ABSTRACT
OBJECTIVE: GnRH antagonist has been recently developed and has provided a new treatment option for controlled ovarian hyperstimulation (COH). However, the use of GnRH antagonist (GnRH-ant) has been hesitated in women with polycystic ovary syndrome (PCOS) due to their high levels of tonic luteinizing hormone (LH). This study was performed to evaluate the efficacy of 2 kinds of GnRH-ant multidose protocols (MDPs) in infertile women with PCOS undergoing IVF-ET, compared with standard GnRH agonist (GnRH-a) luteal long protocol (LP). METHODS: Sixty-five patients with PCOS, aged 24-38 years were recruited for this prospective study and they were randomized to undergo GnRH-ant MDP during early and late follicular phase (GnRH-ant MDPEL) (group 1), GnRH-ant MDP during late follicular phase (GnRH-ant MDPL) (group 2), or GnRH-a luteal LP (group 3). All of the subjects were pretreated with low dose monophasic oral contraceptives (OCs) and they were administered recombinant FSH for ovarian stimulation. RESULTS: There were no differences in serum concentrations of progesterone and endometrial thickness on the day of hCG injection among three groups but serum concentrations of estrogen are higher in group 3 (GnRH-a luteal LP) than other groups. Total dose and duration of rFSH used for COH were significantly higher in group 3 than those in group 1 or 2. Number of retrieved oocytes, grade I/II embryos, fertilized oocytes were significantly higher in group 3 than those in group 2 but there were no differences in any parameters including IVF results between group 1 and 3. No difference in ongoing pregnancy rate was found among 3 groups. CONCLUSION: The use of the GnRH-ant, especially during early and late stimulation period (GnRH-ant MDPEL) is as effective as GnRH-a LP and might be considered more advantageous because of the short-term and small dose application, and therefore GnRH-ant MDPEL could be cheaper alternative in COH for PCOS women undergoing IVF-ET.
Subject(s)
Female , Humans , Contraceptives, Oral , Embryonic Structures , Estrogens , Follicular Phase , Gonadotropin-Releasing Hormone , Luteinizing Hormone , Oocytes , Ovulation Induction , Polycystic Ovary Syndrome , Pregnancy Rate , Progesterone , Prospective StudiesABSTRACT
OBJECTIVE: Recent reports have demonstrated that GnRH antagonists can be successfully used in controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF). In these antagonist stimulation cycles, oral contraceptive (OC) pretreatment was used to schedule COH. This study was performed to evaluate the effect of OC pretreatment before COH in the antagonist cycles according to the duration of OC administration in infertile patients undergoing IVF-ET. METHODS: Prospective trial was performed on a total 85 IVF cycles carried out on 85 infertile patients with tubal factor only. Eighty-five patients was allocated randomly to the short term OC user (14-21 days), long term OC user (>or=22 days) and Non-user of OC. In all patients, COH was carried out using GnRH antagonist and recombinant FSH (rFSH). RESULTS: No differences among the three groups were found in numbers of oocytes retrieved, mature oocytes, fertilized oocytes, embryos grade I/II, transferred embryos and clinical pregnancy rate. There were also no differences in total dose and duration of rFSH used for COH among three groups. CONCLUSION: Oral contraceptive pretreatment can be used successfully to schedule patients before COH in GnRH antagonist cycles. The OCs can be administered for extended period as necessary for cycle timing. However OC pretreatment in antagonists cycles does not offer any advantage in COH and pregnancy outcome.
Subject(s)
Female , Humans , Pregnancy , Appointments and Schedules , Embryonic Structures , Fertilization in Vitro , Gonadotropin-Releasing Hormone , Oocytes , Pregnancy Outcome , Pregnancy Rate , Prospective StudiesABSTRACT
OBJECTIVE: This study was performed to evaluate the efficacy of GnRH antagonist multidose protocol (GnRH-ant MDP) with or without oral contraceptive (OC) pretreatment in low responders undergoing IVF-ET, compared with standard GnRH agonist (GnRH-a) lowdose long protocol (LP). METHODS: Eighty-two patients, aged 28-42 years who were defined as low responders were recruited for this prospective study and they were randomized to undergo GnRH-ant MDP after OC pretreatment (group 1) or GnRH-ant MDP without OC pretreatment (group 2) or GnRH-a luteal lowdose LP (group 3). All of the subjects were administered recombinant human FSH (rhFSH) for ovarian stimulation. RESULTS: Patients' characteristics were comparable among three groups. Total dose and duration of rhFSH used for COH were significantly higher in group 3 than those in group 1 or 2. The number of mature oocytes, fertilization rate and the number of grade I, II embryos were significantly lower in group 2 than those in other groups. The clinical pregnancy rate seemed to be lower in group 2 but the difference did not achieve statistical significance. There were also no differences in the miscarriage rate and multiple pregnancy rate among three groups. CONCLUSION: This study demonstrates that GnRH-ant MDP with OC pretreatment is as effective as GnRH-a lowdose LP and might be considered more advantageous because of the short-term and small dose application in low responders.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Embryonic Structures , Fertilization , Follicle Stimulating Hormone, Human , Gonadotropin-Releasing Hormone , Oocytes , Ovulation Induction , Pregnancy Rate , Pregnancy, Multiple , Prospective StudiesABSTRACT
OBJECTIVE: To compare the expression of epidermal growth factor (EGF) and fibroblast growth factor-2 (FGF-2) in the eutopic endometrium of women with and without endometriosis. METHODS: Thirty-two women with histologically confirmed endometriosis after laparotomy or laparoscopy were recruited. Twenty-eight women with carcinoma in situ of the uterine cervix, uterine myoma and ovarian tumor but no evidence of endometriosis served as control. Following isolation of total RNA from endometrial tissue and reverse transcription, cDNA samples were amplified by real time PCR to quantify the expression of EGF, FGF-2, and GAPDH genes. RESULTS: Including all menstrual phases, the levels of mRNA expressions of EGF and FGF-2 were not different between the eutopic endometrium of women with and without endometriosis. When analyzed separately according to the 6 menstrual phases, no differences were found between the two groups, either. CONCLUSION: This study shows that the levels of mRNA expressions of EGF and FGF-2 in the eutopic endometrium were not different between women with and without endometriosis.
Subject(s)
Female , Humans , Carcinoma in Situ , Cervix Uteri , DNA, Complementary , Endometriosis , Endometrium , Epidermal Growth Factor , Fibroblast Growth Factor 2 , Fibroblasts , Laparoscopy , Laparotomy , Leiomyoma , Real-Time Polymerase Chain Reaction , Reverse Transcription , RNA , RNA, MessengerABSTRACT
OBJECTIVE: The Id family of helix-loop-helix proteins are thought to affect the balance between cell growth and differentiation by negatively regulating the function of basic-helix-loop-helix (bHLH) transcriptional factors. The aim of this study was to investigate the expression pattern of Ids (Id-1,-2,-3, and -4) in preimplantation mouse embryos at mRNA and protein levels. METHODS: Oocytes and preimplantation embryos were collected from reproductive organs of female ICR mice following superovulation. RT-PCR was performed to investigate the mRNA expression patterns of Id genes and their protein were localized by immunofluorescence analysis. RESULTS: Id-1 and Id-3 mRNAs were strongly expressed at the germinal vesicle (GV) oocyte and the blastocyst stages. Id-2 mRNA was expressed throughout preimplantation embryo development, but Id-4 was not expressed. Immunofluorescence showed that Id-1 and Id-2 were predominantly localized in cytoplasmic region, but the immunofluorescence signal of Id-3 was weak throughout preimplantation embryo development. CONCLUSION: These data show for the first time that Ids are expressed in preimplantation mouse embryos and suggest that Ids may play an important role in early preimplantation embryo development and uterine physiological changes.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Blastocyst , Cytoplasm , Embryonic Development , Embryonic Structures , Fluorescent Antibody Technique , Mice, Inbred ICR , Oocytes , RNA, Messenger , SuperovulationABSTRACT
No abstract available.
Subject(s)
Animals , Mice , Estrogens , Immunohistochemistry , UterusABSTRACT
No abstract available.
Subject(s)
Animals , Mice , DNA, Complementary , Estrogens , Laser Capture Microdissection , Oligonucleotide Array Sequence Analysis , UterusABSTRACT
No abstract available.
Subject(s)
Animals , Mice , DNA, Complementary , Estrogens , Laser Capture Microdissection , Oligonucleotide Array Sequence Analysis , UterusABSTRACT
No abstract available.
Subject(s)
Animals , Mice , Blastocyst , Epidermal Growth Factor , Matrix Metalloproteinase 2 , ErbB ReceptorsABSTRACT
OBJECTIVES: The purpose of this study was to evaluate effects of heparin-binding epidermal growth factor (HB-EGF) on the rate of blastocyst formation and hatching in the mouse embryos and the expression of matrix metalloproteinase-9 (MMP-9) and ATPase g-subunit mRNA. METHODS: Late 2-cell mouse embryos was cultured for 72 hours in HTF medium containing with 1, 10, and 100 ng/ml HB-EGF. The mRNA expression level of MMP-9 and ATPase gamma-subunit was detected by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The rate of hatching was significantly higher (p<0.05) in group containing with 1 ng/ml HB-EGF than other groups. Also, the rate of hatched blastocyst was significantly higher (p<0.05) in 10 ng/ml. The mRNA expression level of MMP-9 mRNA was not shown any difference among groups, but ATPase g-subunit was higher than other groups. CONCLUSIONS: Taken together these results suggest that HB-EGF has the positive effect to promote the blastocyst formation and hatching process and influences the blastocoel expansion by promoting the ATPase mRNA expression in the mouse embryos.
Subject(s)
Animals , Mice , Adenosine Triphosphatases , Blastocyst , Embryonic Structures , Epidermal Growth Factor , Matrix Metalloproteinase 9 , RNA, MessengerABSTRACT
OBJECTIVE: We performed this study to evaluate the effects of Sil-Select and Percoll in sperm preparation. METHODS: Semen samples of 22 patients with normal sperm parameters by WHO criteria were divided into two equal parts and prepared with Percoll and Sil-Select. After completion of semen preparation procedures with Percoll and Sil-Select, sperm concentration, motility and morphology using strict criteria were evaluated in each group and all semen samples were fixed and stained for transmission electron microscopy(TEM). RESULTS: There were no significant diffrences in sperm concentration, percentage of motile spermatozoa and percentage of normal spermatozoa in morphology evaluation using strict criteria under light microscopy between Percoll and Sil-Select-treated groups. However, the percentage of normal shape and position of acrosome, and normal helix assembly of mitochondria under TEM were significantly higher in the Sil-Select-treated group compared to Percoll-treated group (p < 0.001, p < 0.001, p < 0.001). CONCLUSIONS: These data demonstrate that Sil-Select is less detrimental to the acrosome and mitochondria of spermatozoa in sperm preparation compared to Percoll.