• Clinical and Experimental Reproductive Medicine
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• 제14권2호
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• pp.109-118
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• 1987

Ninety-one patients with irreparable tubal disease underwent in Vitro Fertilization-Embryo Transfer (IVF-ET) in Seoul National University Hospital. Ovulation was stimulated in 104 cycles by human menopausal gonadotropin (HMG) or follicular stimulating hormone (FSH)/human chorionic gonadotropin (HCG). The patients were classified as high (>900 pg/ml), intermediate (400-900 pg/ml), or low (<400pg/ml) responder according to preovulatory $E_2$ response and four $E_2$ patterns were found. The overall pregnancy rate per cycle in this consecutive series was 11.5% (n=12). The number of preovulatory oocytes per cycle was higher significantly in intermediate and high responder group than in low responder group (P<0.01), While the number of immature oocytes per cycle significantly higher in low responder group than high and intermediate responder group (P<0.01). The pregnancy rate in each responder group was not signigicant. According to the $E_2$ pattern of response, there was no significant difference in number of the immature and preovulatory oocytes recovery per cycle. There was a apparently direct relationship between the preovulatory $E_2$ pattern and pre gnancy rate was noted.

• 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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• 제44권2호
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• pp.63-72
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• 2017

Objective: Hyperstimulation methods are broadly used for in vitro fertilization (IVF) in patients with infertility; however, the side effects associated with these therapies, such as ovarian hyperstimulation syndrome (OHSS), have not been well studied. N-glycoproteomes are subproteomes used for the remote sensing of ovarian stimulation in follicular growth. Glycoproteomic variation in human follicular fluid (hFF) has not been evaluated. In this study, we aimed to identify and quantify the glycoproteomes and N-glycoproteins (N-GPs) in natural and stimulated hFF using label-free nano-liquid chromatography/electrospray ionization-quad time-of-flight mass spectrometry. Methods: For profiling of the total proteome and glycoproteome, pooled protein samples from natural and stimulated hFF samples were selectively isolated using hydrazide chemistry to obtain the total proteomes and glycoproteomes. N-GPs were validated by the consensus sequence N-X-S/T (92.2% specificity for the N-glycomotif at p<0.05). All data were compared between natural versus hyperstimulated hFF samples. Results: We detected 41 and 44 N-GPs in the natural and stimulated hFF samples, respectively. Importantly, we identified 11 N-GPs with greater than two-fold upregulation in stimulated hFF samples compared to natural hFF samples. We also validated the novel N-GPs thyroxine-binding globulin, vitamin D-binding protein, and complement proteins C3 and C9. Conclusion: We identified and classified N-GPs in hFF to improve our understanding of follicular physiology in patients requiring assisted reproduction. Our results provided important insights into the prevention of hyperstimulation side effects, such as OHSS.

• Clinical and Experimental Reproductive Medicine
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• 제35권4호
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• pp.309-317
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• 2008

목 적: 체외수정을 위한 과배란유도 시 난소 반응성의 예측 인자로서 항뮬러리안 호르몬 (AMH)의 효용성을 FSH와 비교하여 알아보고, 체외수정 결과와의 관계도 알아보고자 하였다. 연구방법: 2007년 1월부터 2007년 8월까지 단기 요법이나 GnRH antagonist 요법을 이용하여 체외수정을 시행하는 111명을 대상으로, 생리주기 3일째 혈중 AMH 및 FSH를 전향적으로 측정하였다. 과배란유도 후 채취된 난자 개수와 AMH 또는 FSH의 상관관계를 분석하였고, 채취된 난자 수 및 AMH 수치에 따라 과배란유도 결과와 체외수정 결과를 비교하였다. 저반응군 및 과반응군의 예측을 위한 AMH의 임계치를 알아보기 위해 ROC curve 분석을 시행하였다. 결 과: AMH는 채취된 성숙 난자 수와 밀접한 양의 상관관계를 나타냈으며 (r=0.792, p<0.001), FSH (r=-0.477, p<0.001) 보다 더 높은 상관관계를 보였다. 난소 반응성에 따라 저반응군 (성숙난자수 ${\leq}2$), 정상반응군 ($3{\sim}16$), 과반응군 (${\geq}17$)으로 나누어 AMH와 FSH 수치는 유의한 차이를 보였으며, 저반응군 (채취된 성숙 난자 수${\leq}2$) 및 과반응군 (채취된 성숙 난자 수${\geq}17$)을 예측하는데 ROC curve 상 AMH의 임계치는 각각 <0.50 ng/ml (sensitivity 88.9%, specificity 89.5%), 및 ${\geq}2.60\;ng/ml$ ((sensitivity 85.7%, specificity 87.0%)였다. AMH level에 따라 low AMH group (${\leq}0.60\;ng/ml$), normal AMH group ($0.60{\sim}2.60\;ng/ml$), high AMH group으로 구분하여, 각 군간 채취된 성숙 난자 수와 ($2.7{\pm}2.2$, $8.1{\pm}4.8$, $16.5{\pm}5.7$, p<0.001), 투여된 성선자극호르몬제의 용량에 ($3530.5{\pm}1251.0$, $2957.1{\pm}1057.6$, $2219.2{\pm}751.9\;IU$, p<0.001) 유의한 차이를 보였다. 성숙 난자의 비율과 수정율에 유의한 차이는 없었으며 임신율도 23.8%, 34.0%, 37.5%로 각 군간 유의한 차이는 없었다. 결 론: 혈중 기저 AMH는 과배란유도 시 채취되는 성숙 난자 수와 높은 상관관계가 있어 난소 반응성의 예측 인자로서 유용할 것으로 생각된다. AMH 수치에 따라 체외수정 결과에는 차이가 없었으나, 저반응군 및 과반응군의 예측에 유용하여 체외수정 시 주기의 취소나, 환자별 적정 용량의 결정 및 난소과자극 증후군의 위험을 감소시키는데 도움이 될 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제29권4호
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• pp.229-236
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• 2002

Objective : The purpose of this study was to evaluate the effect of Cytochalasin B (CCB) on the cytoskeletal stability of mouse oocyte frozen by vitrification. Methods : Mouse oocytes retrieved from cycle stimulated by PMSG and hCG were treated by CCB and then vitrified in EFS-30. These oocytes were placed onto an EM grid and submerged immediately in liquid nitrogen. Thawing of the oocytes was carried out at room temperature for 5 seconds, then the EM grid was placed into 0.75 M, 0.5 M and 0.25 M sucrose at $37^{circ}C$ for 3 minutes, each. These oocytes were fixed in 4% formaldehyde for an hour and then washed in PPB for 15 minutes 3 times, then incubated in PPB containing anti-tubulin monoclonal antibody at $4^{circ}C$ overnight. And then, the oocytes were incubated with FITC-conjugated anti-mouse IgG and propidium iodide (PI) for 45 minutes. Pattern of microtubules and microfilaments of oocytes were evaluated with a confocal microscope. Results: The rate of oocytes containing normal microtubules and microfilaments was significantly decreased after vitrification. The rate of oocyte containing normal microtubules in CCB treated group was higher than those in non-treated group (53.7% vs. 48.9%), but the difference was not significant. The rate of oocyte containing normal microfilaments in CCB treated group was significantly higher than those in non-treated group (64.5% vs. 38.3%, p<0.05). Conclusion: Microfilaments stability could be improved by CCB treatment prior to vitrification. It is suggested that CCB treatment prior to vitrification improve stability of cytoskeleton and then increase success rate in IVF-ET program using vitrification and thawing oocyte.