• 제목/요약/키워드: implantation rate

검색결과 385건 처리시간 0.027초

Cessation of gonadotropin-releasing hormone antagonist on triggering day in flexible multiple-dose protocol: A randomized controlled study

  • Chang, Hye Jin;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Lee, Won Don;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제40권2호
    • /
    • pp.83-89
    • /
    • 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.

Effectiveness of ultra-wide implants in the mandibular and maxillary posterior areas: a 5-year retrospective clinical study

  • So-Yeon Kim;Hyeong-Gi Kim;Pil-Young Yun;Young-Kyun Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제49권1호
    • /
    • pp.13-20
    • /
    • 2023
  • Objectives: Ultra-wide implants may be used as a replacement if existing implants fail. This study was conducted to evaluate the factors influencing the prognosis and failure of ultra-wide implants. Patients and Methods: This study evaluated whether sex, age, site, diameter, length, additional surgery, implant stability (primary and secondary), and reason for ultra-wide implant placement affect the 5-year survival and success rates and marginal bone loss (MBL) of ultra-wide implants. Seventy-eight ultra-wide implants that were placed in 71 patients (39 males and 32 females) from 2008 to 2010 were studied. One-way ANOVA analysis was conducted to evaluate the statistical significance of MBL according to the patient's sex, implant site, and diameter. Independent sample t-tests were used to determine the statistical significance of MBL analysis which was used to determine the significance of the 5-year success and survival rates related to the variables. One-way ANOVA was conducted to evaluate the statistical significance of sex, implantation site, diameter, and MBL. Independent sample t-tests were used to evaluate the correlation between implantability and MBL for implantation reasons, while additional surgery, length, and Kaplan-Meier analysis were used to evaluate 5-year survival and success rates. Results: The mean age of patients was 54.2 years with a survival rate of 92.3% and a success rate of 83.3% over a mean 97.8-month period of observation. MBL averaged 0.2 mm after one year of prosthetic function loading and 0.54 mm at the time of final observation. Success rates correlated with primary stability (P=0.045), survival rates correlated with secondary stability (P=0.036), and MBL did not correlate with any variables. Conclusion: Ultra-wide implants can be used to achieve secure initial fixation in the maxillary and mandibular molar regions with poor bone quality or for alternative purposes in cases of previous implant failure.

동결보존 배아이식에서 분비기 자궁내막 유도시 프로게스테론 투여 방법에 따른 착상율과 임신율의 비교 (Implantation Rate and Clinical Pregnancy Rate According to Dosage and Timing of Progesterone Administration for Secretory Endometrial Preparation in Frozen-Thawed Embryo Transfer Cycles)

  • 박찬우;허걸;김문영;송현정;김혜옥;양광문;김진영;송인옥;유근재;천강우;변혜경;궁미경;강인수
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제30권3호
    • /
    • pp.193-202
    • /
    • 2003
  • Objective: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. Methods: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness $\geq$7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. Results: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. Conclusions: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.

난자공여를 통한 체외수정 시술에서 성선자극호르몬 유리호르몬 효능제 장기요법과 길항제 단기요법 사이의 임상 결과 비교 (The Comparison of Clinical Outcomes between GnRH Agonist Long Protocol and GnRH Antagonist Short Protocol in Oocyte Donation Cycles)

  • 이정호;박준철;김종인
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제30권1호
    • /
    • pp.95-103
    • /
    • 2003
  • Objective : To assess and compare the clinical outcomes between GnRH agonist long protocol and GnRH antagonist short protocol in oocyte donation program. Materials and Methods: Of total 18 oocyte donation cycles, controlled ovarian hyperstimulation (COH) were performed with GnRH agonist long protocol and GnRH antagonist short protocol in initial 9 cycles and later 9 cycles, respectively. Oral estradiol valerate and progesterone in oil we re administrated to all recipients for endometrial preparation. Oral estradiol administration was started from donor cycle day 1 after full shut down of gonadal axis with GnRH agonist in patients with ovarian function. Progesterone was injected from oocyte retrieval day of donor initially, then continuously till pregnancy 12 weeks if pregnancy was ongoing. We compared the parameters of clinical outcomes, such as number of the retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate, COH duration, total gonadotropin dose for COH between GnRH agonist long protocol group and GnRH antagonist group. Statistical analysis was performed using Mann-Whitney test, p<0.05 was considered as statistically significant. Results: The number of retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate were $14.89{\pm}7.83$, 81%, 64%, 78%, 31%, 78%, respectively in GnRHa long protocol group and $11.22{\pm}8.50$, 79%, 64%, 67%, 34%, 56%, respectively in GnRH antagonist group. There was no significant differences in parameters of clinical outcomes between 2 groups (all p value >0.05). Duration and total gonadotropin dose for COH were $10.94{\pm}1.70$ days and $43.78{\pm}6.8$ vials in 18 cycles, $12.00{\pm}1.73$ days and $48.00{\pm}6.93$ vials in agonist group, $9.88{\pm}0.78$ days and $39.55{\pm}3.13$ vials in antagonist group, respectively. In GnRH agonist long protocol group, significantly longer duration and higher gonadotropin dose for COH were needed (p=0.012). Conclusion: In oocyte donation program, clinical outcomes from controlled ovarian hyperstimulation with GnRH antagonist were comparable to those from GnRH agonist long protocol group, so controlled ovarian hyperstimulation with GnRH antagonist may be effective as GnRH agonist long protocol. At least there may not be harmful effects of GnRH antagonist on oocyte development and quality.

용담사간탕(龍膽瀉肝湯)이 Estradiol Valerate로 유발된 흰쥐의 다낭성 난소 발달과 수태에 미치는 영향 (Effects of Yongdamsagan-tang on the Progression of the Estradiol Valerate-induced Polycystic Ovaries and on the Conception in Rats)

  • 이인재;이동녕;서일복;김형준
    • 대한한방부인과학회지
    • /
    • 제24권3호
    • /
    • pp.48-72
    • /
    • 2011
  • Objectives: This study was designed to investigate the effects of Yongdamsagantang on the polycystic ovary(PCO) induced by estradiol valerate(EV) in rats. Methods: After administrating Yongdamsagan-tang to PCO induced rats, we measured the weight of body, ovaries, adrenal glands, and uterus of rats. The observation through naked eye and histopathological observation of ovaries were evaluated. Also, the number of follicle and corpora lutea and content of androstenedione(ADD) and total estrogen were evaluated. The expressions of nerve growth factor(NGF) and corticotropin releasing factor(CRF) were analyzed by immunohistochemistry. The breeding rate and number of implantation with normal male rats were evaluated. Results: - The weight(mg) of ovaries in YST treated group($73.8{\pm}7.6$) was significantly increased(p<0.001) compared with control group($54.3{\pm}4.5$). - The number of mature follicles in YST treated group($7.3{\pm}2.4$) was significantly increased(p<0.01) compared with control group($3.5{\pm}1.2$). - The number of atretic follicles in YST treated group($9.0{\pm}1.5$) was significantly decreased(p<0.01) compared with control group($13.4{\pm}3.8$). - The number of cystic follicles in YST treated group($3.1{\pm}1.1$) was significantly decreased(p<0.01) compared with control group($6.0{\pm}2.0$). - The number of corpora lutea in YST treated group($3.8{\pm}2.1$) was significantly increased(p<0.001) compared with control group($0.3{\pm}0.7$). - The expression of NGF-immunoreactive cells in the ovarian granulosa cells in YST treated group was lesser observed than control group. - The expression of NGF-immunoreactive cells in the adrenal cortex in YST treated group was lesser observed than control group. - The breeding rate in YST treated group(100 %) was significantly increased (p<0.05) compared with control group(50 %). - The number of implantation in YST treated group($6.4{\pm}4.7$) was significantly increased(p<0.05) compared with control group($1.4{\pm}2.6$). Conclusions: We concluded that Yongdamsagan-tang activates the maturation of follicles, normal ovulation, breeding rate and number of implantation. Therefore, this may be effective for the treatment of anovulation, amenorrhea and sterility of PCOS patients.

구강 설 편평 상피 세포암의 임상적, 치료적 고찰 (Clinical and Therapeutic Aspects of Squamous Cell Carcinoma of Oral Tongue)

  • 류삼열;이창걸;박인규;서창옥;김귀언;노준규
    • Radiation Oncology Journal
    • /
    • 제5권2호
    • /
    • pp.105-110
    • /
    • 1987
  • 구강 내 설암은 설의 전방 삼분의 이에서 발생하는 것으로 근치적 요법으로는 수술과 방사선 치료가 그 근간을 이루어 왔으며, 같은 병기에서 두 요법간의 완치율은 거의 동일한 것으로 보고되고 있다. 특히 조기병소(T1, T2)에서는 이 두 요법간에 비슷한 국소 퇴치율을 보이므로 치료법의 선택에는 그 치료로 인해 발생하는 기능적 손상 및 미용적 결손을 최소화하는데 역점을 두어야 할 것이다. 그러므로 큰 기능적 손상 없이 용이하게 절제할 수 있는 첨단부 및 배부의 작은 병소를 제외하고 대부분의 조기병소는 방사선 요법으로 정상적인 발성 및 연하작용을 유지하며 치료할 수 있다. 그러나 비교적 진행된 병소(late T2, T3) 중 하부 침윤이 심하지 않으면 방사선 치료만으로 완치될 수 있으며 수술은 방사선 치료 후 재발암의 구원요법으로 유보해 두는 것이 바람직할 것이다. 방사선 치료의 방법으로는 외부 조사법 외에 자입요법 등이 있으나 최대의 국소 퇴치를 위해서는 자입요법이 필수적인 것으로 나타났다. 이러한 자입요법으로 치료기간을 단축할 수 있음은 말할 것도 없고 투여되는 선량을 증가시킴으로서 국소 퇴치율의 향상을 기대하고 나아가 생존율을 높일 수 가 있을 것이다.

  • PDF

인간 착상 과정에 자궁내막과 배아의 역할 (The Role of the Endometrium and Embryo in Human Implantation)

  • 지병철
    • 한국발생생물학회지:발생과생식
    • /
    • 제13권1호
    • /
    • pp.1-11
    • /
    • 2009
  • 착상은 배아측과 모체측의 내분비적, 측분비적 및 자가분비적 인자들의 상호 작용에 의하여 조절된다. 착상의 적기는 $2{\sim}4$일로서 이 특수한 시간대 안에서 signaling, appositioning, attachment 및 invasion을 통하여 순차적으로 배아의 착상이 이루어지는데, 이는 자궁내막과 배아로부터 여러 사이토카인, 성장인자, 부착인자와 같은 다수의 생화학 인자의 생성과 분비를 포함하며 이로 인하여 수용적인 자궁내막이 형성된다. LIF, CSF-1, IL-1과 같은 사이토카인들은 착상을 이끄는 연속적인 사건에서 중요한 역할을 수행하며 integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF, pinopodes는 appositioning과 attachment에 관여한다. 배아 또한 사이토카인과 성장인자 및 LIF, CSF-1, IGF, HB-EGF에 대한 수용체들을 분비하여 능동적으로 대처한다. 자궁내막의 수용성을 평가하고 자연주기 또는 보조생식술을 이용한 임신의 예후를 예측하는데, 이와 같은 인자들이 유용한지는 앞으로 더 연구되어야 한다. 현재로서는 내막조직으로부터 채취한 integrins, pinopodes, glycodelin, LIF가, 자궁강내 세척액에서는 glycodelin과 LIF가 유망한 인자로 떠오르고 있다. 혈액내 마커로서는 VEGF, glycodelin, CSF가 약간의 연관성을 보여주고 있다. 이러한 인자들이 보조생식술 전후로 자궁내막의 기능과 임신의 예후를 평가하는 선별검사로 이용될 수 있는지를 증명하기 위해서는 향후 불임 여성과 대조군인 가임 여성을 대상으로 한 대규모의 연구가 필요할 것이다. 인간의 착상에서 이들 인자들의 기능을 충분히 이해해야 치료적 기법으로 연결되어 보조생식술에서도 더 높은 성공률을 이루어 낼 것으로 사료된다.

  • PDF

A GFP-labeled Human Colon Cancer Metastasis Model Featuring Surgical Orthotopic Implantation

  • Chen, Hong-Jin;Yang, Bo-Lin;Chen, Yu-Gen;Lin, Qiu;Zhang, Shu-Peng;Gu, Yun-Fei
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권9호
    • /
    • pp.4263-4266
    • /
    • 2012
  • Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP-labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.

Effects of Epidermal Growth Factor on the Apoptosis and Implantation Related Genes in Bovine Embryos Developing in vitro

  • Park, Sae-Young;Tae, Jin-Cheol;Kim, Eun-Young;Park, Se-Pill;Lim, Jin-Ho;Kim, Nam-Hyung
    • 한국발생생물학회:학술대회논문집
    • /
    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
    • /
    • pp.114-114
    • /
    • 2003
  • Epidermal growth factor (EGF) induces well-documented mitogenic and differentiating effects on murine and bovine preimplantation embryos. However, the effects of EGF on apoptosis and implantation-related gene expression in bovine embryos developing in vitro have not been evaluated. The objective of this study was to determine the effects of exogenous EGF in the presence and absence of BSA on the preimplantation development of bovine embryos. In addition, we measured cell number, apoptosis, and expression of apoptosis and implantation-related genes of the blastocysts that developed in these culture conditions. In vitro produced bovine embryos were randomly cultured in the same medium containing 0 or 10 ng/ml EGF in the presence and absence of 0.8% BSA. More 2-cell embryos developed into blastocysts at day 7 when BSA was present than when BSA was absent. The addition of 10 ng/$m\ell$ EGF into the medium did not significantly increase the developmental rate and the cell numbers per blastocyst. However, addition of EGF in the presence of 0.8% BSA significantly reduced the degree of apoptosis in the blastocysts (P<0.01). To investigate whether EGF modulates mRNA expression of apoptosis-related genes, mRNA was prepared from single blastocysts and each preparation was subjected to RT-PCR for Bcl-2 and Bax transcripts. EGF did not alter the relative abundance of Bax gene expression in the presence of BSA, but increase Bcl-2 (P<0.01) The relative abundance of Interferon tau expression was increased by EGF treatment in the presence of BSA. These results suggest that EGF and BSA synergistically enhance Bcl-2 and interferone tau gene expression, which may result in a net increase in viability in bovine embryos.

  • PDF

Effects of Epidermal Growth Factor on the Apoptosis and Implantation Related Genes in Bovine Embryos Developing in vitro

  • Park, Sae-Young;Tae, Jin-Cheal;Kim, Eun-Young;Park, Se-Pill;Lim, Jin-Ho;Kim, Nam-Hyung
    • 한국발생생물학회:학술대회논문집
    • /
    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
    • /
    • pp.99-99
    • /
    • 2003
  • Epidermal growth factor (EGF) induces well-documented mitegenic and differentiating effects on murine and bovine preimplantation embryos. However, the effects of EGF on apoptosis and implantation-related gene expression in bovine embryos developing in vitro have not been evaluated. The objective of this study was to determine the effects of exogenous EGF in the presence and absence of BSA on the preimplantation development of bovine embryos. In addition, we measured cell number, apoptosis, and expression of apoptosis and implantation-related genes of the blastocysts that developed in these culture conditions. In vitro produced bovine embryos were randomly cultured in the same medium containing 0 or 10 ng/$m\ell$ EGF in the presence and absence of 0.8% BSA. More 2-cell embryos developed into blastocysts at day 7 when BSA was present than when BSA was absent. The addition of 10 ng/$m\ell$ EGF into the medium did not significantly increase the developmental rate and the cell numbers per blastocyst. However, addition of EGF in the presence of 0.8% BSA significantly reduced the degree of apoptosis in the blastocysts (P< 0.01). To investigate whether EGF modulates mRNA expression of apoptosis-related genes, mRNA was prepared from single blastocysts and each preparation was subjected to RT-PCR for Bcl-2 and Bax transcripts. EGF did not alter the relative abundance of Bax gene expression in the presence of BSA, but increase Bcl-2 (P < 0.01). The relative abundance of Interferon tau expression was increased by EGF treatment in the presence of BSA. These results suggest that EGF and BSA synergistically enhance Bcl-2 and interferone tau gene expression, which may result in a net increase in viability in bovine embryos.

  • PDF