• 제목/요약/키워드: Dominant Follicle

검색결과 28건 처리시간 0.024초

배란유도주기에 따른 초음파검사와 기초체온표의 비교분석 (A Comparative Analysis of Basal Body Temperature to Ultrasound, as a Method of Ovulation Detection in Induced Ovulatory Menstrual Cycles)

  • 최욱;서병희;이재현
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제12권2호
    • /
    • pp.25-37
    • /
    • 1985
  • Four points on the basal body temperature (B.B.T.) curve was correlated with the estimated time of ovulation, as determined by serial ultrasound in 50 induced menstrual cycles from 22 subjects. The time of ovulation was estimated by measuring the maximal diameter of follicles and observing the morphologic changes within the ovary from follicle to corpus luteum. The results were as following; 1. The diameter of the follicle measured at the day before disappearance was 21.1 mm on an average (S.D.: 2.14). The average follicular growth for 4 days before ovulation was measured at a rate of 2.8 mm/day, and rapid growth of follicle was observed 3.1 mm/day at the day before. 2. The changes associated with rupture of the follicles were the followings, in order of frequency; decrease in size(94%), disappearance of follicles(64%), fluid in the Cul-de-Sac(26%) and increased internal echoes(16%). 3. Only 20 of 50 cycles, exhibited a BBT dip and correlated with the estimated time of ovulation by ultrasound in 2 of which cases(10%). BBT nadir, 30 of 50 cycles, correlated in 5(16.7%). The first day of hyperthermic plateau(FDHP) and BBT coverline was exhibited in all cycles, correlated in 41(82%) and 35(70%) cases. 4. The relationship between the diameter of dominant dominant follicle, measured by ultrasound, and the basal body temperature curve were as following. During cycles in which dip was observed on the BBT curve, the follicular diameter were 10.5${\pm}$2.12 mm on 4 days prior to the point (D-4), and 12.5${\pm}$2.12 mm (D-3), 15.5${\pm$2.12 mm (D-2), 17.0${\pm}$1.41 mm (D-1) and 21.5${\pm}$2.12 mm just prior to the dip (D-0). In the nadir; 9.6${\pm}$1.67 mm (N-4), 12.8${\pm}$1.79 mm (N-3), 16.2${\pm}$1.92 mm (N-2), 18.2${\pm}$2.17 mm (N-1) and 21.4${\pm}$2.61 mm (N-0). In the First day of Hyperthemic Plateau (FDHP); 9.8${\pm}$1.36 mm (F-4), 12.4${\pm}$1.41 mm (F-3),15.1${\pm}$1.57 mm (F-2), 18.1${\pm}$1.67 mm (F-1) and 21.2${\pm}$2.25 mm (F-0). In the BBT coverline endopint; 9.9${\pm}$.39 mm (C-4), 12.5 ${\pm}$1.44 mm (C-3), 15.2${\pm}$1.64 mm (C-2), 18.0 ${\pm}$1.69 mm (C-1), and 21.2${\pm}$2.31 mm (C-0). 5. The relationship between the ultrasonographic signs of ovulation and the basal body temperature curve were as following. The BBT dip correlated with the ovulation in 2 cases, which revealed decrease in follicular diameter (100%), fluid pattem in the Cul-de-Sac (1 case, 50%) and complete disappearance of follicle (1 case, 50%). In the nadir (5 cases); the ultrasonographic signs of ovulation were decrease in follicular diameter (5 cases, 100%), fluid pattern in the Cul-de-Sac (1 case, 20%) and complete disappearance of follicle (3 cases, 60%). In the First day of Hyperthermic Plateau (41 cases); decrease in follicular diameter (40 cases, 97.6%), fluid pattern in the Cul-de-Sac (11 cases, 26.8%), appearance of internal echo and thickening of the wall (6 cases, 14.6%) and com plete disappearance of follicle (28 cases, 68.3%). In the BBT coverline endpoint (35 cases); decrease in follicular diameter (33 cases, 94.3%), fluid pattern in the Cul-de Sac (9 cases, 25.7%), appearance of internal echo and thickening of the wall (5 cases 14.3%) and complete disappearance of follicle (20 cases, 57.1%).

  • PDF

배란장애를 동반한 다낭성 난소인 여성에서 혈중 Inhibin 농도의 증가 (Increased Serum Level of Inhibin in Oligo-amenorrheic Women with Polycystic Ovaries)

  • 노재숙;유중배;문형;황윤영
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제25권1호
    • /
    • pp.93-102
    • /
    • 1998
  • Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol $(E_2)$, testosterone (T), androstenedione (ADD), dehydroepiandrosterone-sulfate (DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and $E_2$ in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thecal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH than FSH. Inhibin may inhibit FSH action on granulosa cell in the PCO follicle, impairing follicular development and dominant follicle selection resulted in ovulatory disturbance.

  • PDF

다낭성 난소질환의 치료에 관한 임상연구 (Treatment of Clomiphene Citrate-Resistant Poly-Cystic Ovarian Syndrome)

  • 송정수;김은임;김영민;박용석;허광옥;목영자
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제18권2호
    • /
    • pp.215-222
    • /
    • 1991
  • Treatment with low-dose follicle-stimulating hormone and laparoscopic laser vaporization is associated with a high rate of ovulation in anovulatory women with polycystic ovarian syndrome (PCOS), but it is not clear which is better. We undertook a randomized controlled study to compare the effects of urinary FSH and hMG using a low dose regimen and laparoscopic laser vaporization of ovaries in sixty women with PCOS. Ovulation occured in 65% subjects and in 71.1% of cycles induced with FSH and in 70% of women and 76% of cycles of those treated with hMG and in 80% of women in laparoscopic laser vaporization of ovaries. A single dominant follicle developed in 62.2% (FSH) and 60% (hMG) of cycles, respectively. Eight singleton pregnancies occured in FSH, hMG group and 12 singleton pregnancies occured in laparoscopic laser vaporization. This study shows that selected patients with PCOS and by induced to ovulate and subsequently conceive by laparoscopically partially vaporizing their ovaries with laser energy.

  • PDF

Anti-Müllerian hormone as a predictor of polycystic ovary syndrome treated with clomiphene citrate

  • Hestiantoro, Andon;Negoro, Yuwono Sri;Afrita, Yohana;Wiweko, Budi;Sumapradja, Kanadi;Natadisastra, Muharam
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제43권4호
    • /
    • pp.207-214
    • /
    • 2016
  • Objective: This study aimed to determine the threshold of $anti-M{\ddot{u}}llerian$ hormone (AMH) as predictor of follicular growth failure in polycystic ovary syndrome (PCOS) patients treated with clomiphene citrate (CC). Methods: Fifty female subjects with PCOS were recruited and divided into two groups based on successful and unsuccessful follicular growth. Related variables such as age, infertility duration, cigarette smoking, use of Moslem hijab, sunlight exposure, fiber intake, body mass index, waist circumference, AMH level, 25-hydroxy vitamin D level, and growth of dominant follicles were obtained, assessed, and statistically analyzed. Results: The AMH levels of patients with successful follicular growth were significantly lower (p= 0.001) than those with unsuccessful follicular growth ($6.10{\pm}3.52$ vs. $10.43{\pm}4.78ng/mL$). A higher volume of fiber intake was also observed in the successful follicular growth group compared to unsuccessful follicular growth group (p= 0.001). Our study found the probability of successful follicle growth was a function of AMH level and the amount of fiber intake, expressed as Y =-2.35+($-0.312{\times}AMH\;level$)+($0.464{\times}fiber\;intake$) (area under the curve, 0.88; 95% confidence interval, 0.79-0.98; p< 0.001). Conclusion: The optimal threshold of AMH level in predicting the failure of follicle growth in patients with PCOS treated with CC was 8.58 ng/mL.

Azoospermic men with isolated elevation of follicle-stimulating hormone represent a specific subpopulation of patients with poor reproductive outcomes

  • Gamidov, Safar;Shatylko, Taras;Popova, Alina;Gasanov, Natig;Sukhikh, Gennadiy
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제49권1호
    • /
    • pp.62-69
    • /
    • 2022
  • Objective: This study aimed to describe a distinct subpopulation of azoospermic patients with isolated elevation of follicle-stimulating hormone (iFSH) and poor outcomes of microdissection testicular sperm extraction (microTESE). Methods: A retrospective analysis of microTESE outcomes was conducted among 565 patients with non-obstructive azoospermia (NOA). Testicular pathology was assessed by the dominant histological pattern and Bergmann-Kliesch score (BKS). Descriptive statistics were presented for the iFSH subgroup. Inhibin B levels, the sperm retrieval rate (SRR), and BKS were compared in iFSH patients and other NOA patients. Results: The overall SRR was 33.3% per microTESE attempt. The median BKS was 0.6 (interquartile range, 0-2). Of all NOA patients, 132 had iFSH, and microTESE was successful only in 11 of those cases, with an SRR of 8.3%, while the total SRR in other NOA patients was 38.1% (p<0.001). iFSH had a sensitivity of 32.1% (95% confidence interval [CI], 27.4%-36.8%) and specificity of 94.1% (95% CI, 90.8-97.5%) as a predictor of negative microTESE outcomes. Conclusion: Patients with iFSH may harbor a distinct testicular phenotype with total loss of the germ cell population and poor outcomes of surgical sperm retrieval.

기초 혈중 Follicle Stimulating Hormone 농도가 높은 체외수정시술 환자의 과배란유도시 Gonadotropin-Releasing Hormone Agonist의 단기투여법과 장기투여법의 비교 (Comparison of Superovulation Outcomes between Short and Long Protocols Using Gonadotropin-Releasing Hormone Agonist in Patients with High Basal Serum Follicle Stimulating Hormone Levels)

  • 김석현;송은섭;송용상;이경희;김정구;문신용;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제18권2호
    • /
    • pp.201-208
    • /
    • 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.

  • PDF

백두산 분화구내 천지 주변의 식물 군락 분포에 관한 연구 (A study on distribution of plant communities around chunji in a crater on mt. paektu)

  • Chang, Nam-Kee;Yeau, Sung-Hee;Lee, Sun-Kyung
    • The Korean Journal of Ecology
    • /
    • 제15권3호
    • /
    • pp.209-220
    • /
    • 1992
  • We investigated major plant communities and seed dispersal patterns in areas a(alt. 2,263 ~2,350m),b(alt. 2,350~2,420m), c(alt. 2,420m) with levels of a crater on mt. paektu. Thirty two species distributed around chunji consisted of 24 perennial herbs, 1 biennial herb and 7 alpine dwarf shurbs. Their fruit types were quite diverse; capsule(11), achene(10), grain(4), legume(2), follicle(2), schizocarp(2) and drupe(1). in area a, adjancent to the chunji(lake) water surface, gramineae sp., cyperaceae sp., chrysanthemum zawadskii and bistorta ochotensis were occured as members of the major plant communities. Species of gramineae and cyperaceae seem to have become dominant because their seeds float well. Astragalus membranaceus is legume and endures the winter cold and summer drought. in area c, alpine dwarf shrubs (e. g.rhododendron redowskianum, rhododendron aureum, empetrum nigrum) were dominant. In area c, compared to a and b, the weather is drier because of strong wind and lower water holding capacity of the soil. Therefore the pattern of plants distributing around chunji is different from that in western slope on mt.paektu. environmental factor such as wind, temperature and water may contribute to the pattern.

  • PDF

랫드 난소에서 난포 발달에 따른 DNA 결합 단백질 억제인자 (Inhibitor of DNA Binding Protein) Id1 and Id2 mRNA 발현 (Inhibitor of DNA Binding Protein (Id)1 and Id2 mRNA Expression on Folliculogenesis in Rat Ovary)

  • 황성수;김평희;고응규;양병철;성환후;민관식;윤종택
    • 한국수정란이식학회지
    • /
    • 제23권3호
    • /
    • pp.183-187
    • /
    • 2008
  • This study was conducted to analyze the expression pattern of inhibitor of DNA binding proteins (Id)1 and Id2 mRNA on folliculogenesis in rat ovary. The ovaries were obtained from 27 days old Sprague-Dawley rat, fixed, dehydrated, and paraffin embedded. For in situ hybridization, anti-sense and sense Idl and Id2 cRNA probes were prepared and applied to the ovarian section. The ovarian sections were coated with NTB-2 emulsion. After that, the slides were developed and counterstained with hematoxylin and eosin staining. In oocytes, the hybridizational signals of Id1 mRNA were strong in primordial and primary follicles, however, there were no signals in that of atretic or preovulatory follicles. The Id2 mRNA signals were also strong in the oocytes of primordial, primary and secondary follicles. Interestingly, the Id2 mRNA was expressed specifically granulosa cells, but nor in oocyte or theca cells in dominant and preovulatory follicles. Based on these results, Id1 and Id2 mRNA was expressed specifically at follicle stages and follicular tissue and might be closely related with follicle development.

쥐 난소에서 난포 발달에 따른 Id3 mRNA의 발현 (Id3 mRNA Expression on Folliculogenesis in Rat Ovary)

  • 황성수;고응규;임현주;성환후;윤종택;민관식
    • Reproductive and Developmental Biology
    • /
    • 제31권3호
    • /
    • pp.181-186
    • /
    • 2007
  • DNA 결합 단백질 억제(Inhibitor of DNA binding protein) 또는 분화억제(Inhibitor of differentiation) 인자인 Id는 네 종류(Id1-4)가 있으며, 세포의 증식과 분화, 혈관 형성 및 세포자가사멸 등에 정 또는 부의 조절인자로서 널리 알려져 있다. 하지만 아직까지 번식생리 분야에서 이들 유전자들의 발현이나 기능에 관해 알려진 것은 거의 없다. 따라서 본 연구에서는 쥐 난소에서 난포의 발달에 따른 Id3 mRNA의 발현 양상을 살펴보고자 실시하였다. 쥐에게 PMSG주사 후, 3, 6, 12, 24, 36 및 48시간째에 난소를 회수하여 고정, 탈수 및 파라핀 포매를 실시하였다. In situ hybridization 실험을 위하여 anti-sense와 sense Id3 cRNA 탐침자를 제작한 다음 난소 절편에 반응시켰다. 반응이 끝난 난소 절편은 NTB-2 유광제에 노출시킨 후 현상액에 반응시켰다. 모든 처리가 끝난 슬라이드는 H&E 염색을 실시한 다음 현미경하에서 hybridization 감도를 1+에서 4+로 구분하여 평가하였다. 난자에서는 Id3 mRNA 감도가 원시와 제1차 난포에서 ${\geq}2+$으로 확인되었으나, 제2차, 우성 및 배란전 난포에서는 1+ 이하로 관찰되었다. 한편, 과립막세포에서는 우성과 배란 전 난포에서 Id3 mRNA가 3+ 또는 4+로 강하게 발현되는 것을 확인하였다. 이상의 결과를 종합하여 보면, Id3 mRNA는 난포의 발단 단계 또는 난포세포에 따라 특이적으로 발현하는 것으로 보아 난포의 발달과 밀접한 연관이 있을 것으로 사료된다.

젖소의 초음파 유도 채란율에 대한 FSH 전처리 효과의 비교 (Effect of FSH Pretreatment on Follicle Development and Oocyte Recovery by Ultrasound-guided Aspiration in Holstein Heifers)

  • 박충생;조성근;이정규;강태영;박성재;공일근;최민철
    • 한국가축번식학회지
    • /
    • 제21권2호
    • /
    • pp.147-156
    • /
    • 1997
  • Ultrasound-guided follicular aspiration was performed in Holstein heifers once weekly with or without pretreatment of single or multiple decreasing doses using a total of 400 mg FSH. Oocytes were aspirated with a 6.5 MHz convex-array ultrasound trasducer designed for intravaginal use. All the visible follicles larger than 4 mm in diameter were punctured with a 17 gauge, 55 cm needle at each aspiration session and the follicular fluids containing oocytes were obtained by vacuum suction. The results obtained were as follows: As a preliminary experiment, the recovery rates of folicular oocytes by ultrasound-guided aspiration from the isolated ovaries of Korean native cows were compared between suction methods using manual syringe or vacuum pump. The recovery rate of oocytes using vacuum pump (80.7%) was significantly (P<0.05) higher than that using manual syringe (47.1%). The follicles were counted by their size in diameter with ultrasound image, and recovery rates and grades of follicular oocytes collected by ultrasound-guided aspiration were investigated in Holstein heifers pretreated with or without FSH. A group of heifiers were injected with multiple decreasing doses (twice a day for 3 days) of a total of 400 mg FSH. The other 2 groups were injected with a single dose of 400 mg FSH mixed with 25% PVP. Ultrasound observation of follicle population and/or ultrasound-guided transvaginal oocyte aspiration were performed 12 hrs following the last FSH injection in the multiple dose group, and 48 or 60 hrs after FSH injection in the single dose groups. Most of the visible follicles had small size of less than 3 mm in diameter in unstimulated heifers (71.0%), but medium size in all the heifers treated with FSH. (70.5 to 92.8%). The number of OPU follicles per session (4.6$\pm$1.9) were much less, compared to the vilsible follicle counts (9.7$\pm$2.2), in the nustimulated heifers due to the small dominant follicles. Among 4 goups of heifers the most visible as well as OPU follicles were observed in the heifers at 60 hrs following treatment of a single dose of 400 mg FSH (21.2$\pm$2.3 and 21.0$\pm$2.0), and the differences in both the follicle counts between the groups was found significant (P<0.05) The rates of oocyte recovery from the follicles by ultrasound-guilded aspiration were varied 46.3 to 75.0% in the heifers unstimulated and treated with a single dose of 400 mg FSH, but the group difference was not significant. The number of recovered oocytes per session a, pp.ared to be highest at aspiration at 60 hrs following single FSH (10.6$\pm$2.2) than at aspiration at 48 hrs after single FSH (7.8$\pm$2.7) or in the unstimulated heifers (3.4$\pm$3.0). The proportion of grade I and II oocytes to all oocytes collected was varied 31.8 to 64.0% between the groups. However, there was found no significant difference in both the number of oocytes recovered per session and the percentage and the percentage of grade I and II oocytes. From the above results it was concluded that the more oocytes of superior quality might be recovered economically by ultrasound-guided aspiration at 60 hrs following the pretreatment of a single dose of 400 mg FSH and by suction using a vacuum pump system of about negative pressure of 75 to 85 mmHg.

  • PDF