• Title/Summary/Keyword: sGnRH

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Early gonadotropin-releasing hormone antagonist protocol in women with polycystic ovary syndrome: A preliminary randomized trial

  • Shin, Jae Jun;Park, Kyung Eui;Choi, Young Min;Kim, Hye-Ok;Choi, Dong-Hee;Lee, Woo Sik;Cho, Jung-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.45 no.3
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    • pp.135-142
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    • 2018
  • Objective: To prospectively evaluate the efficacy and safety of a fixed early gonadotropin-releasing hormone (GnRH) antagonist protocol compared to a conventional midfollicular GnRH antagonist protocol and a long GnRH agonist protocol for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). Methods: Randomized patients in all three groups (early antagonist, n = 14; conventional antagonist, n = 11; long agonist, n = 11) received 21 days of oral contraceptive pill treatment prior to stimulation. The GnRH antagonist was initiated on the 1st day of stimulation in the early antagonist group and on the 6th day in the conventional antagonist group. The GnRH agonist was initiated on the 18th day of the preceding cycle. The primary endpoint was the number of oocytes retrieved, and the secondary endpoints included the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and the clinical pregnancy rate. Results: The median total number of oocytes was similar among the three groups (early, 16; conventional, 12; agonist, 19; p= 0.111). The early GnRH antagonist protocol showed statistically non-significant associations with a higher clinical pregnancy rate (early, 50.0%; conventional, 11.1%; agonist, 22.2%; p= 0.180) and lower incidence of moderate-to-severe OHSS (early, 7.7%; conventional, 18.2%; agonist, 27.3%; p= 0.463), especially among subjects at high risk for OHSS (early, 12.5%; conventional, 40.0%; agonist, 50.0%; p= 0.324). Conclusion: In PCOS patients undergoing IVF, early administration of a GnRH antagonist may possibly lead to benefits due to a reduced incidence of moderate-to-severe OHSS in high-risk subjects with a better clinical pregnancy rate per embryo transfer. Further studies with more subjects are required.

Short Coasting of One or Two Days by Withholding Both Gonadotropins and GnRH Agonist Prevents Ovarian Hyperstimulation Syndrome without Compromising the Outcome (성선자극호르몬 및 GnRH agonist을 동시에 중단하는 1$\sim$2일 단기 코스팅이 임신율을 포함한 난소과자극증후군 예방에 미치는 효과)

  • Lee, Soo-Kyung;Joo, Bo-Sun;Park, Sea-Hee;Lee, Su-Kyung;Kim, Kyung-Seo;Moon, Sung-Eun;Moon, Hwa-Sook
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.1
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    • pp.49-56
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    • 2007
  • Objective: To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome(OHSS) without compromising pregnancy outcome. Method: Thirty-seven women who had been coasted during COH for IVF were coasted when $\geq$20 follicles > 15 mm with serum E$_2$ level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E$_2$ level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E$_2$ levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed. Results: The mean serum E$_2$ level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E$_2$ level was 43% in one day coasting group and 15% (1$^{st}$ day) and 81% (2$^{nd}$ day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3(8.1%) patients. Conclusions: Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.

Prediction and Prevention of Ovarian Hyperstimulation Syndrome (난소과자극증후군의 예측과 예방)

  • Kim, Hye-Ok;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.293-305
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    • 2010
  • Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovulation induction. Before ovarian stimulation, identification of patients vulnerable to developing OHSS is necessary. And ovarian stimulation should be started with low doses of gonadotropin or GnRH antagonist protocol. During monitoring of ovarian stimulation with risk of OHSS, coasting, low doses hCG and GnRH agonist for triggering ovulation are considered. If severe OHSS is predicted, cycle cancellation and cryopreservation of all embryos should be considered to reduce late-onset OHSS and morbidity. And metformin and dopamine agonist for reducing OHSS are being proposed as a prophylactic treatment for OHSS.

Effects of exogenous hormones treatment on spermiation and plasma levels of gonadal steroids in Roughscale sole, Clidoderma asperrimum

  • Woo, Sol Min;Lee, Hyo Bin;Seo, Young Seok;Lim, Han Kyu
    • Fisheries and Aquatic Sciences
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    • v.24 no.12
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    • pp.437-445
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    • 2021
  • Roughscale sole (Clidoderma asperrimum) is only wild caught because basic reproductive research on this species is lacking and gamete production in an artificial setting has not been successful. Exogenous hormone treatment has been used to induce gonadal maturation and final spermiation in wild-caught individuals. In this study, the effects of an exogenous hormone on spermiation in roughscale sole was investigated by implanting different concentrations of a salmon gonadotrophin-releasing hormone analog (sGnRH; 0, 25, 50, and 100 ㎍/kg body weight) into male fishes. The control group did not produce sperm after 21 days post-implantation, and the duration of spermiation was shorter compared to the other groups. The spermiation period and milt amount differed among the hormone-treated groups according to the hormone concentration used. Milt volumes in the groups treated with 25 and 100 ㎍/kg sGnRH increased compared to the control group, whereas exogenous hormone treatment had no effect on the movable sperm ratio. The spermatocrit was high at the beginning of spermiation in all groups and then tended to decrease gradually over time except in the experimental group treated with 100 ㎍/kg sGnRH. Plasma levels of testosterone, 11-ketotestosterone, 17α, 20β-dihydroxy-4-pregnen-3-one were not significantly affected by the sGnRH treatments. Our results demonstrate that it is possible to prolong the spermiation period and increase milt volume by treating male roughscale soles with an exogenous hormone. In addition, the artificial hormone treatment did not affect sperm motility.

Direct Action of Genistein on the Hypothalamic Neuronal Circuits in Prepubertal Female Rats : Estrogen Receptor Beta($ER{\beta}$) Pathway? (미성숙한 암컷 흰쥐 시상하부의 신경회로에 미치는 Genistein의 직접 작용 : 에스트로겐 수용체 베타아형 경로?)

  • Heo, Hyun-Jin;Lee, Sung-Ho
    • Development and Reproduction
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    • v.15 no.2
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    • pp.179-185
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    • 2011
  • Some phytoestrogens in soy and red wine, for example, might have beneficiary rather than adverse effects. In particular, dietary soy intake seems to be highly correlated with protection of breast cancer, osteoporosis and cardiovascular disorders. However, questions persist on the potential adverse effects of the main soy constituent genistein (GS) on female reproductive physiology. Previously we found that prepubertal exposure to GS could activate the reproductive system of immature female rats leading to precocious puberty onset, and intracerebroventricularly (ICV) injected GS could directly activate hypothalamic kisspeptin-GnRH neuronal circuits in adult female rats. The present study was performed to examine the hypothalamus-specific GS effects in prepubertal female rats and which subtype of estrogen receptor is mediated in this GS effect. Prepubertal female rats (PND 30) were anaesthetized, treated with single dose of GS (3.4 ${\mu}g$/animal), and sacrificed at 2 hrs post-injection. To determine the transcriptional changes of reproductive hormone-related genes in hypothalamus, total RNAs were extracted and applied to the semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). ICV infusion of GS significantly lowered the transcriptional activities of mTOR (1:$0.361{\pm}0.058$ AU, p<0.001) but increased that of GAD67 (1:$1.285{\pm}0.099$ AU, p<0.05), which are known to act as an upstream modulator of kisspeptin and GnRH neuronal activities in the hypothalamus, respectively. GS administration enhanced significantly the mRNA levels of KiSS-1(1:$1.458{\pm}0.078$ AU, p<0.001), and exerted no effect on the mRNA level of kisspeptin receptor GPR-54 (1:$1.29{\pm}0.08$ AU). GnRH gene expression was significantly decreased in GS-treated group compared to control group (1:$0.379{\pm}0.196$ AU, p<0.05). There was no difference in the mRNA level of $ER{\alpha}$ in the GS-treated group compare to control group (1:$1.180{\pm}0.390$ AU, Fig. 3A). However, icv infusion of GS significantly increased the transcriptional activities of $ER{\beta}$ (1:$4.209{\pm}0.796$ AU, p<0.01, Fig. 3B). Taken together, the present study indicated that the acute exposure to GS could directly alter the hypothalamic GnRH modulating system in prepubertal female rats. Our study strongly suggested the involvement of $ER{\beta}$ pathway in GS's hypothalamus-specific action, and this idea is consistent with the GS's well-known $ER{\beta}$-mediated protective action in breast cancer.

Reproductive Physiology of Pineal Hormone Melatonin (송과선 호르몬 멜타토닌의 생식 생리학)

  • 최돈찬
    • The Korean Journal of Zoology
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    • v.39 no.4
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    • pp.337-351
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    • 1996
  • Melatonin Is a multifunctional hormone secreted from the pineal gland in the middle of cerebrum and cerebellum. Its synthesis and release reflect photopedod;Photopedod is a yearly predictable ambient factor that most animals utilize as an environmental cue for maximum survival. Hamsters maintaln reproductive activity in summer during which day length exceeds night time. Upon the advent of autumnal equinox they undergo gonadal regression. The photoperiodic effects are prevented by removal of the pineal gland and restored by the timed repiacument of melatonin. The results suggest that melatonin constitutes part of control mechanism whereby environmental information is transduced to neuroendocrine signal responsIble for the functional integrity of the reproductive system. From the studies for the action site of melatonin following the treatment of photopedod or melatonin in the lesion of a spedflc portion of hypothalamus, suprachiasmatic nuclei and pars tuberalis are shown to be a consensus site for melatonIn. The action of melatonin. In the regulation of reproduction is largely unknown. It is mainly due to the lack of acute effect of melatonin on gonadotropin secretion. However, reduction of the gonadotropln release and augmentation of the hypothalamic gonadotropin-releasing hormone (GnRH) content by long-term treatment of melatonln Indicate that constant presence of melatonln may partidpate in the regulation of sexual activity via the GnRH neuronal system. The action mechanism by which melatonin exerts Its effect on GnRH neuron needs to be eluddated. The inability of opiold analogues to affect the reproductive hormones in sexually regressed animals by inhibftory photopedod and melatonin suggests that the opioldergic neuron may be a prime intervening mediator. Recent cloning of melatonin receptor will contribute to investigate its anatomical Identification and the action mechanism of melatonin on target tissues at the molecular level.

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The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

  • Ju, Jung Ki;Lee, Hae Lyoung;Lee, Young Ah;Chung, Sang-Keun;Kwak, Min Jung
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.90-94
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    • 2013
  • Background: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. Methods: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. Results: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. Conclusion: The study results showed that serum basal LH levels are useful for screening CPP in girls.

Temporal Changes in the Local Expression of Central Hormone-Regulating Factors in Rat Testis

  • Si-On You;Han-Seo Yoon;Hye-Soo Kim;Jin-Soo Park;Sung-Ho Lee
    • Development and Reproduction
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    • v.28 no.1
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    • pp.21-28
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    • 2024
  • Present study aimed to investigate the temporal changes in expression of some reproductive hormones in testis, originally found in hypothalamus and pituitary. Rats were sacrificed on postnatal day 23 (PND23; immature), pubertal (PND53) and PND 81 (young adult). The testicular RNAs were extracted, and semi-quantitative PCRs for gonadotropin-releasing hormone (GnRH), kisspeptin 1 (KiSS1), pituitary adenylate cyclase-activating polypeptide (PACAP), LH subunits and LH receptor were performed. Transcript levels of GnRH and KiSS1 at PND23 were significantly higher than levels of PND53 and PND81 (p<0.001). PACAP mRNA level at PND23 was significantly lower than those of PND53 and PND81 (p<0.001). The mRNA levels of both testis type and pituitary type luteinizing hormone β subunit (tLHβ and pLHβ, respectively) at PND23 were significantly lower than levels of PND53 and PND81 (p<0.001). The mRNA level of glycoprotein hormone common alpha subunit (Cgα) at PND23 was significantly lower than those of PND53 and PND81 (p<0.001). Present study revealed the intratesticular expression of KiSS1 and GnRH showed a very similar trend while the expression of PACAP in the testis showed reversed pattern. The expressions of LHβ subunits (tLHβ and pLHβ) were very low during immature stage then increased significantly during puberty and early adulthood. Our attempt to study the local role(s) of intratesticular factors will be helpful to achieve precise understanding on the testis physiology and pathology.