• Clinical and Experimental Reproductive Medicine
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• 제44권4호
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• pp.181-186
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• 2017

With advances in the methods of cancer treatment used in modern medicine, the number of breast cancer survivors has been consistently rising. As the number of women who wish to become pregnant after being diagnosed with breast cancer increases, it is necessary to consider fertility preservation in these patients. However, medical doctors may be unaware of the importance of fertility preservation among cancer patients because most patients do not share their concerns about fertility with their doctors. Considering the time spent choosing and undergoing treatment, an early referral to a reproductive specialist is the best way to prevent a delay in cancer treatment. Since it is not easy to make decisions on matters related to cancer diagnosis and fertility, patients should be provided with enough time for decision-making, and to allow for this, an early referral will provide patients with sufficient time to choose an appropriate method of fertility preservation. The currently available options of fertility preservation for patients with breast cancer include cryopreservation of embryos, oocytes, and ovarian tissue and gonadotropin-releasing hormone agonist treatment before and during chemotherapy. An appropriate method of fertility preservation must be selected through consultations between individual patients and health professionals and analyses of the pros and cons of different options.

• 한국가축번식학회지
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• 제19권2호
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• pp.119-127
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• 1995

These studies were carried out to examine the estradiol-17$\beta$ levelsin plasma and ovarian tissues, as well as the contents of collagen and catecholamines in the uterus, and to determine the effects of GnRH administrations of uterine involution in postpartum Korean native goats. Plasma concentrations of estradiol-17$\beta$ were 63.81$\pm$8.00 pg/ml at day 1 of kidding, declined to 36.78$\pm$22.90 ng/ml at day 24 and decreased progressively to 27.81$\pm$17.06 and 12.46$\pm$8.13 pg/ml at days 30 and 36 postpartum, respectively. In ovarian tissues, the concentrations of estaiol-17$\beta$ were increased just before parturition and decreased immediately after parturition. The plasma estradiol-17$\beta$ levels were slightly higher on days 12 and then decreased gradually after parturition. The concentraitons of estradiol-17$\beta$ in the ovaries of postpartum goats were increased at day 36 after treatments with GnRH. The total hydroxyproline contents in the uterus was slightly higher prior to parturition and decreased gradually with the postpartum intervals after parturition. Hydroxyproline concentraitons in the uterus were decreased at days 24 and 36 postpartum after treatments with GnRH. The norepinephrine concentrations in myometrium from the pregnant and postpartum goats were correspondingly low both immediately before and after partuition. Norepinephrine concentrations in the pregnant horn of the uterus were increased from days 12 to 36 of postpartum and those levels of the non-pregnant horn were also increased from days 24 to 36 postpartum. Slightly higher concentrations were present in the non-pregnant horn in comparison to the pregnant horn but these differences were not significant. Postpartum, the uterine norepinephrine concentration was slightly increased at day 36 after treatments with GnRH. Dopamine concentrations were greater than those of norepinephrine. The concentrations of dopamine in the uterus of pregnant goats was not significantly different from that in the postpartum animals. Dopamine concentraitons of pregnant horn in postpartum goats were increased at day 24 after treatments with GnRH.

• Clinical and Experimental Pediatrics
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• 제58권8호
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• pp.294-300
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• 2015

Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.143-151
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• 1997

The present study was designed to investigate if antithyroid antibodies (ATA) could affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization and embryo transfer (IVF-ET). From October 1995 to September 1996, 28 euthyroid women with ATA who underwent IVF-ET were studied. Fifty-one euthyroid women without ATA who underwent IVF-ET served as control. Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were assayed using radio ligand assay kits as ATA. All patients included in study and control groups had only tubal factor in infertility. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. There were no significant differences between study and control groups in patient characteristics such as age, infertility duration and hormonal profile. There were also no significant differences between two groups with respect to the clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transfered. There were no correlations between ATA (TPOA and TGA) titers and fertilization rate. The clinical pregnancy rate per cycle seemed to be lower in the study group than in the control group (26.3% vs 39.3%), but the difference was not statistically significant. The biochemical pregnancy rate per cycle and miscarriage rate were significantly higher in the study group at 18.4% (7/38) and 40.0% (4/10) compared with 5.6% (5/89) and 11.4% (4/35) in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or non-pregnancy group. In 10 women with ATA who achieved pregnancy following IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing or delivery group. In conclusion, euthyroid women with ATA appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.

• 한국발생생물학회지:발생과생식
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• 제17권1호
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• pp.45-53
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• 2013

The action of melatonin within the body of animals is known to be mediated by melatonin receptors. Three different types of melatonin receptors have been identified so far in fish. However, which of these are specifically involved in puberty onset is not known in fish. We cloned and analyzed the sequence of melatonin receptor 1a (mel 1a) gene in Nile tilapia Oreochromis niloticus. In addition, we examined the tissue distribution of gene expressions for three types of receptors, mel 1a, 1b and lc and investigated which of them is involved in the onset of puberty by comparing their expression with that of gonadotropin-releasing hormone receptor I (GnRHr I) gene using quantitative real-time PCR from 1 week post hatch (wph) to 24 wph. The mel 1a gene of Nile tilapia consisted of two exons and one bulky intron between them. Mel 1a gene was found to be highly conserved gene showing high homology with the corresponding genes from different teleost. All three types of melatonin receptor genes were expressed in the brain, eyes and ovary in common. Expression of mel 1a gene was the most abundant and ubiquitous among 3 receptors in the brain, liver, gill, ovary, muscle, eye, heart, intestine, spleen and kidney. Mel 1b and mel 1c genes were, however, expressed in fewer tissues at low level. During the development post hatch, expressions of both mel 1a and GnRHr I genes significantly increased at 13 wph which was close to the putative timing of puberty onset in this species. These results suggest that among three types of receptors mel 1a is most likely associated with the action of melatonin in the onset of puberty in Nile tilapia.

• Clinical and Experimental Reproductive Medicine
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• 제40권2호
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• pp.83-89
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• 2013

Objective: To investigate outcomes of stimulated IVF cycles in which GnRH antagonist was omitted on the ovulation triggering day. Methods: A total of 86 women who underwent controlled ovarian hyperstimulation with recombinant FSH and GnRH antagonist flexible multiple-dose protocols were recruited and prospectively randomized into the conventional group (group A) or cessation group (group B). The GnRH antagonist, 0.25 mg/day of cetrorelix, was started when the leading follicle reached 14 mm in diameter and was continuously administered until the hCG triggering day (group A, 43 cycles) or until the day before hCG administration (group B, 43 cycles). The maturity of oocytes, fertilization rate, embryo quality, and implantation and clinical pregnancy rates were evaluated. Results: The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in group B than group A ($2.5{\pm}0.9$ vs. $3.2{\pm}0.8$ ampoules, p<0.05). There was no premature luteinization in any of the subjects. The proportion of mature oocytes and fertilization rate were not significantly different in group B than group A (70.7% vs. 66.7%; 71.1% vs. 66.4%, respectively). There were no significant differences in the implantation or clinical pregnancy rates. Conclusion: Our prospective randomized study suggested that cessation of GnRH antagonist on the hCG administration day during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising its effects on pregnancy rates.

• 한국동물학회지
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• 제37권2호
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• pp.161-173
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• 1994

면역효소법을 이용하여 3종의 한국산 개구리 참개구리(Rono nigromaculuto), 옴개구리(R. rugosa), 북방산개구리(R. 겨대bowskii)의 뇌에서 GnRH 뉴우런의 분포 부위와 GnRH의 종류 등을 연구하였다. 1차 항체로는 anti-rat GnRH, anti-salmon GnRH anti-chicken 11 GnRH 항체를 사용하였다. 3종의 개구리에서 mGnRH cGnRH 11와 sGnRH가 이둔 동정되었으나 3가지 항체에 대한 각 종의 면역 반응성은 종에 따라 달리 나타났다 mGnRH는 옴개구리와 참개구리에서, sGnRH는 북방산개구리에서 강한 면역 반응을 나타냈으며 cGnRH 11는 3종의 개구리에서 중간 정도의 면역 반응을 나타냈다. 각각의 GnRH의 상대적인 양에는 차이가 있으나 일부 경우를 제외하고는 뇌의 동일한 지역에 분포하였다. 참개구리에서는 GnRH가 중격 내측핵(NMS), Broca band 핵(NDB)에 집단으로 분포하였다. 북방산개구리에서는 GnRH가 중격 내측핵, Broca bnad 핵에서 등쪽에서 배쪽으로 길게 선상으로 가장 협소하게 분포하였으며, 번식기와 직전(1월-3월)에만 면역 반응을 나타냈다. 옴개구리의 뇌에서 가장 광범위한 지역, 즉 종뇌의 중격 내측핵, Broca band 핵, 아래 교차 지역(SCA)과 간뇌에 GnRH 신경세포가 분포하였으며. 제3뇌실 맥락얼기에서 mGnRH 신경세포가 처음으로 동정되었다. 3종에서 공통적으로 중격 내측핵과 Broca band 핵에서 유래한 신경섬유는 복측 시상하부를 거쳐 정중융기에 이르렀다. 이러한 결과는 GnRH가 뇌하수체에서 생식소 자극 호르몬의 분비 조절에 밀접한 관계가 있음을 뜻한다.

• Clinical and Experimental Reproductive Medicine
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• 제26권2호
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• pp.281-285
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• 1999

Kallmann's syndrome has both a general and specific connotation in describing general condition of gonadotropin-releasing hormone (GnRH) deficiency or a particular cluster of anomalies associated with primary eunuchoidism. The familial occurrence of hypogonadotropic hypogonadism associated with anosmia, color blindness, synkinesia, and mental defect is the classic Kallmann's syndrome. Interestingly, anosmia, or lack of smell, was not found in the absence of gonadal deficiency in the original study of this disorder. This disorder was found on both sexes, but the male to female ratio was 11:1, and Kallmann's syndrome is more often listed under disorders of male hypogonadism for this reason. Gross anatomy has shown disorders of the olfactory bulbs associated with Kallmann's syndrome and it was demonstrated a failure of GnRH-containing cells to migrate from the olfactory placode to the hypothalamus and preoptic area. We have experienced a case of Kallmann's syndrome which showed a hypoplasia of olfactory bulb in MRI during the workup of primary amenorrheic patient. So we report this case with a brief review of literatures.

• 대한한방소아과학회지
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• 제31권1호
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• pp.63-73
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• 2017

Objectives The purpose of this study is to analyze recent clinical studies on treatment for precocious puberty. Methods 28 clinical studies from January 2009 to December 2016 about precocious puberty from the China Academic Journal (CAJ), China National Knowledge Infrastructure (CNKI), were selected and reviewed: 22 case control studies and 6 case series. Results The main traditional Chinese medicine (TCM) treatment was the herbal decoctions and granules. The frequently used herbs were root of Bupleurum falcatum (柴胡), fruit of Prunella vulgaris var. aleutica (夏枯草), root stem of Anemarrhena asphodeloides (知母), dried fungus nucleus of Poria cocos (茯苓), Rehmannia glutinosa var. purpurea (生地黃), peony Paeonia suffruticosa Andrews (牧丹皮), bark of Phellodendron amurense (黃柏), roots of a plant Paeoniae lactiflora (白芍藥). On the other hand, the main western medicine (WM) for precocious puberty was Gonadotropin-releasing hormone agonist (GnRHa). Total effective rate of the TCM group was 62.96-100%, that of the WM group was 36.6-93.3% and that of the TCM-WM group was 77.8-93.75%. Conclusions Traditional Chinese medicine has been shown as an effective treatment for precocious puberty. These research results can be utilized in other clinical studies and in treatment of precocious puberty.

• Clinical and Experimental Reproductive Medicine
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• 제24권2호
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• pp.179-185
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• 1997

$23{\sim}40$세 (평균 연령 31.6세)의 자궁내막증 환자35명 (1기 7명, 2기 7명, 3기 14명, 4기 7명)을 대상으로 gonadotropin-releasing hormone agonist (Goserelin) 3.6 mg을 한달 간격으로 6개월 복부의 피하에 이식한 후 자궁내막증에 대한 치료 효과와 부작용을 알아보기 위하여 매달 호르몬 검사와 증상에 대한 설문조사를 시행하였다. 투여 1개월 후 혈청 estradiol농도는 30 pg/mL이었고 이후 치료중 $10{\sim}20$ pg/mL를 유지하였으며 투여를 중간한 1개월 후 50 pg/mL로 증가하였다. 혈청 LH농도는 치료 중 유의하게 감소하였으며 투여를 중단한 후 증가하였다. FSH는 투여 1개월 후 감소하였으나 2개월후부터 계속 치료전과 같은 농도를 유지하였다. 혈청 CA-125치는 19명중 10명에서 치료전에 35 mIU/mL이상으로 증가되었으며 치료 2개월 후부터 모두 정상으로 감소되었다. 월경곤란증은 치료 3개월째 완전히 소실되었고 성교통은 치료가 끝날 때까지 20%의 환자에서 지속되었다. 백혈구수, 혈색소, 전해질, 단백질, 빌리루빈 및 간효소는 치료 중 모두 정상이었다. 혈압과 체중도 치료전, 치료중에 변화가 없었다. 투여후 86%의 환자가 안면홍조를 63%에서 질건조증을 20%가 두통, 우울을 호소하였다. 이와 같은 부작용은 투여를 중단한 1개월 후 모두 소실되었으며 부작용 때문에 투여를 중단한 예는 없었다. 이상의 결과로 GnRH-a는 난소의 estradiol생산을 완벽하게 중단시키고 골반증상을 완하시켜 자궁 내막증 치료에 효과적이라고 사료되며 안면홍조와 같은 부작용의 빈도가 높기 때문에 향후 호르몬 보충요법을 병행하는 것이 바람직 하다고 사료된다.