• Clinical and Experimental Reproductive Medicine
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• 제17권1호
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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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• 제43권3호
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• pp.174-180
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• 2016

Objective: To investigate psychological distress and fertility quality of life (FertiQoL) in infertile Korean women, and to investigate whether a correlation exists between psychological distress and FertiQoL. Methods: Participants in this study were made up of 141 infertile women and 65 fertile women. We conducted a survey on psychological distress (using the Depression Anxiety Stress Scales [DASS]-42 questionnaire) and administered a FertiQoL questionnaire. The levels of stress hormones (adrenocorticotropic hormone [ACTH] and cortisol) in serum were assessed. Results: The scores for depression ($13.7{\pm}8.4$), anxiety ($10.7{\pm}6.4$), and stress ($18.0{\pm}8.3$) among the infertile women were significantly higher than the scores for depression ($9.4{\pm}7.5$), anxiety ($6.6{\pm}6.0$), and stress ($12.2{\pm}8.3$, p<0.001) among the fertile women. There was no difference in the scores for depression ($13.5{\pm}8.2$, $13.8{\pm}8.6$), anxiety ($10.0{\pm}6.2$, $11.5{\pm}6.6$) and stress ($17.7{\pm}8.4$, $18.4{\pm}8.1$) between younger (${\leq}34$) and older (${\geq}35$) participants. The mind-body (r =-0.495) and emotional (r =-0.590) subscales showed a higher negative correlation with stress compared with other scales of psychological distress. At the same time, the social (r =-0.537) and relational (r =-0.385) subscales showed a higher negative correlation with depression. Levels of cortisol and ACTH in infertile women were $9.1{\mu}g/mL$ and 11.9 pg/mL, respectively, which are within normal ranges. Conclusion: The levels of psychological distress and quality of life in infertile Korean women seem to require psychological intervention. This study provides a baseline measurement of psychological distress and FertiQoL in infertile women in Korea, which will be available for developing psychological interventions for infertile Korean women.

• 생명과학회지
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• 제28권7호
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• pp.811-818
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• 2018

본 연구에서는 암컷 생식기관 내 축적된 수은 화합물의 위치와 시간에 따른 수은의 농도 변화를 확인하기 위하여 수행하였다. Methylmercuric chloride를 일주일에 한 번씩 총 3주간 사춘기 암컷 마우스에 피하 주사하였다. 시간에 따른 수은의 농도 변화를 확인하기 위해 투여 종료 후 10일, 150일, 300일째에 희생하였다. 투여 종료 후 10일에 희생한 경우 체중에 유의한 차이가 있었지만, 그 외 경우에는 체중과 난소의 무게에 있어서 대조군과 수은 투여군 사이에 유의한 차이가 없었다. 축적된 수은의 위치를 오토메탈로그라피 방법으로 확인하였고, 자궁, 난소, 난자에 축적된 수은 화합물의 위치를 광학현미경으로 분석하였다. 자궁의 경우, 투여 종료 후 10일째에 수은이 지질 세포와 자궁바깥막의 중피에 위치하였다. 150일째에는 수은 농도가 감소하였으며 300일째에는 나타나지 않았다. 투여 종료 후 10일째 난소의 경우, 수은이 피질 부위의 지질 세포와, 난포를 둘러싸는 난포막 세포, 황체에 분포하였다. 150일째에는 수은이 난소의 수질 부위에 축적되었으며, 300일째에는 분포하지 않았다. 투여 종료 후 10과 150일째 난자의 경우, 수은이 난자의 주변부에 주로 분포하였으며, 300일째에는 수은 농도가 감소되고 난자 전체에 고르게 분포하였다. 이런 결과는 암컷 마우스에서 수은에 의해 호르몬 생성, 착상, 그리고 발생 중인 배아가 영향을 받을 수 있다는 사실을 제시해 준다.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.65-75
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• 2003

Objectives: To investigate the role of TGF (Transforming growth factor-$\beta$) involved in the paracrinic communication during decidualization between UEC (uterine epithelial cells) and USC (uterine stromal cells), we have employed a co-culture system composed of human endometrial epithelial and stromal cells in defined hormonal conditions. Design: In the co-culture, endometrial epithelial cells cultured in the matrigel-coated cell culture insert are seeded on top of the endometrial stromal cells cultured within a collagen gel. The co-culture was maintained for 48 hours under the following hormonal conditions: progesterone dominant condition (100 nM P4 and 1 nM E2) or estrogen-dominant condition (100 nM E2 and 1 nM P4). 10 ng/ ml HGF and/or 10 ng/ml TGF-$\beta$1 are added. Methods: RT-PCR is utilized to detect mRNAs quantitatively. Enzyme-linked immunosorbent assay (ELISA) and immunohistochemical staining are utilized to detect proteins in the tissue. Results: Prolactin mRNA is expressed in the co-cultured stromal cells under the progesterone dominant condition. TGF-$\beta$1 and its receptors are expressed in both the co-cultured epithelial and stromal cells irrespective of the steroid present, which is in contrast with no or negligible expression of TGF-$\beta$1 or its receptor in cells separately cultured. Both estrogen and progesterone significantly elevate the concentration of hepatocyte growth factor (HGF) in the conditioned medium of the co-culture with the value of 4, 325 pg/ml in E2-dominant and 2, 000 pg/ml in P4-dominant condition compare to 150 pg/ml in no hormone. In separately cultured stromal cells, administration of HGF induces the expression of TGF receptor 1 in both hormonal conditions, but induction of TGF receptor 2 is only manifest in the P4-dominant condition. Administration of TGF-$\beta$ and HGF directly induce the decidualization marker prolactin mRNA in separately cultured stromal cells. Conclusion: It is likely that steroid hormones induces prolactin mRNA indirectly by promoting the cell to cell communication between the stromal and the epithelial cells. TGF-$\beta$ and HGF are two possible paracrine mediators in the human endometrial decidualization.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.47-55
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• 2003

Objectives: Bok, Bcl-2-related ovarian killer, is a proapoptotic Bcl-2 family protein identified in the ovary based on its dimerization with the antiapoptotic protein Mcl-1. The present study examined the hormonal regulation and localization of Bok messenger RNA levels in the mouse ovary during the follicle development. Methods: The animals were implanted subcutaneously with Silastic brand capsules containing the synthetic estrogen, DES at $21{\sim}23$ days of age. Ovaries were collected $1{\sim}3$ days after implantation for RNA analysis and in situ hybridization. Some mice were removed capsule for $1{\sim}2$ days to induce ovarian follicle apoptosis. Ovaries were also collected from 26 day-old immature mice at various times after treatment with 10 IU PMSG. Some mice received a single intraperitoneal injection of 10 IU hCG to induce ovulation, and ovaries were obtained at different time intervals for Northern blot and in situ hybridization analysis, respectively. Results: Treatment of immature mice with diethylstilbestrol (DES) for $24{\sim}48$ h increased ovarian Bok mRNA levels. Bok mRNA was remained the same levels in mice removed DES for $24{\sim}48$ h to induce apoptosis. High signals of Bok mRNA after DES treatment were detected in granulosa cells of early antral follicles. Treatment of immature mice with PMSG for 12 h increased markedly ovarian Bok mRNA expression which was detected mainly in preantral and atretic follicles. Interestingly, low levels of Bok mRNA were also expressed in granulosa cells of preovulatory follicles. Treatment of PMSGprimed mice with hCG stimulated strongly ovarian Bok mRNA expression at $6{\sim}9$ h. At that time, Bok mRNA was expressed in granulosa cells of atretic and small growing follicles. Conclusion: These results demonstrate that Bok is one of proapoptotic Bcl-2 members expressed in early growing and atretic follicles during the ovarian follicular development. Gonadotropins induce a transient increase of Bok gene expression in granulosa cells of preantral and preovulatory follicles indicating some role in the ovulatory process.

• 한국발생생물학회지:발생과생식
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• 제4권1호
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• pp.53-59
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• 2000

내분비계 장애물질은 생체내에서 호르몬 등의 내분비계에 영향을 주기 때문에 미량으로도 생식기능에 이상을 가져 올 수 있고, 급ㆍ만성 독성과는 달리 차세대에 그 영향이 발현될 수 있다. 대부분의 내분비계 장애물질은 에스트로겐 유사물질로 알려져 있으며, 내분비계 장애물질의 하나인 bisphenol A (BPA)도 이러한 성질을 가진 물질이다. 본 연구는 BPA가 생쥐의 정자형성과정에 어떤 영향을 미치는가를 분석하고자, 농도별 (저농도, 20 mg/kg, 고농도 200 mg/kg) 구강투여를 실시하였다. 정자수와 테스토스테론 농도 및 산자수가 대조군에 비해 처리군에서 점진적으로 감소하는 경향을 보였으며, 산자수에서 유의적인 차이(P<0.01)를 나타내었다. 특히 국부적이긴 하지만 세정관 내강에서의 정자세포 소실 양상은 정자수의 감소 원인으로 사료된다. 성성숙 이후 정소에서의 발현이 소실되는 것으로 알려진 TGF-$\beta$계에서는 TGF-$\beta$1이 고농도의 BPA투여시 발현되었지만, 그 외의 리간드와 수용체의 발현은 관찰되지 못했다. 결론적으로 고농도의 BPA노출은 웅성생식계에 영향을 미칠 수 있으며, 이는 정자형성에 장애를 일으켜 불임을 유발할 수도 있을 것으로 보여진다.

• Clinical and Experimental Reproductive Medicine
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• 제28권2호
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• pp.141-145
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• 2001

Objective: We inversigated Small Heterodimer Partner (SHP) gene mutation in Korean Polycystic Ovarian Syndrome (PCOS) patients. SHP protein regulates the activity of nuclear receptors which regulate the cellular development and differentiation. Recently, the mutation of SHP gene was found in the obesity and diabetes patients in Japanese group, and suggested that its mutation may involved in pathogenic mechanism of PCOS. Methods: This study was performed in 20 PCOS patients and 20 normal women. The DNAs were extracted from the peripheral bloods, and amplified at each exon (1 and 2) of SHP gene by PCR method. Subsequently, each PCR product was digested with the restriction enzyme indicated below for studying restriction fragment length polymorphism (RFLP). After enzyme digestion, the results of RFLP were compared PCOS patients with control women to find any sequence variation. Results: We examined 9 regions of exon 1 with Msp I, Pvu II, Dde I and 3 regions of exon 2 with Pst I, Dde I. There is no heterozygous or homozygous mutation in patients and control women at these restriction sites. Conclusion: The genetic analysis at our restriction sites in the SHP gene did not show any genetic variation in Korean PCOS patients. Our PCR-RFLP analysis was not covered the entire SHP gene (68 bp/1,006 bp), we need to further analysis of the entire SHP gene.

• Clinical and Experimental Reproductive Medicine
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• 제16권2호
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• pp.205-210
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• 1989

To investigate the effects of ovarian cysts on the controlled ovarian hyper-stimulation cycles, 16 patients with 16 paired cycles for IVF-ET were analyzed. These patients had taken both type of cycles, i.e., with cyst(cyst group) and without cyst(control group). Mean diameter of ovarian cysts in cyst group was 18.2mm. There were no significant differences in hormone levels in early follicular phase between two groups. No significant differences were found in total dosage of hMG(IU) administered during the ovarian stimulation $843.8{\pm}123.0$ vs $891.0{\pm}129.8$, serum estradiol level (pg/ml) on the day of hCG administration($1542.8{\pm}1100.6$ vs $1567.5{\pm}1193.0$), the number of aspirated follicles $10.0{\pm}3.4$ vs $11.2{\pm}4.3$ and oocytes $5.3{\pm}3.3$ vs $6.2{\pm}3.1$, the fertilization rate(51.2 % vs 57.2 %) and the cleavage rate(40.5 % vs 52.0 %). Serum estradiol terminal patterns during COH in one group tended to be repeated in the other group. In conclusion, this study suggests that small ovarian cysts do not adversely impact on the controlled ovarian hyperstimulation parameters in IVF - ET program and the presence of small ovarian cyst without concomitant high basal serum estradiol level is not an indication of the cancellation of the controlled ovarian hyperstimulation for IVF-ET.

• Clinical and Experimental Reproductive Medicine
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• 제21권1호
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• pp.121-130
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• 1994

Expression of gonadotropin releasing hormone(GnRH) has been described in the rat ovary. It remains, however, unkown whether GnRH is synthesized as a prohormone. Therefore, this study was performed to verify the expression of pro-GnRH by in situ hybridization and further to investigate the effect of gonadotropin on GnRH or GnRH mRNA in rat ovary by immunohistochemical and in situ hybridization techniques. Adult female Sprague-Dawely rats were used and the estrous cycle was synchronized by intraperitoneal injection of pregnant mare's serum gonadotropin(PMSG). Ovaries were fixed with 4% paraformaldehyde and embedded with G.C.T. compound and cut by cryostat. For immunohistochemistry, avidin-biotin peroxidase complex(ABS) method was employed and for in situ hybridization, $^{35}S$-end labeled oligonucleotide was used and followed by autoradiography. By in situ hybridization using GnRH oligomer and GAP(GnRH associated protein) oligomer, GnRH mRNA and GAP mRNA were co-localized in the fullicular cells, luteal cells, interstitial cells and theca cells. GnRH or GnRH mRNA signals in the ovary increased by human chorionic gonadotropin(hCG) injection. At the 3 and 6 hrs after hCG injection, the number of GnRH and GnRH mRNA containing cells increased rapidly and the density of GnRH and GnRH mRHA culminated at 9 hrs after heG injection. With the follicular development, the high expression of GnRH and GnRH mRNA was also observed within the follicles. After ovulation, the density of GnRH or GnRH mRNA decreased in the follicles but increased in the corpus lutea.

• Clinical and Experimental Reproductive Medicine
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• 제21권1호
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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.