• 제목/요약/키워드: Ovulatory induction

검색결과 14건 처리시간 0.024초

초음파를 이용한 배란의 연속관찰 (Consecutive Scanning of Ovulation Via Transvaginal Sonography)

  • 강윤철;김동석;이우호;박준영;오혜련;박영선
    • Clinical and Experimental Reproductive Medicine
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    • 제20권2호
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    • pp.131-135
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    • 1993
  • The ultrasonographic examination with vaginal probe(5MHz) was undertaken in 101 patients at infertility clinic of Eul-Ji General Hospital. This study was performed to evaluate the number of mature follicles per menstrual cycle, the relationship of both ovaries for consecutive ovulatory cycle and the responsiveness of follicular growth followed by administration of ovulation inductant. The results were as follows; 1. The ovulation induction group with clomiphene citrate showed more follicles than natural menstrual cycle group. 2. Each means of numbers of follicles between ovaries showed no difference between natural and ovulatory induction groups. 3. The rate of follicular growth per one menstrual cycle showed higher in the clomiphene citrate induced cycle group. 4. Clomiphene citrate induced group tends to be easier for multiple follicular growth but had no significant difference in statistics. 5. The ipsilateral Vs. contralateral follicular growth rate for consecutive menstrual cycles in both ovaries showed no significant difference between two groups.

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클로미펜에 부적절한 반응을 보이는 다낭성 난소 증후군 환자에서 Aromatase Inhibitor의 유용성 (Effect of Aromatase Inhibitor (AI) in Polycystic Ovary Syndrome Patients with an Inadequate Response to Clomiphene Citrate)

  • 김혜옥;양광문;허걸;박찬우;차선화;김해숙;김진영;송인옥;궁미경
    • Clinical and Experimental Reproductive Medicine
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    • 제32권1호
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    • pp.27-32
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    • 2005
  • Objective: To evaluate the effectiveness of aromatase inhibitor (AI) for ovulation induction in polycystic ovary syndrome (PCOS) patients with thin endometrium, hyper-responsiveness after clomiphene citrate (CC) treatment. Material and Methods: A prospective study was performed in 43 PCOS patients (50 cycles) with ovulatory dysfunction between March 2004 and September 2004. AI group (total 36 cycles) included the patients 1) with thin endometrium below 6 mm on hCG day after CC (n=17), 2) with more than 5 ovulatory follicles after 50mg of CC (n=4), 3) who do not want multiple pregnancy (n=14). Patients were treated with Letrozole 2.5mg for days 3 to 7 of the menstrual cycle. CC group (total 14 cycles) were treated with CC 50~100 mg. Results: In PCOS patients, ovulation was occurred 97.2% after AI use. Between AI group and CC group, there was no significant difference in the mean age, duration of infertility, interval of menstruation, basal FSH, prior treatment cycles, and the day of hCG administration. But, the number of mature follicles (${\geq}15mm$) was lower in the AI group ($1.08{\pm}0.45$ vs. $1.64{\pm}0.75$) (p=0.018), and the thickness of endometrium (mm) was significantly thicker in the AI group ($10.35{\pm}1.74$ vs. $9.23{\pm}1.61$) (p=0.044), and E2 (pg/ml) concentration on hCG day was lower in the AI group ($116.9{\pm}75.8$ vs. $479.5{\pm}300.8$) (p=0.001). Among the AI group, patients with prior thin endometrium (below 6 mm) during CC treatment showed $10.6{\pm}1.6mm$ in the endometrial thickness and $106.6{\pm}66.8pg/ml$ in $E_2$ concentration. Patients with more than 5 ovulatory follicles after CC showed decreased follicle number ($1.25{\pm}0.5$) compared to prior CC cycle. Conclusions: In PCOS patients, AI group showed significantly thicker endometrium, lesser number of mature follicles, and lower E2 concentration on hCG day than CC group. AI might be useful alternative treatment for ovulation induction in PCOS patients with thin endometrium and hyper-responsiveness after CC treatment.

Clomiphene Citrate를 이용한 배란유도에 관한 연구 (Induction of Ovulation with Clomiphene Citrate)

  • 문신용;윤병구;윤보현;김정구;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제12권2호
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    • pp.15-23
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    • 1985
  • Therapy for anovulation represents one of the more gratifying and successful type of infertility management. Despite the introduction of bromocriptine, human menopausal gonadotropin (HMG), and gonadotropin releasing hormone (GnRH), clomiphene citrate remains the mainstay of ovulation induction therapy. There is wide variability in reported rates of ovulation induction (57-91%) and conception (25-43%) following clomiphene therapy. Factors contributing to this variability among different reports are the differences in dosage and duration of therapy, different criteria utilized in selecting patients for clomiphene therapy and different luteal phase parameters of presumptive ovulation. A review of recent experience with clomiphene citrate in the Department of Obstetrics and Gynecology in Seoul National University from January, 1983 to May, 1985 yields the following conclusions: 1. Ovulation rate per total patients treated was, 69.0% 2. Pregnancy rate per total patients treated was 31.7%, and that per total patients ovulated was 45.9%. 3. Ovulation rate at the dosage level up to 150 mg/day (50.3-53.8%) was somewhat higher than that at 200 mg/day or more (33.3-34.6%), and pregnancy rate per total patients treated was comparable at each dosage level. 4. Ovulation rate per total patients ovulated at each dosage level, where ovulation and conception occurred, showed a decreasing tendency as the dosage increased, but pregnancy rate per total patients conceived was comparable except at 200 mg/day. 5. Cumulative pregnancy rate per total patients conceived in each ovulatory cycle was 68.9% in 3 cycles, 88.9% in 4 cycles, and 100% in 6 cycles.

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인공수정 시술시 저용량 FSH(Low-dose FSH) 용법의 임상적 효용성에 관한 연구 (The Clinical Efficacy of the Low-dose FSH Regimen for Intrauterine Insemination)

  • 한명석
    • Clinical and Experimental Reproductive Medicine
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    • 제28권1호
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    • pp.47-53
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    • 2001
  • Objective: This study is to investigate the clinical efficacy of low-dose FSH regimen, comparing with clomiphene citrate and human menopausal gonadotropin (CC/hMG) regimen. Methods: Retrospective study of the ovulatory factor infertility 39 patients who had been treated by intrauterine insemination (IUI). The 31 cycles of 21 patients were stimulated by CC/hMG regimen, the 22 cycles of 18 patients were stimulated by low-dose FSH regimen. We compared the rate of clinical pregnancy, multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) of both group. Results: The rate of clinical pregnancy of the CC/hMG group was 25.7% per cycle, and that of the low-dose FSH group was 54.5% per cycle. The low-dose FSH group showed a higher rate of clinical pregnancy per cycle than CC/hMG group (p=0.028). However, no differences was found statistically in the rate of multiple pregnancy and OHSS between CC/hMG group (22.2%, 5.7%) and low-dose FSH group (33.3%, 13.6%). Conclusion: This study showed that the low-dose FSH regimen is superior to CC/hMG regimen in getting clinical pregnancy, but dose not reduce the ovulation induction complications.

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한국인 조기난소부전 여성의 배란양상 (Pattern of Ovulation in Korean Women with Premature Ovarian Failure)

  • 김혜민;김재령;최은주;박은주;홍서유;이진용;박원일
    • Clinical and Experimental Reproductive Medicine
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    • 제35권3호
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    • pp.231-238
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    • 2008
  • 목 적: 조기난소부전 환자의 10$\sim$20%에서 난소기능이 회복될 수 있다고 하며 간헐적으로 배란이 되고 심지어는 임신이 가능할 수 있다는 보고가 있다. 그러나 한국의 조기난소부전 여성의 임상적 특징과 배란가능성은 논의된 적이 없다. 이 연구의 목적은 한국인 조기난소부전 환자에서 자연 난포의 발생 빈도와 배란유도의 가능성을 평가하는 것이다. 연구방법: 특발성 조기난소부전으로 진단된 15명 여성의 전체 진료기록을 후향적으로 연구하였다. 환자별로 6번 이상의 초음파 검사를 시행하였고 36개월 이상의 기간 동안 추적관찰을 하였다. 또한 4명의 환자에서 6주기의 배란유도시도를 하였다. 조사항목은 초음파 검사에서 난포의 발견율, 자연 난포 성장률과 배란유도를 시행한 경우에 그 반응을 평가하여 결과를 분석하였다. 결 과: 15명 중 6명은 초음파상 난포가 발견되었나 (40%) 초음파 검사 당 난포 발견 빈도는 7%였다 (115회 중 8회). 6명 중 한 명은 초음파 추적관찰 상 배란이 확인되었고 나머지 5명은 크기에 변화가 없었다. 배란유도를 시도한 6명 중 성공적인 난포 성장이 관찰된 예는 없었다. 결 론: 한국인 조기난소부전 환자에서 난포의 발견율은 이전 서양 연구에 비하여 낮다고 생각되지만 관찰 방법에 차이가 있어 직접비교는 불가능하다. 배란유도의 성공율은 0%로서 이전 연구에서 발표된 수준보다 낮았다.

Effect of Recombinant Human FSH on Ovulation, Pregnancy and In Vitro Fertilization in Androgen-Sterilized Mice

  • Koh, Sang-Bum;Seo, Kwang-Suk;Kim, Seung-Chul;Ahn, Byoung-Ok;Kim, Won-Bae;Lee, Sung-Hee
    • Archives of Pharmacal Research
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    • 제25권3호
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    • pp.357-363
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    • 2002
  • The effect of a new rhFSH, PG-0801, on oocyte quality, ovulation and in vitro fertilization (IVF) was examined in androgen-sterilized mice. Experimental sterility was induced by a single subcutaneous injection of testosterone propionate (TP, 1 mg/head) into 5 day old female mice. Ovulation was generated in the 10 to 13-week old TP-injected mice by a subcutaneous rhFSH injection (1, 5 or 10 IU/head) followed 48 hours later by a second rhFSH injection (1, 5 or 10 IU/head). For comparison, a subcutaneous PMSG (5 IU/head) injection was used for folliculogenesis and a hCG (5 IU/head) injection was used for ovulation. These were administered using the same protocol. The eggs were harvested from the oviducts and counted 17 to 20 hours after the second injection. IVF was performed by adding sperms ($2{\times}10^{5}/ml{\;}to{\;}2{\times}10^{6}/ml$) to determine the functional activity of the eggs, and the fertilization rate was measured. In addition, the pregnancy rate and fetal development were examined after 15-17 days of gestation. The number of oocytes recovered from the rhFSH/rhFSH group increased dose-dependently and was slightly higher than that of the PMSG/hCG group. The pregnancy rates of the group receiving 1, 5, and 10 IU of rhFSH/rhFSH were 50%, 66.7%, and 75%, respectively, which were significantly higher than that of the control (untreated) group (0%). The numbers of viable fetuses in the 1, 5, and 10 IU/head of the rhFSH/rhFSH group ($8.0{\pm}1.50$, $8.9{\pm}1.02$, and $8.9{\pm}1.12$ fetuses/dam, respectively) were comparable to that of the 5 IU/head PMSG/hCG group ($9.4{\pm}0.94$). The mice receiving rhFSH/rhFSH and PMSG/hCG showed similar fertilization rates (around 65%) via the IVF procedure. These results demonstrate that a new rhFSH, PG-0801, may be useful for inducing ovulation in functionally infertile patients and for superovulation in ovulatory patients participating in assisted reproductive technology (ART) programs.

다낭성난소증후군 환자들에서 Clomiphene Citrate에 대한 난소 반응의 예측 인자들에 관한 연구 (Prognostic Factors of Ovarian Response to Clomiphene Citrate in Patients with Polycystic Ovarian Syndrome)

  • 김대진;채희동;손철;김정훈;강병문;장윤석;목정은
    • Clinical and Experimental Reproductive Medicine
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    • 제25권2호
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    • pp.141-151
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    • 1998
  • Objectives: To determine whether the body weight, body mass index (BMI), and basal serum level of LH, FSH, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) are related to the ovarian response to clomiphene citrate (CC) in patients with polycystic ovarian syndrome (PCOS). Materials and Method: From January 1996 to June 1997, total 57 patients with PCOS were enrolled in the present study. Women who had other infertility factors were excluded from our study. The ovulation induction using CC was used in all patients. The patients were grouped into 50 mg group, 100 mg group, and 150 mg group according to their daily CC dose. The patients were also grouped to ovulatory and non-ovulatory group. The body weight, BMI, and basal serum level of LH, FSH, T, DHEA-S were measured in all patients on the 2nd or 3rd day of the menstrual cycle. Results were analysed with Student's t-test and Fisher's exact test. Results: The body weight and BMI of the nonovulating group were significantly higher than those of the ovulating group in all groups (50, 100, 150 mg of CC). However, there were no significant differences of the level of LH and FSH between ovulating and nonovulating groups in all CC groups (50, 100, 150 mg). The level of T of nonovulating group was significantly higher in 50 and 100 mg of CC groups, but not in 150 mg group. The level of DHEA-S of the non-ovulating group is significantly higher in 50 mg group, but not in 100 and 150 mg groups. Conclusion: The body weight and BMI could be useful predictors of ovarian response to CC in patients with PCOS, and basal T and DHEA-S also might be useful in cases of low-dose CC treatment.

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배란유도주기에서 배란예측지표로서 자궁경관점액의 관강화(Canalization) 현상의 의의 (The Meaning of Canalization of Human Cervical Mucus as an Ovulation Marker in the Induced Ovulatory Menstrual Cycles)

  • 심현남;서병희;이재현
    • Clinical and Experimental Reproductive Medicine
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    • 제14권1호
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    • pp.19-28
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    • 1987
  • 35 patients of normal reproductive age group (22-37 yrs) were selected for ovulation induction using $Clomid^{(R)}$ and HMG. Correlation between canalization of cervical mucus and estradiol level in plasma. morphological ovarian follicular change by ultrasonogram, Ferning and Spinnbarkeit were studied in the induced ovulatory menstrual cycles. By retrospective analysis, the results were following; 1. Canalization appeared on the eighth day of the menstrual cycle in $Clomid^{(R)}$ group, and seventh day of HMG group. And the number of the channels increased gradually until the ovulation time. 2. The mean number of channels increased from 12${\pm}$12 in $Clomid^{(R)}$ group, 19${\pm}$14 in HMG group (Day-6) to a maximum of 46${\pm}$22 in $Clomid^{(R)}$ group (Day-1). 3. The maximum plasma estradiol(E2) level was 812${\pm}$722pg/ml in $Clomid^{(R)}$ group (Day-1), 1792${\pm}$504 pg/ml in HMG group (Day-1), and there was a good statistical correlation between the number of channels and the plasma E2 level. 4. The maximal follicular diameter was 19.4${\pm}$6.7 mm in $Clomid^{(R)}$ Group (Day-1) 19.3${\pm}$4.6mm in HMG group (Day-1) and after than decreased. There was a good statistical correlation between the number of channels and the follicular diameter. 5. When grade of ferning was I, the number of channels were 19.4${\pm}$6.7 in $Clomid^{(R)}$ group, 38${\pm}$26 in HMG group. When grade of ferning was III, the number of channels were 54${\pm}$30 in $Clomid^{(R)}$ group, 71${\pm}$36 in HMG group. 6. The maximum score of Spinnbarkeit was 2.6${\pm}$0.5 in Clomid group (Day-0), 2.6${\pm}$0.5 in HMG group (Day-2). In conclusion, the phenomenon of cervical mucus canalization showed the value of the clinical use as an ovulatin marker.

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The Estrous Cycle and Induction of Ovulation in Mares

  • Yoon, Min-Jung
    • Journal of Animal Science and Technology
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    • 제54권3호
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    • pp.165-174
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    • 2012
  • For horse breeders or managers, it is critical to understand the estrous cycle of mares. Breeding of mares cannot be successfully achieved throughout the whole year as mares breed seasonally. Mares are only able to breed when day length is more than 16 h, and this period is known as the breeding season. Their estrous cycle is approximately 21 days with 5-7 days of estrus and 14 to 15 days of a diestrus period. The estrous cycle of the mare is mainly controlled by gonadotropins, which control follicular development and ovulation. Mares exhibit unique ovulatory events which are not observed in other species. A LH surge occurs for several days, with levels of LH reaching their peak after ovulation. The LH level at the time of LH peak is lower than most other species. The unique anatomical structure of the ovaries of mares is known to limit the number of eggs ovulated. Several attempts have been made to develop chemical/hormonal agents which might be used to manipulate the timed ovulation of mares. Agents that have been tested include hCG, native GnRH, Deslorelin (Ovuplant, GnRH-agonist), Buserelin (GnRH analogue), equine pituitary extracts and equine chorionic gonadotropin (eCG or PMSG). However, the function, purity or stability of these agents is not reliable. Recombinant equine LH, an alternative agent for the timed ovulation, has been developed and tested for its biological activities, through the use of both in vitro and in vivo experiments. The reLH was suggested to be a reliable agent in inducing ovulation within 48 h after being administered through injection, when the size of dominant follicle is 35 mm in diameter.

Immobilization stress increased cytochrome P450 1A2 (CYP1A2) expression in the ovary of rat

  • Hwang, Jong-Chan;Kim, Hwan-Deuk;Park, Byung-Joon;Jeon, Ryoung-Hoon;Baek, Su-Min;Lee, Seoung-Woo;Jang, Min;Bae, Seul-Gi;Yun, Sung-Ho;Park, Jin-Kyu;Kwon, Young-Sam;Kim, Seung-Joon;Lee, Won-Jae
    • 한국동물생명공학회지
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    • 제36권1호
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    • pp.9-16
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    • 2021
  • Under the stressed condition, a complex feedback mechanism for stress is activated to maintain homeostasis of the body and secretes several stress hormones. But these stress hormones impair synthesis and secretion of the reproductive hormones, followed by suppression of ovarian function. Cytochrome P450 1A2 (CYP1A2) plays a major role in metabolizing exogenous substances and endogenous hormones, and its expression is recently identified at not only the liver but also several organs with respect to the pancreas, lung and ovary. Although the expression of CYP1A2 can be also affected by several factors, understanding for the changed pattern of the ovarian CYP1A2 expression upon stress induction is still limited. Therefore, CYP1A2 expression in the ovaries from immobilization stress-induced rats were assessed in the present study. The stress-induced rats in the present study exhibited the physiological changes in terms of increased stress hormone level and decreased body weight gains. Under immunohistological observation, the ovarian CYP1A2 expression in both control and the stressed ovary was localized in the antral to pre-ovulatory follicles. However, its expression level was significantly (p < 0.01) higher in the stress-induced group than control group. In addition, stress-induced group presented more abundant CYP1A2-positive follicles (%) than control group. Since expression of the ovarian CYP1A2 was highly related with follicle atresia, increased expression of CYP1A2 in the stressed ovary might be associated with changes of the ovarian follicular dynamics due to stress induction. We hope that these findings have important implications in the fields of the reproductive biology.