• Clinical and Experimental Reproductive Medicine
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• v.20 no.2
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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.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.1
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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.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.2
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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.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.1
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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.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.3
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• pp.231-238
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• 2008

Objective: Significant portion of premature ovarian failure patients ovulate intermittently and even can achieve pregnancy. The clinical features and reproductive potentials of Korean women with premature ovarian failure have never been elucidated. The purpose of this study is to assess ovarian follicular growth and ovulatory potential. Methods: Complete medical records of fifteen women with idiopathic premature ovarian failure were reviewed retrospectively. Subjects with more than 6 ultrasonographic scans and 36 months of follow-up period were included. Once the ovarian follicle was found by ultrasonography, the follicular growth was serially monitored. The result of ovulation induction of 6 cycles in 4 patients were also evaluated. Rate of positive ovarian follicle by ultrasound, rate of natural follicular growth and response of ovulation induction were assessed. Results: Among the 15 patients, 6 women (40%) had ovarian follicle in random ultrasonography. But the chance of positive follicle per ultrasonography scan was 7% (8 out of 115 scans). One out of 6 women eventually ovulated during the follow-up scan. In remaining 5 subjects, size of follicles remained unchanged. None of 6 ovulation induction cycles resulted successful ovulation. Conclusion: Incidence of positive ovarian follicle in Korean premature ovarian failure patients is lower than that of Western counterpart. This result, however, could not be directly compared because of the differences of study design. The ovulation rate by medical ovulation induction in this group is 0%, which is worse than the reported success rate of Western studies.

• Archives of Pharmacal Research
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• v.25 no.3
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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.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.2
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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.

• Clinical and Experimental Reproductive Medicine
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• v.14 no.1
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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.

• Journal of Animal Science and Technology
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• v.54 no.3
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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.

• Journal of Animal Reproduction and Biotechnology
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• v.36 no.1
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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.