone (GnRH), a critical hormone produced in the hypothalamus, is essential for regulating reproductive processes. It has also been demonstrated the presence of GnRH and its receptors (GnRHR) in ovarian and uterine tissues, but little was known about the regulation mechanism of their expression in these organs and ovarian aging. Therefore, the aim of this study was to investigate the expression of GnRHR in the ovary and uterus of mice, particularly after high-dose gonadotropin treatments and in relation to aging. Quantitative real-time-PCR (qRT-PCR) revealed that pituitary gland had the highest GnRHR expression in both young and aged mice. In addition, liver expression was higher in young mice, whereas thymus expression was higher in aged mice. GnRHR mRNA was present in the ovaries of both young and aged mice but nearly undetectable in the uterus of aged mice. We next examined the expression of GnRHR in the ovary and uterus in response to high-dose administration of pregnant mare serum gonadotropin (PMSG). After PMSG administration, GnRH mRNA levels were significantly decreased in the ovary but increased in the uterus. The expression of GnRH mRNA in these organs showed opposite trends to that of GnRHR expression. These results suggest the involvement of GnRH in age-related reproductive decline and the potential effects of high-dose gonadotropin treatments on reproductive organ function.

• 한국수정란이식학회지
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• 제13권3호
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• pp.261-275
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• 1998

본 연구에서는 GnRH가 과배란 처치된 래트의 초기 난포기와 후기 난포기에서 난소기능에 어떠한 영향을 미치는지를 이해하기 위해서, 30IU PMSG와 10IU hCG로 전처치된 미성숙 래트에 있어서 배란반응, 배란 난자의 형태학적 이상 유무 및 핵 성숙도, 난소 중량, 난소의 조직학적인 변화 및 혈중 스테로이드 호르몬 (17$\beta$-estradiol, progesterone 및 testosterone) 농도에 대하여 GnRH agonist의 효과를 검사하였다. GnRH agonist는 PMSG 전처치 후 초기 난포기 (PMSG 투여 후 6시간부터) 또는 후기 난포기(PMSG 투여 후 54시간부터)에 4시간 동안 20분 간격으로 경정맥 카테타를 통해 혈관내로 투여하였다. 각 실험동물은 혈중 스테로이드 호르몬의 변화를 측정하기 위하여 PMSG 투여 후 54시간, 72시간에 혈액을 채취하고 72시간에 희생시켰다. PMSG로 전처치한 미성숙 래트의 초기 난포기에 GnRH agonist의 투여는 GnRH agonist를 투여하지 않은 군(대조군)에 비해 과배란 억제, 형태학적 비정상 배란난자의 증가, 난소 중량의 감소, 난포폐쇄의 증가 및 혈중 스테로이드 호르몬의 농도 감소가 보였다. 한편 후기 난포기에 GnRH agonist의 투여는 대조군에서의 반응과 전반적으로 유사하였다. 이상의 결과, PMSG 및 hCG 처치로 과배란된 래트의 초기 난포기에 GnRH agonist의 투여는 난소기능을 전반적으로 억제하지만, 후기 난포기에 GnRH agonist의 투여는 난소기능에 영향을 미치지 않았다.

• Clinical and Experimental Reproductive Medicine
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• 제41권4호
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• pp.158-164
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• 2014

Objective: To assess whether an early GnRH antagonist start leads to better follicular synchronization and an improved clinical pregnancy rate (CPR). Methods: A retrospective cohort study. A total of 218 infertile women who underwent IVF between January 2011 and February 2013. The initial cohort (Cohort I) that underwent IVF between January 2011 and March 2012 included a total of 68 attempted IVF cycles. Thirty-four cycles were treated with the conventional GnRH antagonist protocol, and 34 cycles with an early GnRH antagonist start protocol. The second cohort (Cohort II) that underwent IVF between June 2012 and February 2013 included a total of 150 embryo-transfer (ET) cycles. Forty-three cycles were treated with the conventional GnRH antagonist protocol, 34 cycles with the modified early GnRH antagonist start protocol using highly purified human menopause gonadotropin and an addition of GnRH agonist to the luteal phase support, and 73 cycles with the GnRH agonist long protocol. Results: The analysis of Cohort I showed that the number of mature oocytes retrieved was significantly higher in the early GnRH antagonist start cycles than in the conventional antagonist cycles (11.9 vs. 8.2, p=0.04). The analysis of Cohort II revealed higher but non-significant CPR/ET in the modified early GnRH antagonist start cycles (41.2%) than in the conventional antagonist cycles (30.2%), which was comparable to that of the GnRH agonist long protocol cycles (39.7%). Conclusion: The modified early antagonist start protocol may improve the mature oocyte yield, possibly via enhanced follicular synchronization, while resulting in superior CPR as compared to the conventional antagonist protocol, which needs to be studied further in prospective randomized controlled trials.

• 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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• 제39권4호
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• pp.166-171
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• 2012

Objective: We compared the assisted reproductive technology (ART) outcomes among infertile women with polycystic ovary syndrome (PCOS) treated with IVM, conventional IVF, GnRH agonist, and GnRH antagonist cycles. Methods: The prospective study included a total of 67 cycles in 61 infertile women with PCOS. The women with PCOS were randomized into three IVF protocols: IVM/IVF with FSH and hCG priming with immature oocyte retrieval 38 hours later (group A, 14 cycles), GnRH agonist long protocol (group B, 14 cycles), and GnRH antagonist multi-dose flexible protocol (group C, 39 cycles). IVF outcomes, such as clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), were compared among the three groups. Results: Age, BMI, and basal FSH and LH levels did not differ among the three groups. The number of retrieved oocytes and 2 pronucleus embryos was significantly lower in group A compared with groups B and C. The CPR, IR, MR, and LBR per embryo transfer showed no differences among the three groups. There was no incidence of ovarian hyperstimulation syndrome in group A. Conclusion: The IR, MR, and LBR in the IVM cycles were comparable to those of the GnRH agonist and GnRH antagonist cycles. The IVM protocol, FSH and hCG priming with oocyte retrieval 38 hours later, is an effective ART option that is comparable with conventional IVF for infertile women with PCOS.

• 한국양식학회지
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• 제9권3호
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• pp.205-213
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• 1996

한국산 메기의 경제적이고 효율적인 산란유도를 위한 연구로써 GnRH-a의 이용가능성에 대하여 검토하여 다음과 같은 결과를 얻었다. GnRH-a 처리된 메기의 산란유도율은 어체중 kg당 70 ${\mu}g$에서 $67\%$, 90 ${\mu}g$에서 $86\%,\;120{\mu}g$이상에서는 $100\%$로 나타났다. 호르몬 주사후 산란이 유도되기까지 대체로 $22\~25$시간이 소요되었다. 생식소중량지수(GSI)는 $100\%$의 산란유도율을 보인 120 ${\mu}g/kg$처리된 그룹에서 $23\~30\%$를 pseudo-GSI는 $18\~21\%$로 비교적 높고 고른 분포를 나타냈으며, 산란된 난의 수는 어체중 kg당 $58,000\~65,000$개 였다. 또한 수정률 및 부화율은 각각 $94\%$와 $81\%$로 나타났다. GnRH-a 처리에 따른 뇌하수체의 미세구조적 변화를 관찰한 바, 호르몬 주사전 성숙한 암컷 메기의 생식소자극호르몬 분비세포(gonadotrops)는 전자밀도가 높은 $150\~300$ nm 크기의 수 많은 소과립과 $800\~1000\;nm$의 전자밀도가 다소 낮은 소수의 대과립의 존재가 관찰되었다. 한편 호르몬주사후의 gonadotrops에서는 대소 과립들의 현저한 소실과 rER의 현저한 증가가 관찰되었는데, 이는 GnRH-a에 의해 생식소자극호르몬의 대량방출을 시사하는 것이다. 이상의 결과로부터 GnRH-a의 사용은 기존의 HCG 및 잉어뇌하수체 분말보다 적어도 $2\~3$ 배이상의 비용절감을 가져와 메기의 인공 종묘 생산에 매우 효과적이고 경제성이 있는 것으로 나타났다.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.845-851
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• 2010

Purpose: Recombinant human growth hormone (rhGH) has been widely used to treat short stature. However, there are some concerns that growth hormone treatment may induce skeletal maturation and early onset of puberty. In this study, we investigated whether rhGH can directly affect the neuronal activities of of gonadotropin-releasing hormone (GnRH). Methods: We performed brain slice gramicidin-perforated current clamp recording to examine the direct membrane effects of rhGH on GnRH neurons, and a whole-cell voltage-clamp recording to examine the effects of rhGH on spontaneous postsynaptic events and holding currents in immature (postnatal days 13-21) and adult (postnatal days 42-73) mice. Results: In immature mice, all 5 GnRH neurons recorded in gramicidin-perforated current clamp mode showed no membrane potential changes on application of rhGH (0.4, $1{\mu}g/mL$). In adult GnRH neurons, 7 (78%) of 9 neurons tested showed no response to rhGH ($0.2-1{\mu}g/mL$) and 2 neurons showed slight depolarization. In 9 (90%) of 10 immature neurons tested, rhGH did not induce any membrane holding current changes or spontaneous postsynaptic currents (sPSCs). There was no change in sPSCs and holding current in 4 of 5 adult GnRH neurons. Conclusion: These findings demonstrate that rhGH does not directly affect the GnRH neuronal activities in our experimental model.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.389-398
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• 1999

Objective: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days starting on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG $5,000{\sim}10,000$ IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol ($E_2$) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. Conclusion: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.

• Asian-Australasian Journal of Animal Sciences
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• 제9권6호
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• pp.711-714
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• 1996

The present study investigated the hypophysial responsiveness in terms of GnRH induced LH and FSH release in cycling buffalo during the tropical summer and winter climatic conditions (seasons). Peripheral plasma LH and FSH levels were measured at 1 hour before and 6 hours subsequent to the administration of GnRH (1 ug/kg body weight) or saline on Day 14 of oestrous cycle in 2 groups of buffalo (n = 6 each) during summer and winter seasons. Although GnRH induced LH peak concentrations did not differ during the two seasons, time to attain LH peak concentration was shorter (p < 0.05) and the area under LH peak was 39% higher (p < 0.05) during winter season in comparison to summer season. However, season had no effect on GnRH induced peak FSH concentration, time to attain peak FSH concentration and the area under FSH peak. Pretreatment basal LH and FSH levels did not differ during the two seasons. The present study suggests that the summer season adversely affects the GnRH stimulated release of LH in buffalo.