• 제목/요약/키워드: Follicle-stimulating hormone

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Maternal Low-protein Diet Alters Ovarian Expression of Folliculogenic and Steroidogenic Genes and Their Regulatory MicroRNAs in Neonatal Piglets

  • Sui, Shiyan;Jia, Yimin;He, Bin;Li, Runsheng;Li, Xian;Cai, Demin;Song, Haogang;Zhang, Rongkui;Zhao, Ruqian
    • Asian-Australasian Journal of Animal Sciences
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    • 제27권12호
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    • pp.1695-1704
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    • 2014
  • Maternal malnutrition during pregnancy may give rise to female offspring with disrupted ovary functions in adult age. Neonatal ovary development predisposes adult ovary function, yet the effect of maternal nutrition on the neonatal ovary has not been described. Therefore, here we show the impact of maternal protein restriction on the expression of folliculogenic and steroidogenic genes, their regulatory microRNAs and promoter DNA methylation in the ovary of neonatal piglets. Sows were fed either standard-protein (SP, 15% crude protein) or low-protein (LP, 7.5% crude protein) diets throughout gestation. Female piglets born to LP sows showed significantly decreased ovary weight relative to body weight (p<0.05) at birth, which was accompanied with an increased serum estradiol level (p<0.05). The LP piglets demonstrated higher ratio of bcl-2 associated X protein/B cell lymphoma/leukemia-2 mRNA (p<0.01), which was associated with up-regulated mRNA expression of bone morphogenic protein 4 (BMP4) (p<0.05) and proliferating cell nuclear antigen (PCNA) (p<0.05). The steroidogenic gene, cytochrome P450 aromatase (CYP19A1) was significantly down-regulated (p<0.05) in LP piglets. The alterations in ovarian gene expression were associated with a significant down-regulation of follicle-stimulating hormone receptor mRNA expression (p<0.05) in LP piglets. Moreover, three microRNAs, including miR-423-5p targeting both CYP19A1 and PCNA, miR-378 targeting CYP19A1 and miR-210 targeting BMP4, were significantly down-regulated (p<0.05) in the ovary of LP piglets. These results suggest that microRNAs are involved in mediating the effect of maternal protein restriction on ovarian function through regulating the expression of folliculogenic and steroidogenic genes in newborn piglets.

Changes in Plasma Levels of Inhibin and Follicle Stimulating Hormone in Buffaloes Superovulated with eCG

  • Singh, Baljit;Dixit, V.D.;Dixit, V.P.;Singh, P.;Georgie, G.C.;Lohan, I.S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제13권9호
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    • pp.1205-1209
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    • 2000
  • The present study was undertaken to investigate the effect of stimulation of follicular development with eCG on the peripheral levels of inhibin and FSH in Murrah buffaloes. Estrus was synchronized in five normally cycling females by insertion of Crestar (Intervet, Boxmeer, Holland) implants for nine days. Estradiol valerate was administered i.m. on the day of implant insertion. On the 10th day of the induced estrous cycle a single dose of 3000 IU eCG (Folligon, Intervet, Boxmeer, Holland) was given, followed by treatment with 25 mg of $PGF_2$ alpha (Lutalyse, Upjohn, Belgium) 48 h later. Blood samples were obtained during the induced estrus, on cycle day 10 (luteal phase), at the superovulatory estrus (43 h after PGF) and during the periovulatory period (64 h after PGF). Ultrasonography was done daily to monitor follicular development. Plasma concentrations of inhibin and FSH were determined by specific radioimmunoassays. Differences between $mean{\pm}SEM$ values of different phases of the cycle were compared by ANOVA. The mean number of small (2-5 mm), medium (6-9 mm) and large (>10 mm) follicles observed two days after eCG treatment and on the day of superovulatory estrus was $2.8{\pm}0.31$, $5.2{\pm}0.30$ and $1.4{\pm}0.09$ and $1.9{\pm}0.21$, $2.8{\pm}0.40$ and $5.0{\pm}0.83$, respectively. The mean number of ovulations was $3.6{\pm}0.37$ and the mean number of unovulated follicles was $6.1{\pm}0.47$. Most of the follicles >10 mm in diameter had ovulated (72%). The mean ${\pm}SEM $ of plasma inhibin concentration $(2584.15{\pm}17.92pg/ml)$ during the superovulatory estrus was significantly higher $(p{\leq}0.05)$ than during the induced estrus $(749.87{\pm}17.29pg/ml)$, the luteal phase $(1099.54{\pm}24.98pg/ml)$ and periovulatory period $(1682.71{\pm}29.88pg/ml)$, respectively. $Mean{\pm}SEM$ plasma FSH concentration during the induced estrus $(10.35{\pm}0.41ng/ml)$ was not different from that during the superovulatory estrus $(8.52{\pm}0.39ng/ml)$, but was significantly higher $(p{\leq}0.05)$ than during the luteal phase $(2.81{\pm}0.42ng/ml)$ and periovulatory period $(5.7{\pm}0.28ng/ml)$. These data indicate that treatment with eCG in buffaloes for inducing superovulation results in a significant elevation in plasma inhibin levels and a decrease in plasma FSH levels during the superovulatory estrus. Thus, we suggest that the elevated plasma inhibin coming from fully developed follicles continued for a long time which results in inhibition of FSH leading to poor ovulation in the remaining follicles, which may be the cause of suboptimal superovulatory response.

Nitric Oxide Exerts Different Functions on Porcine Oocytes Cultured in Different Models, Which is Affected by Beta-mercaptoethanol

  • Tao, Yong;Xia, Guoliang;Bo, Shumin;Zhou, Bo;Zhang, Meijia;Wang, Fenghao
    • Asian-Australasian Journal of Animal Sciences
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    • 제17권3호
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    • pp.317-324
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    • 2004
  • The present study was conducted to investigate the involvement of nitric oxide (NO) in cumulus expansion, oocyte mortality and meiotic maturation of porcine cumulus enclosed oocytes (CEOs) cultured in two different models when gonadotropins, including follicle-stimulating hormone (FSH) and human chorionic gonadotropin (hCG) were presented or not. And the interaction between NO and $\beta$-mercaptoethanol ($\beta$-ME), a free radical scavenger was also investigated. Two models refer to spontaneous maturation model and hypoxanthine (HX) medium model. All the 3,433 eligible CEOs were incubated at $39^{\circ}C$ and the cumulus expansion, oocyte morphology and nuclear phase were evaluated 44 h after incubation. (1) In spontaneous maturation model, NO stimulates the cumulus expansion and $\beta$-ME delayed it. NO doesn't affect the oocyte meiotic resumption but inhibits the oocytes to develop to metaphase II. (2) In HX medium model, NO or $\beta$-ME doesn't affect the expansion in the absence of gonadotropins, but in the presence of gonadotropins, NO or $\beta$-ME inhibits the expansion. In the presence of gonadotropins, NO inhibits the oocyte meiotic resumption and it especially inhibits the oocyte to develop to metaphase II, and $\beta$-ME reverses such inhibitory effects. The cooperation of gonadotropins and $\beta$-ME stimulates the meiotic resumption and especially, promotes the CEOs to develop to metaphase II in both models. Moreover, HX might contribute to the fragility of oocyte zona pellucida and gonadotropins, nitric oxide and $\beta$-ME could alleviate it separately, and cooperatively. It is concluded that NO exerts different functions in two models and $\beta$-ME affected the functions of NO in different models.

Comparison of follitropin ${\beta}$ administered by a pen device with follitropin ${\beta}$ administered by a conventional syringe in patients undergoing IVF-ET

  • Kang, Hyuk-Jae;Kim, Chung-Hoon;Ahn, Jun-Woo;Lee, Hyang-Ah;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • 제38권1호
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    • pp.37-41
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    • 2011
  • Objective: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin ${\beta}$ with a conventional syringe delivering follitropin ${\beta}$ solution in patients undergoing IVF-ET. Methods: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). Results: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin ${\beta}$. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. Conclusion: The pen device for self-administration of follitropin ${\beta}$ is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin ${\beta}$ when compared with the conventional syringe.

Potentials of Phyllanthus amarus, Viscum album and Moringa oleifera supplements to mitigate heat stress in female rabbits in humid tropics

  • Olatunji Abubakar Jimoh;Blessing Oluwaseun Olakanye;Ayoola Mercy Ajewole;Saanu Olajumoke Akinbuyide;Johnson Sunday Adetifa;Abdul-Quadri Ayodeji Jimoh;Adewale Oluwatosin Mayowa;Feyisayo Pemisire Adesina
    • Journal of Animal Science and Technology
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    • 제66권1호
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    • pp.79-92
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    • 2024
  • Global warming is a key challenge subjecting animals to heat stress conditions resulting in multiple physiological alterations in tropical climate. Dietary approach seems to be the more friendly approach to curb the adverse effects of heat stress in rabbits. Some herbs have been categorized to have high potential for promotion of immune responses for amelioration of heat stress. Thus, this research aims to evaluate the potential of Mistletoe (Viscum album), Moringa (Moringa oleifera) and Phyllanthus (Phyllanthus amarus) leaf meal as herbal supplements for the alleviation of heat stress in female rabbits by measuring improvement in sex and stress hormonal responses in serum biochemistry. 80 Rabbit does were exposed to 4 dietary groups supplemented with each of Mistletoe, Moringa, Phyllanthus and a control in an 84-day trial at the summit of thermal stress in South west Nigeria. Growth indices were monitored throughout the study, blood samples were compiled at the end of the trial to assess serum biochemistry, stress and sex hormonal responses of the Does using standard protocols. The results revealed that final weight and weight gain of Does fed on Phyllanthus were significantly (p < 0.05) higher (11.46% and 14.25%, respectively) than Does on control. The herbal supplements enhance glucose, protein, albumin and globulin, reduced cholesterol, and creatinine of Does under heat stress conditions. Among the herbal treatment groups, mistletoe, moringa and phyllanthus had 12.42%, 18.39% and 16.90%, respectively, lower corticosterone than control groups which had 39.76ng/ml. Triiodothyronine of Does fed control were significantly (p < 0.05) lower than Does on Moringa oleifera and Phyllanthus amarus supplements. Estradiol and Follicle stimulating hormone of rabbit Does fed on moringa supplement were significantly (p < 0.05) higher than other treatments. In conclusion, the herbal supplements tend to mitigate the detrimental outcome of thermal stress on Does by suppressing stress hormones. Moringa oleifera and Phyllanthus amarus enhanced sex hormones while Phyllanthus amarus confered growth promoting effects on the Does.

무지개송어의 유전 육종학적 연구 II. 무지개송어의 난소 발달에 영향을 미치는 혈청중 LH, FSH, Estradiol-$17{\beta}$ 수준과 Albumin, Total Protein, Triglycerides 함량과의 관계 및 성선지수 변화간의 상관관계 (Studies on Genetics and Breeding of Rainbow Trout(Oncorhynchus mykiss) II. Relationships between Levels of Serum LH, FSH and Estradiol-$17{\beta}$ ; and Levels of Albumin, Total Protein, and Triglycerides ; and their Effect on the Changes of Gonadosomatic Indices in the Ovarian Development in the Rainbow Trout)

  • 윤종만;김계웅;박홍양
    • 한국양식학회지
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    • 제4권2호
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    • pp.97-110
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    • 1991
  • 1989년 3월부터 1990년 2월까지 정상적인 광주기 상태에서 한달에 한번씩 채취된 무지개 송어 암컷의 혈청중 LH, FSH, estradiol-$17{\beta}$ 농도, albumin, globulin, triglycerides의 변화 그리고 GSI의 변화를 조사하였고, 각 호르몬과 혈청성분 그리고 GSI간의 상관관계를 알기 위하여 본 연구를 실시하였다. 본 연구에서 얻어진 결과는 다음과 같이 나타났다. 1. 혈청중 LH 수준은 11월에 가장 높게 나타났다. 2. 10월부터 그 이듬해 2월까지 혈청 LH 수준은 점차적으로 낮아지는 경향을 나타내었다. 3. LH 및 FSH와 같은 GTH의 수준은 인공산란직후 낮게 나타났고, 난황형성(vitellosenesis)이 개시되는 늦여름부터 유의하게 증가하였다. 4. 혈청중 FSH 수준은 LH와 estradiol-$17{\beta}$에 대해서 고도의 유의성(P<0.001)을 나타내었다. 5. 혈청중 LH는 estradiol-$17{\beta}$에 대해서 고도의 유의성(P<0.001)을 나타내었다. 6. negative feedback mechanism에 의해서 2월에 estradiol-$17{\beta}$의 수준이 감소하였다. 7. 혈청중 albumin과 total protein의 함량은 난황형성이 개시되는 8월에 유의성있게 증가하다가 산란직전인 11월에 가장 높은 수준을 나타내었다. 8. 혈청중 triglycerides 함량은 8월에 유의하게 증가하였고, 1월에 최고 수준을 나타내었다. 9. 난직경 및 GSI의 크기로 나타나는 난모세포의 성장은 8월에 유의성있게 증가하다가 산란시기인 1월에 최고 수준을 나타내었다. 10. 혈청중 LH와 FSH와의 상관계수는 +0.844이다. 11. 혈청중 LH와 estradiol-$17{\beta}$와의 상관계수는 +0.947이다. 12. 혈청중 FSH와 estradiol-$17{\beta}$와의 상관계수는 +0.894이다. 13. 혈청중 estradiol-$17{\beta}$와 albumin과의 상관계수는 +0.634이다. 14. 혈청중 estradiol-$17{\beta}$와 total protein의 상관계수는 +0.947이다. 15. 혈청중 LH와 GSI와의 상관계수는 +0.506이다. 16. 혈청중 FSH와 estradiol-$17{\beta}$와의 상관계수는 +0.586이다. 17. 혈청중 estradiol-$17{\beta}$와 GSI와의 상관계수는 +0.694이다. 18. 혈청중 LH와 total protein과의 상관계수는 +0.947이다. 19. 혈청중 FSH와 total protein과의 상관계수는 +0.709이다. 20. 혈청중 FSH와 triglycerides와의 상관계수는 +0.549이다. 21. 혈청중 estradiol-$17{\beta}$와 triglycerides와의 상관계수는 +0.673이다. 22. positive feedback mechanism에 의해서 LH, FSH와 estradiol-$17{\beta}$는 간을 자극시켜 albumin, total protein 및 triglycerides를 분필시킴으로서 난황형성(vitellosenesis)에 관여하는 것으로 나타났다.

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소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전 (Endocrine dysfunction after bone marrow transplantation during childhood and adolescence)

  • 진혜영;최진호;임호준;서종진;문형남;유한욱
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.420-427
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    • 2010
  • 목 적 : 소아와 청소년기에 골수이식을 받은 환자들은 여러 가지 조기 또는 후기 합병증이 발생할 수 있다. 본 연구에서는 이식 후 발생할 수 있는 내분비 기능 부전에 대해 분석하여 이식 후 추적 관리에 도움이 되고자 하였다. 방 법 : 골수이식을 받은 100명(남자 61명, 여자 39명)의 환자들을 대상으로 진단명, 이식 당시 연령, 전처치 방법, 만성 이식편대 숙주병 유무, 성장 패턴, 갑상샘 기능, 사춘기 발달 상태 등을 후향적으로 조사하여 내분비 기능 부전과 관련이 있는 위험 인자가 있는지 분석하였다. 결 과 : 이식 당시, 이식 1년후, 최종 내원시의 신장 표준편차 점수는 각각 $0.08{\pm}1.04$, $-0.09{\pm}1.02$, $-0.27{\pm}1.18$로 의미있게 감소하였다(P =0.001). 전처치로 TBI를 받은 경우 TBI를 받지 않은 군에 비하여 이식 전보다 신장 표준편차 점수가 더 많이 감소하였다(P =0.017). TBI를 시행한 환자 중 1명에서 성장 호르몬 결핍을 보였다. 갑상샘 기능 검사를 시행한 94명 중 30명(31.9%)이 보상성 갑상샘저하증이었고 만성 이식편대 숙주병이 있었던 환자에서 보상성 갑상샘저하증의 빈도가 높았다(odds ratio=2.82, P =0.025). 최종 내원 시 만 14세 이상 남자 17명, 만 13세 이상 여자 15명 중에서 비정상적인 LH 또는 FSH의 상승을 보인 경우는 남자 3명, 여자 13명으로 여아가 의미 있게 많았다(odds ratio=30.3, P =0.001). 결 론 : 소아나 청소년기에 골수이식을 받은 환자에서 가장 흔한 내분비 기능 이상은 난소 기능 부전이며 그 외 높은 빈도의 내분비 기능 이상을 보이므로 정기적인 내분비 기능 검사가 필요하다.

높은 기저 난포 자극 호르몬 수치를 가지는 환자와 고령 환자의 체외수정시술을 위한 과배란 유도에서 GnRH antagonist 다회 투여법과 GnRH agonist 장기요법의 효용성에 대한 연구 (Comparison of IVF-ET Outcomes between GnRH Antagonist Multiple Dose Protocol and GnRH Agonist Long Protocol in Patients with High Basal FSH Level or Advanced Age)

  • 김지연;김낙근;윤태기;차선희;김유신;원형재;조정현;차수경;정미경;최동희
    • Clinical and Experimental Reproductive Medicine
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    • 제32권4호
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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.

체외수정시술시 난포자극호르몬 수용체 유전자 다형성이 과배란유도 및 임신 결과에 미치는 영향 (The Effect of Follicle-Stimulating Hormone Receptor (FSHR) Polymorphism on Outcomes of Controlled Ovarian Hyperstimulation (COH) and In-vitro Fertilization and Embryo Transfer (IVF-ET))

  • 윤지성;최영민;임경실;허창영;강영제;정재훈;이원돈;임진호;황규리;지병철;구승엽;서창석;김석현;김정구;문신용
    • Clinical and Experimental Reproductive Medicine
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    • 제31권2호
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    • pp.133-139
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    • 2004
  • Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.

저 반응군의 체외수정시술을 위한 과배란유도에 있어 GnRH Antagonist 요법과 GnRH Agonist Flare Up 요법의 효용성에 관한 연구 (GnRH Antagonist Versus Agonist Flare-up Protocol in Ovarian Stimulation of Poor Responder Patients)

  • 안영선;연명진;조연진;김민지;강인수;궁미경;김진영;양광문;박찬우;김혜옥;차선화;송인옥
    • Clinical and Experimental Reproductive Medicine
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    • 제34권2호
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    • pp.125-131
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    • 2007
  • 목 적: 난소 반응이 저하된 환자에서 GnRH agonist flare up protocol과 GnRH antagonist protocol의 효용성을 비교하고자 하였다. 연구방법: 2003년 1월부터 2005년 8월까지 체외수정시술을 받은 환자들 가운데 이전의 체외수정시술 주기에서 5개 이하의 난자가 채취되고 기저 FSH 농도가 12 mIU/ml 이상인 총 144명 가운데 73명은 GnRH agonist flare up요법을 사용하였고 71명은 GnRH antagonist 요법을 사용하였다. 양군간에 주기의 취소율, 채취된 난자수, 양질의 수정란의 수, 착상율, 임신율, 출산율을 비교하였다. 결 과: 각 군간에 나이는 평균 37.4세와 38.1세로 antagonist group에서 높았으나 통계학적 유의성은 없었다. 그 외에 기저 FSH 농도와 이전 주기의 취소율도 통계학적 유의성은 없었다. GnRH agonist flare up 주기와 GnRH antagonist 주기에서 취소율은 각각 30.1%, 53.5%로 GnRH antagonist protocol에서 유의 있게 높게 나타났다. 채취된 난자수도 각각 4.18개와 2.16개로 차이를 보였으며 난소 과자극 기간은 각각 10.5일과 9.2일로 antagonist protocol에서 약간 낮은 모습을 보였다. 최고 혈중 E$_2$의 농도와 good embryo 개수도 GnRH agonist flare up요법에서 유의 있게 높게 나타났다. 각 군에서의 착상율, 이식 주기당 임신율, 이식 주기당 출생율은 GnRH agonist flare up요법에서 약간 높은 경향을 보이기는 하였으나 통계학적인 유의성은 없었다. 결 론: 두 군간의 비교에서 GnRH agonist flare up 요법이 시작 주기당 임신율, 출산율에서 높은 경향을 보였으나 통계학적 의의는 없었다. 하지만 난소기능이 저하된 환자에서 난자의 채취 개수는 GnRH agonist flare up 요법이 GnRH antagonist를 사용한 주기보다 의의있게 높게 나타났다. 이러한 연구 결과로 볼 때 저 반응군에 있어서 GnRH antagonist flare up요법이 저 반응군에 있어 향상된 난소 반응을 기대할 가능성이 높을 것으로 생각된다.