The Role of CD4(+)CD25(bright) Regulatory T Cells in the Maintenance of Pregnancy, Premature Rupture of Membranes, and Labor

PURPOSE: The aim of this study was to evaluate the changes of the regulatory T cell subset in peripheral blood caused by gestational age and premature rupture of membranes (PROM) with or without labor to verify the role of regulatory T cells in pregnancy. PATIENTS AND METHODS: We investigated regulatory T cell distribution in the peripheral blood of pregnancies during the first trimester (group I, n=2), the second trimester (group II, n=12), and the third trimester without PROM and labor (group III, n=15). In addition, we evaluated pregnancies in the third trimester complicated by PROM (group IV, n=4) and labor with no complication by PROM (Group V, n=5). Comparisons were made with non-pregnant controls (group VI, n=4) using flow cytometry. RESULTS: During uncomplicated pregnancy, the CD4(+)CD25(bright) regulatory T cell population decreased with advancing gestational age (group I=3.35+/-0.47, group II=2.91+/-1.44, group III=2.81+/-1.36, group VI=2.52+/-0.71, p=NS). When we compared group IV with group III and V to evaluate the changes of the regulatory T cells with PROM, the CD4(+)CD25(bright) regulatory T cell population was significantly decreased in group IV compared to group III (p=0.001) and group V (p=0.026). CONCLUSION: The present results revealed that the regulatory T cell population increased in early pregnancy but decreased in pregnancies complicated by PROM, indicating that regulatory T cells might be related to the maintenance of pregnancy.

Three-dimensional gestational sac volumetry with automatic tracing mode of the VOCAL-imaging program as the new biometric parameter in determining gestational age: Preliminary study / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to verify the correlation between gestational sac volume (GSV) from automatic tracing mode the VOCAL-imaging program and gestational age and to construct the nomogram of gestational sac volume as the new biometric parameter in early pregnancy. METHODS: The cross-sectional study has been conducted in 242 uncomplicated singleton pregnancies. 47 cases were excluded due to early pregnancy failure, fetal malformations, elective abortion, age discrepancy, etc. In 195 uncomplicated singleton pregnancies from 5 to 12 weeks' menstrual age, gestational sac volume, mean sac diameter and crown-lump length were measured for the assessment of gestational age. Gestational sac volumetry was carried out with automatic method and manual method of the VOCALTM (Virtual Organ Computer- aided AnaLysis) for the comparison between two methods. The collected data were analyzed for mean, standard deviation, 90% reference interval, 5th, 50th and 95th percentiles of gestational sac volume, mean sac diameter and CRL, and the nomogram were constructed. RESULTS: Polynomial regression analysis demonstrated the statistically significant positive correlation between gestational age and gestational sac volume by automatic tracing mode (R2 0.826, p<0.001), gestational sac volume by manual tracing mode (R2 0.844, p<0.0001), mean sac diameter (R2 0.763, p<0.0001) and crown-lump length (R2 0.950, p<0.0001). The 5th, 50th and 95th percentiles of the gestational sac volume were calculated and the nomogram was tabulated. In determining gestational age, the standard deviation (SD) of gestational sac volume by automatic tracing mode is 5.6 days, the SD of gestational sac volume by manual tracing mode is 5.2 days and the SD of MSD is 6.6 days. CONCLUSION: we can conclude that three-dimensional GSV with automatic tracing mode of the VOCAL-imaging program can be used as the new biometric measurement in determining gestational age. Gestational sac volumetry with automatic tracing mode of the VOCAL-imaging program have been proven available and convenient method and it can be recommended in 5-7 weeks' of gestation, when CRL is not clearly visualized.

The Significance of the Antral Follicle Number Prior to Stimulation in Predicting the Outcome of Assisted Reproductive Technologies / 대한산부인과학회잡지

BACKGROUND: Recruitment and development of multiple follicles in response to gonadotropin stimulation are the key factors leading to successful treatment by assisted reproductive technologies. Prediction of ovarian responses prior to stimulation is useful in counselling and helpful in adjusting the dosage of gonadotropin to individual patients. OBJECTIVE: To evaluate the number of antral follicles of both ovaries as a predictor of outcome of assisted reproductive technologies. METHODS: Data were collected by a retrospective analysis. A total of 56 consecutive infertile women were undergoing the first cycle using a standard regimen of ovarian stimulation from July, 2000 to June, 2001. Basal FSH, LH, prolactin, and estradiol concentration were measured. The number of follicles (2-5 mm) were recorded. RESULTS: In women with fewer antral follicles, the number of retrieved eggs was significantly decreased and increased the duration and dosage of human menopausal gonadotropin, but pregnancy rate was similar to those with a higher number of antral follicles. CONCLUSION: It is suggested that the total antral follicle number is sensitive ultrasound parameter in predicting the ovarian response.