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

OBJECTIVESTo detect the sexual hormone level in semen of patients with idiopathic azoospermia and oligospermia, and further analyze the relationship between sexual hormone and idiopathic azoospermia and oligospermia.

METHODS50 male patients with idiopathic azoospermia, 50 in idiopathic oligospermia and 50 male controls with normal sperm density were selected. The sperm density and sexual hormone in semen were detected respectively by routine semen analysis and chemical luminescence technique.

RESULTSThe values of LH were (5.19 +/- 0.67) IU/L and (4.77 +/- 0.68) IU/L, and those of FSH were (1.90 +/- 0.79) IU/L and (2.27 +/- 0.25) IU/L in idiopathic azoospermia and oligospermia respectively, and the values of LH and FSH were (2.19 +/- 0.22) IU/L and (1.61 +/- 0.14) IU/L in normal control group respectively. There were significant differences in the values of LH and FSH between idiopathic azoospermia and normal control group(P < 0.01 or P < 0.05). The values of PRL were (6.25 +/- 0.51) ng/ml and (6.33 +/- 0.34) ng/ml, and those of T were (1.51 +/- 0.12) ng/ml and (1.68 +/- 0.71) ng/ml in idiopathic azoospermia and oligospermia respectively, and the values of PRL and T were (6.36 +/- 0.32) ng/ml and (1.83 +/- 0.09) ng/ml in normal control group respectively. There were no significant difference in the values of PRL between idiopathic azoospermia, oligospermia and normal control group, but there were significant differences of T between idiopathic azoospermia and normal control. Compared with 0.84 +/- 0.20 in normal control, the values of T/LH were 0.35 +/- 0.09 and 0.29 +/- 0.04 in idiopathic oligospermia and azoospermia respectively and there were significant differences(P < 0.05).

CONCLUSIONSThe changes of LH, FSH and T values may be one of the reasons that cause the dysfunction of spermatogenesis and sperm maturation in patients with idiopathic azoospermia and oligospermia. The study of semen hormone may lead to new strategies in the treatment to azoospermia and oligospermia.

Adult ; Azoospermia ; metabolism ; Case-Control Studies ; Follicle Stimulating Hormone ; analysis ; Humans ; Luteinizing Hormone ; analysis ; Male ; Middle Aged ; Oligospermia ; metabolism ; Semen ; chemistry ; Sperm Count ; Testosterone ; analysis

PURPOSE: The aim of this study was to investigate the influence of body mass index (BMI) on the level of peak luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation in girls with central precocious puberty (CPP) and advanced puberty (AP). METHODS: This study conducted a retrospective review of the medical records of 113 girls (7 to 9 years old; 24 CPP, 89 AP) who underwent a GnRH stimulation test. The following parameters were evaluated: chronologic age (CA), bone age (BA), the difference between BA and CA (BA-CA), height, weight, BMI, and the levels of basal LH, peak LH, basal follicle stimulating hormone (FSH), peak FSH, and basal estradiol. RESULTS: The peak LH level was negatively correlated with weight-standard deviation score (SDS) and BMI-SDS; furthermore, the peak LH level was positively correlated with both basal and peak FSH levels. Using multivariate analysis, BMI-SDS was found to be a significant factor in predicting peak LH levels after GnRH administration. When the subjects were divided into four groups by quartile of peak LH level, the mean BMI-SDS of the highest LH group was significantly lower than the mean BMI-SDS of the lowest LH group. CONCLUSION: LH levels rise after GnRH administration is blunted in precocious and advanced pubertal girls with high BMI. The impact of BMI on the GnRH stimulation test should be considered when evaluating sexual precocity in girls.
Body Mass Index ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Lutein ; Luteinizing Hormone ; Medical Records ; Multivariate Analysis ; Piperazines ; Puberty ; Puberty, Precocious ; Retrospective Studies

OBJECTIVETo study diagnosis and differential diagnosis of Kallmann syndrome.

METHODSThe examinations including routine karyotyping, sex hormone, GnRH stimulation test and MRI were performed.

RESULTSCytogenetic analysis of his peripheral lymphocyte by G banding showed a normal male karyotype. GnRH stimulation test presented a good reaction. Plasma levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone were very low. Absent olfactory bulb was found by magnetic resonance imaging (MRI).

CONCLUSIONKaryotype analysis, sexual hormone, GnRH stimulation test and MRI are very important the diagnosis of Kallmann syndrome.

Adult ; Diagnosis, Differential ; Follicle Stimulating Hormone ; blood ; Gonadotropin-Releasing Hormone ; analysis ; Humans ; Kallmann Syndrome ; diagnosis ; Karyotyping ; Luteinizing Hormone ; blood ; Magnetic Resonance Imaging ; Male

OBJECTIVE: Ovarian reserve tests are commonly used to predict ovarian response in infertile patients undergoing ovarian stimulation. Although serum markers such as basal follicle-stimulating hormone (FSH) or random anti-Müllerian hormone (AMH) level and ultrasonographic markers (antral follicle count, AFC) are good predictors, no single test has proven to be the best predictor. In this study, we developed appropriate equations and novel nomograms to predict the number of oocytes that will be retrieved using patients' age, serum levels of basal FSH and AMH, and AFC. METHODS: We analyzed a database containing clinical and laboratory information of 141 stimulated in vitro fertilization (IVF) cycles performed at a university-based hospital between September 2009 and December 2013. We used generalized linear models for prediction of the number of oocytes. RESULTS: Age, basal serum FSH level, serum AMH level, and AFC were significantly related to the number of oocytes retrieved according to the univariate and multivariate analyses. The equations that predicted the number of oocytes retrieved (log scale) were as follows: model (1) 3.21-0.036×(age)+0.089×(AMH), model (2) 3.422-0.03×(age)-0.049×(FSH)+0.08×(AMH), model (3) 2.32-0.017×(age)+0.039×(AMH)+0. 03×(AFC), model (4) 2.584-0.015×(age)-0.035×(FSH)+0.038×(AMH)+0.026×(AFC). model 4 showed the best performance. On the basis of these variables, we developed nomograms to predict the number of oocytes that can be retrieved. CONCLUSION: Our nomograms helped predict the number of oocytes retrieved in stimulated IVF cycles.
Biomarkers ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Humans ; Linear Models ; Multivariate Analysis ; Nomograms* ; Oocytes* ; Ovarian Reserve ; Ovulation Induction*

PURPOSE: The purpose of this study is to evaluate the preoperative factors that influenced postoperative sperm concentration after vasovasostomy. MATERIALS AND METHODS: We retrospectively reviewed 97 consecutive single-layer vasovasostomy procedures performed by a single surgeon between March 2003 and September 2010. The patients were stratified into three groups based on sperm concentration at 1 month follow-up: group I-azoospermia, group II-oligospermia, and group III-normal. We evaluated the preoperative factors that may have influenced sperm concentration at postoperative 1 month. Patients with serial semen analysis were divided into four groups according to the change in postoperative sperm concentration at the 6-month visit: group II-N-from oligospermia to normal, group II-O-from oligospermia to oligospermia, group III-O-from normal to oligospermia, group III-N-from normal to normal. We compared the pregnancy rate among the four groups. RESULTS: The mean obstructive interval was 9.69 years in group I, 6.02 years in group II, and 7.82 years in group III. There were significant differences found among the groups (p=0.035). There was significantly different change in sperm concentration, sperm motility, and sperm morphology between each of the groups. A total of 32 patients underwent serial semen analyses at 1 month, 3 months, and 6 months after vasovasostomy. There was no significant difference in patient age, obstructive interval, or follicle-stimulating hormone among the groups. The natural pregnancy rate in group II-O was lower than that in group II-N, and in group III-O was lower than that in group III-N. However, there was no significant difference among each of the groups. CONCLUSIONS: The sperm concentration after vasovasostomy was significantly related to the obstructive interval between vasectomy and reversal.
Follicle Stimulating Hormone ; Humans ; Male ; Oligospermia ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Vasectomy ; Vasovasostomy

OBJECTIVETo investigate the correlation of the testis volume and reproductive hormone level with the results of testicular sperm aspiration (TESA) in non-obstructive azoospermia (NOA) patients, and to explore the cut-off value of the testis volume and reproductive hormone level in predicting the results of TESA so as to provide reliable information for the diagnosis and treatment of NOA.

METHODSWe enlisted 121 NOA patients in this study, divided them into a sperm group and a non-sperm group based on the results of TESA, and measured their testis volumes and reproductive hormone levels.

RESULTSThe left testis volume, the right testis volume, and the levels of prolactin (PRL), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol (E2) and total testosterone (T) in the non-sperm and sperm groups were (7.07 +/- 1.06) ml vs (11.75 +/- 1.38) ml, (7.37 +/- 1.37) ml vs (11.70 +/- 1.98) ml, (12.43 +/- 11.69) ng/ml vs (9.60 +/- 4.55) ng/ml, (15.77 +/- 10.84) mIU/ml vs (8.01 +/- 7.43) mIU/ml, (6.12 +/- 2.92) mIU/ml vs (8.11 +/- 20.11) mIU/ml, (119.36 +/- 43.52) pmol/L vs (141.12 +/- 48.33) pmol/L, and (11.43 +/- 4.05) nmol/L vs (12.46 +/- 4.60) nmol/L, respectively. The mean levels of serum FSH and PRL were significantly higher in the non-sperm than in the sperm group. Although the mean testis volume of the former was less than that of the latter, there were no significant differences between the two groups, and nor were any significant differences in age and the levels of E2 and T. The cut-off value of the testis volume was 9 ml, with sensitivity of 93.8%/89.6% (left/right) and specificity of 100%/94.3% (left/right). The area under curve (AUC) of the left testis volume was 0.984 and that of the right was 0.961, indicating a high diagnostic accuracy. The cut-off value of the serum FSH level was 8.18 mIU/ml, with a sensitivity of 71.2% and a specificity of 75.0%. The AUC of the FSH level was 0.743, suggestive of a moderate diagnostic accuracy.

CONCLUSIONThe testis volume and FSH level are important for predicting the TESA results of NOA patients, and the former has even a higher diagnostic accuracy than the latter.

Adult ; Azoospermia ; pathology ; physiopathology ; Follicle Stimulating Hormone ; analysis ; Humans ; Luteinizing Hormone ; analysis ; Male ; Organ Size ; Sperm Retrieval ; Testis ; anatomy & histology ; Young Adult

In this study, we evaluated the effects of ascorbic acid (VC), epidermal growth factor (EGF) and follicle stimulating hormone (FSH) on in vitro culture of sheep ovarian cortical tissue. Using 2 x 2 x 2 factor experimental design, we cultured sheep ovarian cortex fragments in 8 media with MEM (control), MEM+VC (50 microg/mL), MEM +EGF (100 ng/mL), MEM+FSH (50 ng/mL), MEM+VC+EGF, MEM+VC+FSH, MEM+EGF+FSH, MEM+VC+EGF+FSH. After 0 (non-cultured control), 2, 6, 12 days of culture, the pieces of ovarian cortex were proceed to histological and proliferating cell nuclear antigen (PCNA) examination, or observed by transmission electron microscopy (TEM). The percentages of developing follicles were increased (P < 0.05) and the percentages of healthy follicles were reduced (P < 0.05). When compared to the MEM group, the addition of FSH with VC or EGF promoted a significant increase of follicles diameter and follicles survival rate (P < 0.05), and stimulated the proliferation of granulosa cells. After 12 days of culture, medium supplemented with MEM+VC+EGF resulted the lowest proportion of developing follicles (49.3% +/- 3.2%), follicles diameter((32.3 +/- 2.3) microm), follicles survival rate (41.6% +/- 3.1%) and the proportion of PCNA stained follicles (26.4% +/- 1.2%, P < 0.05). In contrast, MEM+VC+EGF+FSH resulted the highest follicles diameter ((42.5 +/- 5.1) microm), follicles survival rate (59.7% +/- 6.1%) and proportion of PCNA stained follicles (43.5% +/- 4.1%, P < 0.05). Ultrastructural analysis confirmed the integrity of follicles cultured in VC+EGF+FSH group, while follicles cultured in MEM+VC+EGF groups showed more degeneration characters. In conclusion, the addition of VC and EGF to culture medium inhibited follicular development, VC+EGF+FSH was the most effective treatment to maintain follicular integrity and promote sheep primordial follicular activation and growth during in vitro culture.
Animals ; Ascorbic Acid ; pharmacology ; Culture Techniques ; Epidermal Growth Factor ; pharmacology ; Female ; Follicle Stimulating Hormone ; pharmacology ; Ovarian Follicle ; growth & development ; Ovary ; growth & development ; Proliferating Cell Nuclear Antigen ; analysis ; Sheep

PURPOSE: We performed the present study to evaluate the prognostic factors for the surgical outcome of varicocelectomy in the treatment of a painful varicocele. MATERIALS AND METHODS: A total of 77 patients undergoing varicocelectomy were enrolled. All the patients were examined for body mass index (BMI), varicocele grade, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), semen analysis, maximal vein diameter, and discrepancy of testicular volume. At a follow-up visit 3~6 months after the surgery, the patient response was graded as a complete response, partial response, or no response. The resolution of pain was defined as a complete or partial response. We used logistic regression analyses to determine the preoperative factors for predicting a complete response and the resolution of pain. RESULTS: Ten subjects were lost to follow-up. The remaining 67 patients were included in this study. The pain was completely resolved in 47.8% of patients, partial resolution was observed in 25.4% of patients, and failure was reported in 26.9% of patients. Among the parameters, only a longer duration of pain (> or =3 months) was an independent factor related to the complete response of pain (odds ratio, 7.371; p=0.010) and the resolution of pain (odds ratio, 7.209; p=0.042). The parameters of semen analysis results, testosterone, LH, FSH, BMI, grade, ultrasonography results, and the type of surgical approach did not significantly predict the resolution of pain. CONCLUSIONS: The duration of pain (> or =3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain.
Body Mass Index ; Follicle Stimulating Hormone ; Follow-Up Studies ; Humans ; Laparoscopy ; Logistic Models ; Lost to Follow-Up ; Luteinizing Hormone ; Microsurgery ; Semen Analysis ; Testosterone ; Varicocele ; Veins

PURPOSE: Hypogonadotropic hypogonadism (HH) is an uncommon cause of virilization and male infertility. We evaluated the effect of the combination therapy with human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) in patients with HH. MATERIALS AND METHODS: Between May 2000 and April 2007, we evaluated 15patients with HH. Testicular volume, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, and semen analysis were consecutively monitored at 6, 12, 24, 36 and 48 months after hCG/hMG combination therapy. Statistical analysis was performed by Paired Student's t-test. RESULTS: Testicular volume showed a time-dependent increase in all patients who received hCG/hMG combination therapy (p<0.01). At 12 months, 12 patients showed and were significant improvement in FSH (1.6+/-0.97mIU/ml, p<0.033) and in serum total testosterone (71+/-2.73ng/ml, p=0.003), respectively. During hCG/hMG combination therapy, semen volume, sperm number, sperm motility, and sperm morphology were improved. However, there was no significant change in LH levels. CONCLUSIONS: Our experience in the management of the patients with HH suggests that hCG/hMG combination therapy might be effective in improving the sperm volume, sperm number, sperm motility, sperm morphology, plasma FSH, total testosterone level, and testicular volume. Thus hCG/hMG therapy seems a better choice in the patients with HH who want pregnancy.
Chorionic Gonadotropin ; Follicle Stimulating Hormone ; Gonadotropins ; Humans ; Hypogonadism ; Infertility, Male ; Luteinizing Hormone ; Male ; Plasma ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Testosterone ; Virilism