• Clinical and Experimental Reproductive Medicine
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• v.17 no.1
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• pp.29-44
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• 1990

In 105 patients with the past history of poor response to the previous controlled ovarian hyperstimulation(COH) due to poor follicular growth or premature LH surge, the effectiveness of pituitary suppression with gonadotropin-releasing hormone agonist(GnRH agonist) in IVF/GIFT program was evaluated in 112 cycles of COH using a combination regimen of Leuprolide acetate (Lupron TAP Pharmaceuticals, USA) and FSH/hMG or pure FSH from May to December, 1989 at SNUH. Starting on day 21 of the menstrual cycle(MCD #21, Day 1), Lupron (1.0mg/day, subcutaneous) was administered once a day till next MCD #3(suppression phase). After the confirmation of pituitary suppression, ovarian follicular growth was stimulated with FSH/hMG or pure FSH from MCD #3(Day + 1), and Lupron was continued with hMG or FSH until hCG administration (D 0) (stimulation phase). After suppression phase, serum E2 level decreased from 183.7${\pm}$95.1(Day 1) to 17.4${\pm}$12.3pg/ml (Day +1), and serum progesterone level from 19.17${\pm}$8.67 to 0.12${\pm}$0.05ng/ml. But there was no decresas in serum LH and FSH levels; LH from 12.74${\pm}$6.21 to 15.49${\pm}$4.93mIU/ml,FSH from 7.60${\pm}$3.84 to 8.58${\pm}$3.15 rnlU/ml. There was no occurrence of premature LH surge during COH. Eleven cycles(9.8%) were cancelled due to poor follicular growth during stimulation phase, and 3 cycles (3.0%) failed in the transvaginal oocytes fretrieval. Serum E2 level was 1366.8${\pm}$642.4 on D 0 and 1492.3${\pm}$906.9pg/ml on D+1. 7.00${\pm}$3.32 follicles(FD${\geq}$12mm) were observed on D 0, and 6.11${\pm}$4.15 oocytes were retrieved, with the oocyte retrieval rate per follicle of 95.0%. 3.59${\pm}$2.57 oocytes were fertilized and cleaved with the oocyte cleavage rate of 55.7%. In 83 IVF patients, 4.08${\pm}$2.39 embryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET 2.39 mebryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET of 19.3%. In 6 GIFT patients, 7.83${\pm}$3.31 oocytes were retrieved and transferred with maximum number of 6, but no pregnancy was obtained. When compared with the previous 108 cycles of COH using FSH/hMG or pure FSH regimen, the cancellation rate during COH was significantly decreased, and all the parameters of the outcome of COH including the pregnancy rate were increased. These data suggest that GnRH agonist therapy for pituitary suppression is an effective adjunct to the current gonadotropin regimens for COH in IVF/GIFT and can increase the probability of oocytes retrieval and pregnancy, especially in the previous poor responders.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.1
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• pp.43-48
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• 1994

To evaluate the effectiveness of GnRH agonist for the treatment of uterine myoma as a cause of infertility, fourteen women were recruited to the study. The patients were treated with a delayed-release formulation of D-$Trp^6$-LHRH in biodegradable microcapsules(Decapeptyl-CR), administered intramuscularly at four week intervals for a period of six monthes. The first injection was given on day 21 of the cycle. Serum estradiol levels fell significantly to the mean value of 257.7pgjml 4 weeks after the first injection. Eleven patients in fourteen treated patients had a reduction in the size of uterine myoma as assessed by ultrasonography, two patients had no change of size and one patient had a increase of size. After the first or second injection, all patients became amenorrheic, then resumption of menstruation ocurred at 12 to 14 weeks after the last injection. Common side effects were hot flush, sweating and dyspareunia, whitch were acceptale. In Eleven patients who had a reduction in the size of uterine myoma by treatment with a delayed- release formulation of D-$Trp^6$-LHRH(Decapeptyl-CR), after above treatment with GnRH agonist, then four patients were treated with myomectomy, three patients had pregnancy and full term delivered by Cesarean section. These data suggest that administration of a delayed-release formulation of a GnRH agonist can be a worthwhile and convenient approach to the medical treatment of uterine myoma as a cause of infertility.

• Proceedings of the Zoological Society Korea Conference
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• 1996.10a
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• pp.151.2-151
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• 1996

No Abstract, See Full Text

• Development and Reproduction
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• v.13 no.4
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• pp.353-362
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• 2009

GnRH and its receptor are known to express locally in the ovary and to regulate the ovarian function by affecting on granulosa and lutein cells. It has been reported that GnRH directly causes apoptosis in the granulosa and lutein cells of the ovary. However, whether the apoptosis of the cells by GnRH is recovered by FSH as an anti-apoptotic factor is not yet known. In this study, we evaluated the apoptosis and the production of progesterone $(P_4)$ and estradiol $(E_2)$ after treatment with 5, 50, and 100 ng/$m\ell$ GnRH and 1 IU/ml FSH in the granulosa-lutein cells that are obtained during oocyte-retrieval for IVF-ET. Results of DNA fragment analysis and TUNEL assay demonstrated that DNA fragmentation and the rate of apoptotic cells were increased in a dose-dependent manner showing a significant increase in the cells treated with 100 ng/$m\ell$ GnRH. In addition, we found that FSH suppresses the apoptosis of the cells induced by GnRH. In the results of chemiluminescence assay for $P_4$ and $E_2$, $P_4$ production was decreased by GnRH treatment, whereas $E_2$ production was not changed. We also demonstrated that FSH inhibits the suppressive effect of GnRH on $P_4$ production as the result of apoptosis. The present results suggest that GnRH agonist using in ovarian hyperstimulation protocol might induce the dysfunction of the ovary, but its function could be recovered by FSH. These results also will be expected to use as the basic data to elucidate the physiological role of GnRH and to develop new ovarian hyperstimulation protocols for IVF-ET.

• 대한생식의학회:학술대회논문집
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• 1995.12a
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• pp.51-51
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• 1995

• 대한생식의학회:학술대회논문집
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• 1995.12a
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• pp.55-56
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• 1995

• 대한생식의학회:학술대회논문집
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• 1995.12a
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• pp.71-72
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• 1995

• Proceedings of the Korean Society of Developmental Biology Conference
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• 2001.08a
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• pp.7-9
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• 2001

• Clinical and Experimental Reproductive Medicine
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• v.47 no.4
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• pp.300-305
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• 2020

Objective: The feasibility of a gonadotropin-releasing hormone agonist (GnRHa) trigger in normal responders is still a matter of debate. The aim of this study was to compare the number of mature oocytes, the number of good-quality embryos, and the live birth rate in normal responders triggered by GnRHa alone, GnRHa and human chorionic gonadotropin (hCG; a dual trigger), and hCG alone. Methods: A retrospective cohort study was conducted at the infertility clinic of a university hospital. Data from 200 normal responders who underwent controlled ovarian hyperstimulation and intracytoplasmic sperm injection with a GnRH antagonist protocol between January 2016 and January 2017 were reviewed. The first study group consisted of patients with cycles triggered by GnRHa alone. The second study group consisted of patients with cycles triggered by both GnRHa and low-dose hCG (a dual trigger). The control group consisted of patients with cycles triggered by hCG alone. Results: The groups were comparable in terms of demographics and cycle characteristics. The numbers of total oocytes retrieved and metaphase II oocytes were similar between the groups. The total numbers of top-quality embryos were 3.2±2.9 in the GnRHa group, 4.4±3.2 in the dual-trigger group, and 2.9±2.1 in the hCG group (p=0.014). The live birth rates were 21.4%, 30.5%, and 28.2% in those groups, respectively (p=0.126). Conclusion: In normal responders, a dual-trigger approach appears superior to an hCG trigger alone with regard to the number of top-quality embryos produced. However, no clinical benefit was apparent in terms of live birth rates.

• YAKHAK HOEJI
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• v.51 no.6
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• pp.402-408
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• 2007

The aim of this study was to evaluate the effect of menstration among the influencing factors for the GnRH agonist (as G: depot goserelin 3.6 mg) therapy prior to the planned myomectomy for women who wanted to preserve their fertility. We reviewed total 48 patients. with the G therapy prior to the planned myomectomy from August 1st, 2005 to August 31st, 2006. The patients were classified by the G group (n=28) and the immediate surgery (as S) group (n=20). The G group (n=19) underwent the G therapy for 3 month courses, and then the efficacy was evaluated by menstruation and the myoma volumes. In the G group (n=19), therapy was effective, and the mean age was $32.4{\pm}6.5$ years. After the completion of G therapy, the mean volume of the myoma by ultrasonography was reduced to $85.2{\pm}71.2cm^3$ comparing of $430.6{\pm}248.8cm^3$ at first visit. The 11 patients had menstruation and the rest 8 patients with amenorrhea had less reduced volume of the myoma ($124.05{\pm}79.85cm^3\;v.s.\;329.41{\pm}234.0cm^3$ p<0.05). In the immediate S group, the myoma volumes by sonography was also checked for accuracy (${\alpha}=1.0$). As the result, the initial myoma volume had the positive correlations to the effectiveness with G therapy. However, the occurrence and frequency of the menstruation during the G therapy had a negative correlation. In conclusion, the use of G prior to the planned myomectomy was effective in reducing myoma volume and the menstruation.