• Clinical and Experimental Reproductive Medicine
• /
• 제47권4호
• /
• pp.306-311
• /
• 2020

Objective: The aim of this study was to determine whether co-administration of a gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) for final oocyte maturation improved mature oocyte cryopreservation outcomes in young women with decreased ovarian reserve (DOR) compared with hCG alone. Methods: Between January 2016 and August 2019, controlled ovarian stimulation (COS) cycles in women (aged ≤35 years, anti-Müllerian hormone [AMH] <1.2 ng/mL) who underwent elective oocyte cryopreservation for fertility preservation were retrospectively analyzed. Results: A total of 76 COS cycles were triggered with a GnRH agonist and hCG (the dual group) or hCG alone (the hCG group). The mean age and serum AMH levels were comparable between the two groups. The duration of stimulation, total dose of follicle-stimulating hormone used, and total number of oocytes retrieved were similar. However, the number of mature oocytes retrieved and the oocyte maturation rate were significantly higher in the dual group than in the hCG group (p=0.010 and p<0.001). After controlling for confounders, the dual-trigger method remained a significant factor related to the number of mature oocytes retrieved (p=0.016). Conclusion: We showed improved mature oocyte collection and maturation rate with the dual triggering of oocyte maturation in young women with DOR. A dual trigger appears to be more beneficial than hCG alone in terms of mature oocyte cryopreservation for young women with DOR.

• 한국수정란이식학회지
• /
• 제24권3호
• /
• pp.169-176
• /
• 2009

Domestic bitches are non-seasonally monoestrus; spontaneously ovulate only once or twice occurs at anytime of the year. Estrus induction has been applied infrequent estrus, misleading ovulation, mating difficulties, failure to conceive after normal mating, pregnancy failure and biological research. Protocol of estrus induction which included variable hormones such as FSH, GnRH, and PMSG have been applied for the last decades. Recently, Bromocriptine, one of anti-prolatin/dopamine agonist has been occasionally applied for estrus induction. The study was carried out to investigate the effective method for the induction of estrus in bitches using different hormone treatments, and the initiation time of estrus from hormone treatment by assessments of cytological observation and blood plasma progesterone concentration. A total of 54 bitches on anestrus were selected for the study and divided randomly into 8 treatment groups as follow. Control, natural estrus; FSH (L), FSH (1.5 mg/kg, twice a day, $Falltrophin^{(R)}$, Vetrepharm); FSH (H), FSH (3.0 mg/kg, twice a day); GnRH+FSH, GnRH (5 ug/kg, once first day, $GNADON^{(R)}$, Dongbang)+FSH (3 mg/kg, SID); PMSG, PMSG (50 IU/kg, every third day $FOLLIGON^{(R)}$, Intevet); GnRH+PMSG, GnRH (5 ug/kg, only first day)+PMSG (50 IU/kg, every third day); GnRH, GnRH (5 ug/kg, only first day); Bromocriptine, bromocriptine (0.3 mg/kg, SID, $Parlodel^{(R)}$, Novartis). The bitches were evaluated clinical sign, cytological exam and $OVUCHECK^{(R)}$ Premate for assessment of estrus induction. Estrus induction rates were significantly (P<0.05) higher in GnRH+PMSG (100%) compared to others. PMSG and GnRH+PMGS (87.5 and 100%) and Bromocriptine (77.8%) were higher than others except GnRH+PMSG. Analysis of vaginal smear has proved to be effective a correct assessment of estrus induction with assay of progesterone concentration by $OVUCHECK^{(R)}$ Premate. Proestrus initiated by the $6^{th}$ after induction in most case. In conclusion, bromocriptine is an effective drug for estrus induction in bitches and assay of progesterone concentration by $OVUCHECK^{(R)}$ Premate with examination of vaginal smear that should be useful to detection of estrus induction of estrus induced bitches.

• 대한생식의학회:학술대회논문집
• /
• 대한불임학회 1995년도 추계 학술대회 및 정기총회
• /
• pp.60-61
• /
• 1995

• 대한생식의학회:학술대회논문집
• /
• 대한불임학회 2006년도 제51차 추계학술대회
• /
• pp.121.1-121.1
• /
• 2006

• 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.

• Clinical and Experimental Reproductive Medicine
• /
• 제26권2호
• /
• pp.163-170
• /
• 1999

Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

• 대한생식의학회:학술대회논문집
• /
• 대한불임학회 2006년도 The 5th Biannual Meeting of Pacific Rim Society for Fertility and Sterility
• /
• pp.155.1-155.1
• /
• 2006

• Asian-Australasian Journal of Animal Sciences
• /
• 제16권9호
• /
• pp.1268-1273
• /
• 2003

Sixty postpartum lactating Friesian cows in 3 treatments at a commercial dairy farm were used to study the effect of using progesterone supplementation with GnRH and PGF2$\alpha$ synchronization with and without timed AI on fertility during summer. Cows in treatment1($Tr_1$) and treatment2 ($Tr_1$) were fitted with progesterone releasing intravaginal device (PRID) device and injected with 10 g GnRH agonist on $51{\pm}3$ d postpartum (pp). Seven days later, PRID was removed and cows received 25 mg PGF2$\alpha$. Two days later, $Tr_1$ cows received another injection of 10 g GnRH and timed AI 16-20 h later. Control cows received only 25 mg PGF2$\alpha$ $58{\pm}3d\;pp$. $Tr_2$ and control cows were AI at detected estrus. Serum progesterone for all cows was determined on days of injection, AI and 21, 23 and 28 d postinsemination. Pregnancy rates from first AI based on serum P4 concentrations on d 21, 23 and 28 postinsemination (50, 40 and 35%) and that based on rectal palpation 40-45 d postinsemination (30, 15 and 15% for $Tr_1$, $Tr_2$ and control cows, respectively) did not differ among the three groups. Whereas, pregnancy rate at 120 d pp for $Tr_1$ (65%) was higher (p<0.05) than that in $Tr_2$ (30%) or control (30%). The overall pregnancy rate was not significantly different (90, 90 and 75% for $Tr_1$, $Tr_2$ and control, respectively). Days open for cows in $Tr_1$ ($100.3{\pm}9$) was less (p<0.03) than that in $Tr_2$ ($130.9{\pm}9$) or control ($135.1{\pm}10$). Results indicate that using PRID device with Ovsynch program had significantly increased pregnancy rate and decreased days open compared to AI at detected estrus after synchronization with GnRH, PRID and PGF2$\alpha$ or synchronization with one injection of PGF2$\alpha$.

• Clinical and Experimental Reproductive Medicine
• /
• 제20권1호
• /
• pp.37-43
• /
• 1993

In 27 patients with the past history of poor response to the gonadotropin superovulation induction due to poor follicular growth or permature surge of endogenous luteinizing hormone, the effectiveness of pituitary supperssion with the gonadotropin releasing hormone agonist(GnRH-a) in in vitro fertilization(IVF) program was evaluated in 43 cycles using a combination regimen of D-Trp-6 LHRH(Decapeptyl, Ferring)and FSH/hMG from June, 1989 to August, 1990 at Korea University Hospital IVF Clinic. At midluteal phase of menstrual cycle, Decapeptyl-CR was administered by long-term protocol to minimize initial agonistic effect of endogenous gonadotropins. After the confirmation of pituitary suppression, about 2-3 weeks after GNRH-a administration, ovarian follicle growth was stimulated with FSH/hMG and followed by transvaginal ultrasonic measurement of follicle size and by monitoring of serm E2 and LH if necessary. When compared with the control group stimulated with gonadotropin regimen only, the cancellation rate and occurrence rate of premature LH surge during gonadotropin treatment were significantly lower in study group(11.6% and 2.4%, respectively). There is no significant differences in the mean number of aspirated oocytes, fertilization/cleavage rate, embryo transfer(ET) rate, and mean number of embryos transferred between the two groups. The pregnancy rate per treatment cycle, 16.3%, and per ET cycle, 23.3%, were significantly higher in the study group compared with those of control group. These data suggest that GnRH-a therapy is effective for previous poor responder In gonadotropin superovulation induction for IVF.

• Clinical and Experimental Pediatrics
• /
• 제50권2호
• /
• pp.198-204
• /
• 2007

목 적: 성조숙증에서 관찰된 최근의 연구 결과를 보면 사춘기 발육이 빠른 당시에는 신장이 커보일 수 있으나 결국 최종성인신장은 감소하게 된다. 이에 사춘기를 중단시킴으로써 최종 성인신장을 증가시킬 수 있을 것이라는 기대로 성선자극호르몬 방출호르몬 효능약제를 사용하여 골성숙의 기간을 연장하고자 하였다. 또한 조기 사춘기로 인하여 최종성인신장의 예후가 불량한 소아에서 성선자극호르몬 방출호르몬 효능약제 및 성장호르몬의 병합요법 효과를 성선자극호르몬 방출호르몬 효능약제 단독 사용 시의 효과와 비교하여 각각의 성장 촉진 효과를 알아보고자 하였다. 방 법: 역연령에 비하여 골연령이 증가되어 있으며 조기 사춘기를 보이는 여아를 대상으로 GnRHa 및 성장호르몬을 단기간 투여하였다. 제 1군은 triptorelin을 단독으로 4주에 한 번씩 근육주사하였고, 제 2군은 성장호르몬을 병합하여 치료하였다. 치료 기간은 약 1년이었으며 치료 시작시와 치료 후의 두 군간의 역연령, 골연령, 역연령과 골연령의 차이, 예측성인신장, 표적키, 표적키와 예측성인신장과의 차이, 혈청 IGF-1 및 IGFBP-3치를 비교하였다. 결 과: 치료 시작시 두 군 간의 골연령, 표적키, 예측성인신장, 예측성인신장과 표적키의 차이는 없었으나 골연령과 역연령의 차이 및 역연령은 유의한 차이를 보였다. 혈청 IGF-1 및 IGFBP-3값의 차이는 없었고 평균 치료기간은 $1.06{\pm}0.93$년이었다. 치료 후의 골연령과 역연령의 차이는 전체적으로 감소하였으며 두 군간에도 유의한 차이를 보였다. 치료 후의 예측성인신장은 치료전과 비교했을 때 모두 증가하여 단기간의 치료에도 효과가 있었으며 두 군 모두 의미 있는 값을 가지나 특히 성장호르몬을 같이 사용한 2군에서 더욱 큰 차이를 보여 병합요법의 성장촉진효과를 알 수 있었다. 표적키와 예측성인신장의 차이는 전체적으로 치료전보다 의미 있는 감소를 보였으며 두 군을 비교했을때 역시 2군에서 더욱 의미 있게 감소하였다. 혈청 IGF-1과 IGFBP-3는 GnRHa 사용 후에 성장호르몬-IGF 축이 억제되어 1군에서 모두 감소하였으나 성장호르몬을 병합한 2군에서는 모두 증가하였고 이때 통계적인 의미는 없었다. 결 론: 조기 사춘기로 인하여 역연령에 비해 골연령이 증가함으로써 성인신장에 나쁜 영향을 끼치는 경우에는 단기간의 GnRHa의 사용으로 사춘기의 빠른 진행을 억제하고 골성숙의 기간을 연장시킴으로써 예측성인신장을 증가시킬 수 있다. 또한 성장호르몬 병합요법으로 예측성인신장이 표적키에 도달하는데 있어 GnRHa 만으로 성장호르몬-IGF 축이 억제된 경우보다 성장촉진 효과를 나타낸다. 그러나 이는 단기간 사용 시의 치료효과이므로 최종성인신장의 비교를 위해서는 향후 장기적인 추적관찰이 필요하다.