The authors performed a comprehensive review of current literature to create a model comparing commonly evaluated variables in male factor infertility, for example, follicle-stimulating hormone (FSH), testicular volume (TV), and testosterone (T), to better predict sperm retrieval rate (SRR). Twenty-nine studies were included, 9 with data on conventional testicular sperm extraction (cTESE) for a total of 1227 patients and 20 studies including data on microdissection testicular sperm extraction (mTESE) for a total of 4760 patients. A weighted-means value of SRR, FSH, T, and TV was created, and a weighted linear regression was then used to describe associations among SRR, type of procedure, FSH, T, and TV. In this study, weighted-means values demonstrated mTESE to be superior to cTESE with an SRR of 51.9% vs 40.1%. Multiple weighted linear regressions were created to describe associations among SRR, procedure type, FSH, T, and TV. The models showed that for every 1.19 mIU ml^-1 increase in FSH, there would be a significant decrease in SRR by 1.0%. Seeking to create a more clinically relevant model, FSH values were then divided into normal, moderate elevation, and significant elevation categories (FSH <10 mIU ml^-1, 10-19 mIU ml^-1, and >20 mIU ml^-1, respectively). For an index patient undergoing cTESE, the retrieval rates would be 57.1%, 44.3%, and 31.2% for values normal, moderately elevated, and significantly elevated, respectively. In conclusion, in a large meta-analysis, mTESE was shown to be more successful than cTESE for sperm retrievals. FSH has an inverse relationship to SRR in retrieval techniques and can alone be predictive of cTESE SRR.
Humans ; Male ; Follicle Stimulating Hormone ; Follicle Stimulating Hormone, Human ; Infertility, Male ; Linear Models ; Semen ; Sperm Retrieval ; Spermatozoa ; Testis/surgery*

OBJECTIVE: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin beta with a conventional syringe delivering follitropin beta solution in patients undergoing IVF-ET. METHODS: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). RESULTS: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin beta. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. CONCLUSION: The pen device for self-administration of follitropin beta is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin beta when compared with the conventional syringe.
Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Follicle Stimulating Hormone, beta Subunit ; Follicle Stimulating Hormone, Human ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Injections, Subcutaneous ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Recombinant Proteins ; Syringes

OBJECTIVE: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin beta with a conventional syringe delivering follitropin beta solution in patients undergoing IVF-ET. METHODS: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). RESULTS: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin beta. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. CONCLUSION: The pen device for self-administration of follitropin beta is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin beta when compared with the conventional syringe.
Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Follicle Stimulating Hormone, beta Subunit ; Follicle Stimulating Hormone, Human ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Injections, Subcutaneous ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Recombinant Proteins ; Syringes

Recent evidence suggests that a high level of serum LH during follicular recruitment and development is associated with poor reproductive outcome. Consequently, exogenous LH administration for controlled ovarian hyperstimulation(COH) in in vitro fertilization and embryo transfer(IVF-ET) may be harmful to folliculogenesis. The purpose of this clinical study was to evaluate and compare the efficacy of human menopausal gonadotropin(hMG) and human follicle-stimulating hormone(hFSH) for COH with long protocol of gonadotropin-releasing hormone(GnRH) agonist in IVF-ET program. Randomized clinical trial was performed in 125 patiens undergoing IVF-ET at Seoul National University Hospital from May to Septebmer, 1995. The inclusion criteria of patients included age < 40 years and normal semen analysis, and the study population was also classified into two groups by the etiology of infertility : Group T - 95 patients with only tubal factor and Group O - 30 patients with endometriosis or anovulatory factor. There were no statistically significant differences in dosage(29.0+/-7.9 vs 26.0+/-6.8 ampoules) and duration(12.3+/-1.3 vs 12.2+/-1.5 days) of gonadotropin administration, serum E2 level on hCG day(1,943+/-1,255 vs 1,580+/-1,067 pg/mL), cancellation rate(7.5% vs 6.7%), number of oocytes retrieved(9.9+/-6.0 vs 11.3+/-6.0), fertilization rate(68.4% vs 64.5%), number of embryos transferred(4.7+/-2.0 vs 4.7+/-2.0), and preganancy rate per cycle(26.3% vs 24.4%) and per ET(28.4% vs 26.2%) between hMG(N=80) and hFSH(N=45) Groups. In Group T, no significant differnces in results of IVF-ET were also detected between hMG (N=61) and hFSH(N=34) Groups. In Group O, serum E2 level on hCG day was significantly higher in hMG Group (N=19) compared with hFSH Group(N=11), but other results of IVF-ET were similar in both Groups. As this study could not demonstrate any significant differences in results of IVF-ET between hMG and hFSH when used for COH in IVF-ET program, it could be concluded that hFSH is at least as efficacious as hMG for COH.
Embryo Transfer* ; Embryonic Structures* ; Endometriosis ; Female ; Fertilization ; Fertilization in Vitro* ; Follicle Stimulating Hormone* ; Follicle Stimulating Hormone, Human ; Gonadotropins* ; Humans* ; Infertility ; Oocytes ; Semen Analysis ; Seoul

Objective: To compare pre-operative and post-operative ovarian reserve by measuring the follicle stimulating hormone (FSH) serum level on day 3 of the menstrual cycle following a laparoscopic ovarian cystectomy for endometriotic cyst/s. Design: Prospective descriptive study Setting: Tertiary referral center. Study Population: Patients who are 18 to 34 years old with unilateral/bilateral endometriotic cyst/s were recruited in the study. All patients underwent laparoscopic ovarian cystectomy at the charity service of Reproductive Endocrinology and Infertility Section in a tertiary hospital. Outcome Measures: Serum day 3 FSH was determined pre-operatively and 1 month post-operatively and analyzed for statistical significance. Results: Majority of our patients aged 31-34 years old, were nulligravid and with history of infertility. The mean post-operative FSH level decreased slightly compared to the pre-operative FSH level. The size and number of endometriotic cyst did not affect significantly the ovarian reserve as well as the ovarian residual volume. Likewise, the menstrual pattern did not significantly change post-operatively. Conclusion: The mean overall postoperative FSH level improved very slightly but is not significant. Somehow, laparoscopic ovarian cystectomy may be beneficial in improving the ovarian reserve. However, further studies and samples are needed.
Human ; Female ; Adult ; Young Adult ; FOLLICLE STIMULATING HORMONE ; LAPAROSCOPY ; ENDOMETRIAL NEOPLASMS

The LH and FSH responses to synthetic LH-RH and the prolactin response to synthetic T-RH were evaluated during different phases of the mentrual cycle in order to understand secretory capacity of the pituitary during the menstrual cycle. Eleven regularly menstruating women between 22 and 35 years of age with a usual cycle length of 27 to 31 days volunteered for this Study. Volunteers received an intra-venous injection of 100 microgram synthetic LH-RH and 200 microgram synthetic T-RH during the early and the late follicular phases and during the early and midluteal phases of the menstrual cycle. LH-RH induced a prompt increase in circulating LH, reaching the peak concentration at 30 minutes following LH-RH administration in all phases of the cycle studied. A change in responsiveness with greater and more sustained LH release from the early to the late follicular phases was observed. The response during the luteal phase was significantly greater than the responses in both the early and the late follicular phases. A concomitant but a much smaller FSH response was observed. T-RH elicited a prompt increase in circulating prolactin within 30 minutes and decreased gradually thereafter, reaching the baseline level by 2 hours after T-RH administration. Maximum concentration of prolactin was reached in 30 minutes following T-RH during all phases of the menstrual cycle. No variation in pituitary responsiveness to T-RH, however, was observed during different phases of the menstrual cycle. These data indicate that the sensitivity of the pituitary gonadotrophs to LH-RH varies during different phases of the menstrual cycle.
Adult ; Female ; Follicle Stimulating Hormone/secretion ; Gonadorelin/pharmacology* ; Human ; Luteinizing Hormone/secretion ; Menstruation* ; Pituitary Gland/drug effects* ; Protirelin/pharmacology*

PURPOSE: Early pubertal timing in girls is associated with psychological and behavioral problems. This study aimed to evaluate the psychological features of girls who perceived breast development beginning by analyzing their depression levels and self-concept. METHODS: From March 2007 to December 2012, 93 girls were enrolled and assigned to a pre-8 (younger than 8 years, n=43) or post-8 (8 years and older, n=50) group according to the age at onset of perceived breast development, and their height, body weight, body mass index, bone age (BA), Tanner stage, and luteinizing hormone and follicle-stimulating hormone levels were examined. We investigated their psychological state with the Korean Children's Depression Inventory (CDI) and Piers-Harris Children's Self-Concept Scale (PHCSC) to evaluate depression levels and self-concept, respectively. RESULTS: The pre-8 group had a significantly greater height standard deviation score, (0.5+/-1.01 vs. 0.11+/-0.86, P = 0.048) and more advanced BA (2.07+/-1.02 years vs. 1.40+/-0.98 years, P = 0.004) compared to the post-8 group. There were no statistically significant intergroup differences for the CDI and PHCSC scores; however, the pre-8 group scored higher than the post-8 group in the physical appearance and attributes domain of the PHCSC (9.93+/-2.57 vs. 8.52+/-3.03, P = 0.017). CONCLUSION: The timing of perceived breast development among girls who thought puberty to begin did not affect depression levels and self-concept. There was no correlation between Tanner stage and depression levels and self-concept despite the perception of pubertal onset. The pre-8 group had a more positive view of their physical appearance than the post-8 group.
Adolescent ; Body Height ; Body Weight ; Breast ; Depression* ; Human ; Female ; Follicle Stimulating Hormone ; Luteinizing Hormone ; Puberty ; Self Concept ; Sexual Development

Fertility management is a global issue of medical, economic, and social consequence. Although many methods have been devised to inhibit reproduction, more acceptable alternatives are still needed. Regulation by immune intervention is a promising technology as applied to human beings. The objective of this review is to indicate several immunocontraceptive antigens.
Acrosin ; immunology ; Animals ; Antigens ; Contraception ; Extracellular Matrix Proteins ; immunology ; Female ; Follicle Stimulating Hormone, Human ; immunology ; Gonadotropin-Releasing Hormone ; immunology ; Humans ; Luteinizing Hormone ; immunology ; Male ; Spermatozoa ; immunology

Objective: To assess the association of the FSHR Thr307Ala-Asn680Ser gene polymorphism with male infertility. METHODS: We searched Pubmed, EMBASE, Web of Science, CNKI, and WANFANG databases for literature on the correlation of the FSHR Thr307Ala-Asn680Ser gene polymorphism with male infertility published from 2005 to the present time. According to the inclusion criteria, we included 12 epidemiological case-control studies and subjected them to a comprehensive analysis with the Stata11.0 software. RESULTS: A total of 2 893 male infertility patients and 3 312 controls were involved in the 12 studies. The Thr307Ala (rs6165) gene polymorphism was shown to be a risk factor for male infertility among the three comparison models (homozygous comparison model, hybrid comparison model and dominant comparison model), with the pooled odds ratios (OR) of 1.26 (95% CI: 1.03－1.54, P = 0.023), 1.18 (95% CI: 1.03－1.36, P = 0.018), and 1.20 (95% CI: 1.05－1.37, P = 0.006), respectively. And the Asn680Ser(rs6166) polymorphism was a risk factor for male infertility in the homozygous comparison and recessive comparison models, with the pooled ORs of 1.24, (95% CI: 1.05－1.45, P = 0.009) and 1.20 (95% CI: 1.04－1.39, P = 0.013), respectively. Layered meta-analysis showed that in the homozygous comparison model, the Thr307Ala-Asn680Ser polymorphism is a risk factor for male infertility in the white population, with the OR of 1.37 (95% CI: 1.03－1.82, P = 0.003) and 1.21 (95% CI: 1.00－1.47, P = 0.048), respectively. CONCLUSIONS In the homozygous model (GG vs AA), the FSHRThr307Ala-Asn680Ser gene polymorphism might be a protective factor against male infertility.
Case-Control Studies ; Follicle Stimulating Hormone, Human ; genetics ; Homozygote ; Humans ; Infertility, Male ; genetics ; Male ; Polymorphism, Genetic ; Risk Factors

The need for simplified in-vitro fertilization (IVF) treatment approaches with the aim of reducing treatment burden and to prevent drop-outs after a failed IVF cycle can be met by the use of corifollitropin alfa for COS in association with a GnRH antagonist protocol. This is a report of the first local case of a successful pregnancy using corifollitropin alfa in IVF. This is a case of a 33 year-old G3 PO (0030) whose partner has teratozoospermia. COS using corifollitropin alfa yielded eight mature oocytes with no occurrence of OHSS. Six oocytes were fertilized using ICSI with six good quality embryos reaching cleavage stage. Two grade 1 embryos at day 3 cleavage stage were transferred. A clinical pregnancy was documented at 7 weeks age of gestation. Congenital anomaly scanning at 24 weeks age of gestation revealed a grossly normal fetus. Patient delivered a healthy, live, term baby boy. Review of literature suggests that corifollitropin alfa is as effective as rFSH in delivering live birth rate, ongoing pregnancy rate and clinical pregnancy rate. The sustained and higher FSH immunoreactivity concentrations and the inability for dose adjustment after treatment with a single dose of corifollitropin compared with the daily rFSH regimen underscores the need for careful patient selection in the use of corifollitropin alfa.

Human ; Male ; Adult ; Pregnancy Rate ; Follicle Stimulating Hormone, Human, With Hcg C-terminal Peptide ; Sperm Injections, Intracytoplasmic ; Teratozoospermia ; Fertilization In Vitro ; Oocytes ; Gonadotropin-releasing Hormone