Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지

Growth Rate of Dominant Follicles During Controlled Ovarian Hyperstimulation

과배란유도 여성에서 우성난포의 성장속도

  • Hwang, Eun-Ju (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Ku, Seung-Yup (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Yong-Jin (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Jee, Byung-Chul (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Suh, Chang-Suk (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Seok-Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Choi, Young-Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Jung-Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Moon, Shin-Yong (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • 황은주 (서울대학교 의과대학 산부인과학교실) ;
  • 구승엽 (서울대학교 의과대학 산부인과학교실) ;
  • 김용진 (서울대학교 의과대학 산부인과학교실) ;
  • 지병철 (서울대학교 의과대학 산부인과학교실) ;
  • 서창석 (서울대학교 의과대학 산부인과학교실) ;
  • 김석현 (서울대학교 의과대학 산부인과학교실) ;
  • 최영민 (서울대학교 의과대학 산부인과학교실) ;
  • 김정구 (서울대학교 의과대학 산부인과학교실) ;
  • 문신용 (서울대학교 의과대학 산부인과학교실)
  • Received : 2010.08.17
  • Accepted : 2010.09.25
  • Published : 2010.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To evaluate if there is any correlation between the growth rate of dominant follicles and clinical characteristics or outcome variables in women undergoing controlled ovarian hyperstimulation (COH). Methods: This study was performed in 313 in vitro fertilization (IVF) cycles. Follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were measured on day 3 of menstrual cycle, and serial ultrasonographic measurement of the diameter of growing follicles was performed. The growth rates of dominant follicles calculated by diameter difference divided by days were correlated with clinical characteristics and outcome variables. Results: There was no significant difference in the growth rate of the dominant follicles between gonadotropin releasing hormone (GnRH) agonist and antagonist cycles. No significant correlation was found between the growth rates and evaluated factors such as age, body mass index, LH, FSH, $E_2$, retrieved oocytes and fertilization rate. Conclusion: The Growth rate of dominant follicles seems to show an independent feature of basal characteristics and ovarian response.

목 적: 과배란유도 환자에서의 우성난포의 성장속도와 임상인자들과의 연관성을 평가하고자 하였다. 연구방법: 체외수정시술을 위한 과배란유도 313주기를 대상으로 혈중 호르몬 농도를 측정하고 과배란유도 주기 중 난포 직경의 변화를 초음파를 이용하여 연속적으로 측정하였다. 우성난포의 성장 속도를 계산하고, 임상지표와의 연관성을 분석하였다. 결 과: Gonadotropin releasing hormone 작용제와 길항제 주기 사이에 우성난포의 성장속도의 유의한 차이는 관찰되지 아니하였다. 우성난포의 성장속도와 환자의 연령, 체질량 지수, 생리 시작 3일의 follicle stimulating hormone, luteinizing hormone, 에스트라디올, 획득 난자의 수, 수정률 등의 임상지표는 유의한 연관성이 없었다. 결 론: 본 연구 결과는 우성난포의 성장속도는 난소 반응을 포함한 임상지표와 연관성이 없는 독립적인 변수임을 시사한다.

Keywords

References

  1. Bomsel-Helmreich O. Ultrasound and the preovulatory human follicle. Oxf Rev Reprod Biol 1985; 7: 1-72.
  2. Hackeloer BJ, Fleming R, Robinson HP, Adam AH, Coutts JR. Correlation of ultrasonic and endocrinologic assessment of human follicular development. Am J Obstet Gynecol 1979; 135: 122-8.
  3. Hackeloer BJ, Robinson HP. Ultrasound examination of the growing ovarian follicle and of the corpus luteum during the normal physiologie menstrual cycle (author's transl). Geburtshilfe Frauenheilkd 1978; 38: 163-8.
  4. Lenz S. Ultrasonic study of follicular maturation, ovulation and development of corpus luteum during normal menstrual cycles. Acta Obstet Gynecol Scand 1985; 64: 15-9.
  5. O'Herlihy C, De Crespigny LJ, Robinson HP. Monitoring ovarian follicular development with real-time ultrasound. Br J Obstet Gynaecol 1980; 87: 613-8. https://doi.org/10.1111/j.1471-0528.1980.tb05015.x
  6. Queenan JT, O'Brien GD, Bains LM, Simpson J, Collins WP, Campbell S. Ultrasound scanning of ovaries to detect ovulation in women. Fertil Steril 1980; 34: 99-105. https://doi.org/10.1016/S0015-0282(16)44889-2
  7. Renaud RL, Macler J, Dervain I, Ehret MC, Aron C, Plas-Roser S, et al. Echographic study of follicular maturation and ovulation during the normal menstrual cycle. Fertil Steril 1980; 33: 272-6. https://doi.org/10.1016/S0015-0282(16)44592-9
  8. Dornbluth NC, Potter JL, Shepard MK, Balmacedo JP, Siler-Khodr TM. Assessment of follicular development by ultrasonography and total serum estrogen in human menopausal gonadotropin-stimulated cycles. J Ultrasound Med 1983; 2: 407-12. https://doi.org/10.7863/jum.1983.2.9.407
  9. Kemeter P, Feichtinger W. Ultrasound monitoring of follicle growth in IVF. Wien Med Wochenschr 1991; 141: 9-13.
  10. Leerentveld RA, van Gent I, van der Stoep M, Wladimiroff JW. Ultrasonographic assessment of Graafian follicle growth under monofollicular and multifollicular conditions in clomiphene citrate-stimulated cycles. Fertil Steril 1985; 43: 565-9. https://doi.org/10.1016/S0015-0282(16)48498-0
  11. Ritchie WG. Ultrasound in the evaluation of normal and induced ovulation. Fertil Steril 1985; 43: 167-81. https://doi.org/10.1016/S0015-0282(16)48369-X
  12. Doody MC, Gibbons WE, Zamah NM. Linear regression analysis of ultrasound follicular growth series: statistical relationship of growth rate and calculated date of growth onset to total growth period. Fertil Steril 1987; 47: 436-40. https://doi.org/10.1016/S0015-0282(16)59051-7
  13. Gougeon A, Lefevre B. Evolution of the diameters of the largest healthy and atretic follicles during the human menstrual cycle. J Reprod Fertil 1983; 69: 497-502. https://doi.org/10.1530/jrf.0.0690497
  14. Pache TD, Wladimiroff JW, de Jong FH, Hop WC, Fauser BC. Growth patterns of nondominant ovarian follicles during the normal menstrual cycle. Fertil Steril 1990; 54: 638-42. https://doi.org/10.1016/S0015-0282(16)53821-7
  15. Rossavik IK, Gibbons WE. Variability of ovarian follicular growth in natural menstrual cycles. Fertil Steril 1985; 44: 195-9. https://doi.org/10.1016/S0015-0282(16)48735-2
  16. Veeck LL. Fertilization and early embryonic development. Curr Opin Obstet Gynecol 1992; 4: 702-11.
  17. Broekmans FJ, de Ziegler D, Howles CM, Gougeon A, Trew G, Olivennes F. The antral follicle count: practical recommendations for better standardization. Fertil Steril 2010; 94: 1044-51. https://doi.org/10.1016/j.fertnstert.2009.04.040
  18. Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996; 17: 121-55. https://doi.org/10.1210/edrv-17-2-121
  19. Jayaprakasan K, Hilwah N, Kendall NR, Hopkisson JF, Campbell BK, Johnson IR, et al. Does 3D ultrasound offer any advantage in the pretreatment assessment of ovarian reserve and prediction of outcome after assisted reproduction treatment? Hum Reprod 2007; 22: 1932-41. https://doi.org/10.1093/humrep/dem104
  20. Hansen KR, Thyer AC, Sluss PM, Bremner WJ, Soules MR, Klein NA. Reproductive ageing and ovarian function: is the early follicular phase FSH rise necessary to maintain adequate secretory function in older ovulatory women? Hum Reprod 2005; 20: 89-95. https://doi.org/10.1093/humrep/deh544
  21. Klein NA, Harper AJ, Houmard BS, Sluss PM, Soules MR. Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002; 87: 5746-50. https://doi.org/10.1210/jc.2002-020622
  22. Awartani KA, Nahas S, Al Hassan SH, Al Deery MA, Coskun S. Infertility treatment outcome in sub groups of obese population. Reprod Biol Endocrinol 2009; 7: 52. https://doi.org/10.1186/1477-7827-7-52
  23. Orvieto R, Meltcer S, Nahum R, Rabinson J, Anteby EY, Ashkenazi J. The influence of body mass index on in vitro fertilization outcome. Int J Gynaecol Obstet 2009; 104: 53-5. https://doi.org/10.1016/j.ijgo.2008.08.012
  24. Sneed ML, Uhler ML, Grotjan HE, Rapisarda JJ, Lederer KJ, Beltsos AN. Body mass index: impact on IVF success appears age-related. Hum Reprod 2008; 23: 1835-9. https://doi.org/10.1093/humrep/den188