Comparisons of matrix metalloproteinase 1, 2, and 9 activity in periovulatory follicular fluid from natural and stimulated menstrual cycles.

We studied the activity levels of matrix metalloproteinase 1, 2, and 9 in periovulatory fluids from naturally occurring menstrual cycles versus those from samples taken from menstrual cycles stimulated with clomiphene citrate or recombinant stimulating hormone. No statistically significant differences were found.

Midluteal matrix metalloproteinase and tissue-inhibiting metalloproteinase plasma levels after embryo transfer.

This study demonstrates significant differences in the midluteal concentrations of active matrix metalloproteinase (MMP)-1, MMP-2, and total MMP-3 between patients who conceived and those who did not after day 3 ET.

A case of gonadal dysgenesis, breast development, Graves' disease, and low bone mass.

OBJECTIVE: To describe a case of XY gonadal dysgenesis with Tanner stage 4 breast development in the absence of a hormone-producing gonadal neoplasm and with Graves' disease and low bone mass. METHODS: The clinical features, laboratory results, and cytogenetic findings in the patient are presented, and the potential mechanisms of breast development are discussed. A MEDLINE search was performed, and related articles in the English-language literature published between 1955 and 2001 were reviewed. RESULTS: A 23-year-old African American woman was referred to the University of Louisville Hospital for evaluation of hyperthyroidism. About 4 months before this referral, hyperthyroidism was diagnosed, and treatment with methimazole was initiated. She continued to have thyrotoxicosis. Additionally, systemic review disclosed a history of primary amenorrhea. Physical examination revealed a tall phenotypic female patient with Tanner stage 4 breast development. Pelvic examination showed normal findings except for sparse pubic hair. Laboratory evaluation confirmed the diagnosis of Graves' disease as well as primary gonadal failure. Pelvic ultrasonography revealed a small uterus and bilateral adnexal masses (0.9 by 0.6 cm). On chromosomal analysis, a 46,XY karyotype was found. Further analysis of Y-DNA by polymerase chain reaction confirmed the presence of an intact Y chromosome, and no microdeletions were identified. Dual-energy x-ray absorptiometry demonstrated a Z-score of -4.7 and -4.2 at the lumbar spine and right hip, respectively. Graves' disease was successfully treated with (131)I. Laparoscopy was performed to resect streak gonads. On histologic examination, no typical ovarian, testicular, or neoplastic tissue was identified. The breast development in this patient remains unexplained. CONCLUSION: To the best of our knowledge, this is the first case report of a tall XY female patient with breast development in the absence of a hormone-producing gonadal neoplasm and without clearly identifiable gonads. Breast development was most likely related to estrogens, possibly produced by either streak gonads at the time of puberty or peripheral conversion of androgens, or to increased sensitivity of breast tissue to estrogens. Graves' disease is likely coincidental and could contribute to bone loss in such subjects.

Spontaneous pregnancy in a woman with 45,X/47,XXX mosaicism in both serum and germ cell lines. A case report.

BACKGROUND: This is the first published case report of pregnancy in a women with 45, X/47, XXX mosaicism in both blood and germ cell lines. CASE: The patient conceived, and analysis of ovarian tissue confirmed a karyotype of 45, X/47, XXX. CONCLUSION: Women with a 45, X/47, XXX karyotype in the germ cell line can conceive, as this case demonstrates.

Modulation of T-cell CD3-zeta chain expression in early pregnancy.

PROBLEM: To assess the modulation of T-cell CD3-zeta chain expression by a factor in the sera of women, prior to egg retrieval and 14 days after an in vitro fertilization (IVF) and to delineate the mechanism of this modulation. METHOD OF STUDY: In this prospective study, blood samples were obtained from 17 patients during an IVF cycle, prior to human chorionic gonadotropin (hCG), and 14 days after embryo return. Serum was incubated with cultured T-lymphocytes (Jurkat cells) for 96 hr and expression of CD3-zeta chain was evaluated. RESULTS: Eight patients had a positive serum hCG titer 14 days after retrieval, while nine patients had a negative hCG titer. Serum from pregnant patients significantly suppressed CD3-zeta chain expression as compared with their sample prior to retrieval (85.6 +/- 6.2%), while subjects not becoming pregnant failed to suppress zeta expression (99.1 +/- 0.9%, P < 0.0001). CONCLUSION: A factor capable of suppressing TcR/CD3-zeta expression can be detected in the sera of pregnant women 14 days after embryo retrieval. Loss of zeta chain was associated with the induction of apoptosis.

Modulation of T-cell CD3-zeta chain expression during normal pregnancy.

The objectives of this study were to assess the modulation of T-cell CD3-zeta expression by factor(s) present in sera of pregnant women, to correlate this activity with markers of T-cell function associated with pregnancy, and to identify the presence of a circulating pregnancy-associated factor responsible for the suppression of CD3-zeta chain. The suppression of TcR/CD3-zeta expression on cultured T-lymphocytes (Jurkat cells) by sera and amniotic fluids from pregnant women was examined by Western immunoblots and quantitated by densitometry. This suppression was correlated with the induction of T-cell apoptosis and reduced production of IL-2. The serum component suppressing zeta expression was characterized by ultrafiltration and protease sensitivity. Incubation of Jurkat cells with sera obtained from women in the first trimester produced a slight, but not statistically significant, suppression of zeta expression; however, sera from pregnant women in the second and third trimesters and amniotic fluids significantly suppressed zeta levels in a dose-dependent manner. The loss of zeta chain correlated with both reduced secretion of IL-2 and induction of lymphocyte apoptosis. Fractionation of sera by ultrafiltration demonstrated that the zeta chain suppressive factor was <5 kDa, and its trypsin-sensitivity suggests a proteinaceous moiety. Pregnancy is associated with a progressive suppression of cell-mediated immunity. These suppressed T-cell functions have been linked to Fas/Fas ligand-induced apoptosis and suppression of Th1 cytokines, including IL-2. We demonstrate that these pregnancy-associated events are mimicked by a factor(s) present in patient-derived fluids. Suppression of zeta expression appears to be due to a circulating low-molecular-weight protein that suppresses CD3-zeta in a concentration-dependent manner.