PURPOSE: We evaluated the result of varicocelectomy on semen and hormone status to assess the effect of the operation. MATERIALS AND METHODS: Between March 2001 and January 2004, 63 men with varicocele underwent microsurgical inguinal varicocelectomy. Based on their chief complaint, they were classified into two groups: scrotal pain group (n=17) and infertility group(n=14). They were checked by semen analysis and hormone status(LH, FSH, testosterone) and GnRH stimulation test before the operation and 3 months after the operation. RESULTS: The mean ages of the pain and infertility groups were 24.8+/-5.2 years and 32.6+/-2.9 years, respectively. The results of postoperative semen analyses were improved in both groups and in all items. In the pain group, postoperative LH, FSH, and testosterone levels were increased, and the ratio of changes of FSH and testosterone after GnRH stimulation were decreased significantly after operation. In the infertility group, post-operative hormone levels were increased, and the ratio of changes of hormone level after GnRH stimulation were decreased, but, the results were not statistically significant. CONCLUSIONS: The results of semen analyses were improved significantly after varicocelectomy. Post-operative hormone levels were increased, and the ratio of changes of hormone level after GnRH stimulation were decreased. We think that the pre- and post-operative semen analyses, hormone level, and GnRH stimulation test could be useful in assessing the success of varicocelectomy.
Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Male ; Semen Analysis ; Semen* ; Testosterone ; Varicocele*

OBJECTIVETo explore the specific regulative law of electroacupuncture (EA) for the hypothalamus-pituitary-gonad axis.

METHODSThe adult female SD rats were divided into a simulant EA group, Guanyuan (CV 4) group and Neiguan (PC 6) group according to 4 stages of the estrous cycle. Acupuncture was given from 9 : 30 AM to 10 : 00 AM and the brain tissue samples were collected at 15 : 00 PM. GnRH expressions in the nuclei related with genital neuroendocrine in the hypothalamus were investigated with immunohistochemical method.

RESULTS(1) The GnRH expression quantity was different in different estrous cycles in the simulant EA group, with more expression in the proestrus and the estruation; (2) After acupuncture, the GnRH expressions in the medial preoptic area, the arcuate nuclei and the nuclei periventriculares were increased in different stages of the estrous cycle in varying degrees, with the "strong" GnRH expression increased significantly in the diestrus and the metaoestrus in the Guanyuan (CV 4) group.

CONCLUSIONAfter EA, the expression of the GnRH-positive reactant in the medial preoptic area, the arcuate nuclei and the nuclei periventriculares of the hypothalamus significantly increases, with the Guanyuan (CV 4) group better than the Neiguan (PC 6) group, and more obvious expressions in the diestrus and the metaoestrus.

Animals ; Electroacupuncture ; Estrus ; metabolism ; Female ; Gonadotropin-Releasing Hormone ; analysis ; Immunohistochemistry ; Rats ; Rats, Sprague-Dawley

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

OBJECTIVETo explore the effects of obesity on the peak level of luteinizing hormone (LH) in the gonadotropin-releasing hormone (GnRH) agonist test and obesity-related hormones in girls with central precocious puberty (CPP).

METHODSThree hundred and thirty-three girls with CPP who underwent the GnRH agonist test between 2012 and 2014 were classified into three groups: normal weight (n=123), overweight (n=108), and obesity (n=102), according to body mass index (BMI). The sexual development indices were compared between the three groups. Twenty girls were randomly selected from each group for evaluation of the serum levels of leptin, sex hormone binding globulin (SHBG), neurokinin B, and kisspeptin. The correlation of BMI with the levels of various hormones was assessed using Pearson correlation analysis.

RESULTSThere was no significant difference in mean age at diagnosis between the three groups; however, the bone age was significantly higher in the overweight and obesity groups than in the normal weight group (P<0.05). The peak level of LH in the GnRH agonist test and SHBG level in the normal weight group were significantly higher than those in the overweight and the obesity groups, while the serum levels of leptin and neurokinin B were significantly lower in the normal weight group than in the overweight and the obesity groups (P<0.05). BMI was negatively correlated with the peak level of LH in the GnRH agonist test and SHBG level (P<0.05), and positively correlated with the levels of leptin and neurokinin B (P<0.05).

CONCLUSIONSThe effects of BMI on the result of the GnRH agonist test and levels of obesity-related hormones should be taken into account in girls with precocious puberty.

Body Mass Index ; Child ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Leptin ; blood ; Luteinizing Hormone ; blood ; Neurokinin B ; blood ; Obesity ; blood ; Puberty, Precocious ; blood ; Sex Hormone-Binding Globulin ; analysis

BACKGROUND: Kallmann's syndrome is related to the defect in migration of olfactory neuron and GnRH neuron from the olfactory placode to the brain and it represents hypogonadism with anosmia or hyposmia. There are 3 modes of transmission in Kallmann's syndrome: X-linked, autosomal recessive and autosomal dominant. X-linked form is the most common. KAL gene is responsible for the X-linked form of Kallmann's syndrome and it had been localized to Xp22.3. The intron-exon organization had been determined and KAL gene mutation had also been identified in familial Kallmann's syndrome and it is very rare and shows heterogeneity. Furthermore, in the sporadic cases, KAL gene mutation is more rare. METHODS: In order to investigate the KAL gene mutation and the regulation of the gene expression in Kallmann's syndrome, we examined genomic DNA of 35 patients with sporadic Kallmann's syndrome. In the exon 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 of KAL gene and 1, 2, 3 of GnRH receptor gene, the mutations were analyzed by PCR-based DNA sequencing. RESULTS: In our study, the mutation of KAL gene and GnRH receptor gene was not identified in the studied exons that were known as preferable sites of the mutation. CONCLUSION: The mutation of KAL gene and GnRH receptor gene is rare, and it might be needed to investigate mutations in other genes or in other part of the KAL gene such as intron or promoter region.
Brain ; DNA ; Emigration and Immigration ; Exons ; Gene Expression ; Gonadotropin-Releasing Hormone* ; Humans ; Hypogonadism ; Introns ; Kallmann Syndrome* ; Neurons ; Olfaction Disorders ; Population Characteristics ; Promoter Regions, Genetic ; Receptors, LHRH* ; Sequence Analysis, DNA

OBJECTIVE: This study was designed to assess the actual circumstances of post-operative anemia and associating factors, during the laparoscopic myomectomy. METHODS: A retrospective chart review of 172 patients who underwent laparoscopic myomectomy from 2008 to 2009 was performed. Characteristics of patients (age, parity, body mass index, and preoperative gonadotropin releasing hormone agonists injection) and fibroids (the largest diameter, number, width, type and location), and surgical outcomes (operating time, pre- and post-operative hemoglobin level, blood loss, hospital stay, and complications, including transfusion) were retrieved. RESULTS: One patient (0.6 %) required transfusion and significant hemoglobin change (> or =2.0 g/dL) occurred in 45 patients, after laparoscopic myomectomy. The largest diameter, width, type, and location of fibroids, and pre-operative gonadotropin releasing hormone agonist injection were not associated with the hemoglobin change (p=0.193, 0.172, 0.764, 0.741, and 0.954 respectively). Multivariate analysis revealed that nulliparity (p=0.195, 95% confidence interval (CI): 0.286-1.291) was not a risk factor, but long operating time (> or =90 min; p=0.048, 95% CI: 1.008-5.054) and multiple myoma (> or =3 in number; p=0.009, 95% CI: 1.320-6.717) were independent risk factors for significant hemoglobin change. CONCLUSION: In our data, symptomatic anemia after laparoscopic myomectomy was uncommon. In addition, the only useful predictive factor for hemoglobin change during the laparoscopic myomectomy was a multiplicity of myoma.
Anemia ; Body Mass Index ; Female ; Gonadotropin-Releasing Hormone ; Hemoglobins ; Humans ; Leiomyoma ; Length of Stay ; Multivariate Analysis ; Myoma ; Parity ; Retrospective Studies ; Risk Factors

Sometimes, the clinical findings and the results of the gonadotropin-releasing hormone (GnRH) stimulation test are inconsistent in girls with early breast development and bone age advancement. We aimed to investigate the factors predicting positive results of the GnRH stimulation test in girls with suspected central precocious puberty (CPP). We reviewed the records of 574 girls who developed breast budding before the age of 8 yr and underwent the GnRH stimulation test under the age of 9 yr. Positive results of the GnRH stimulated peak luteinizing hormone (LH) level were defined as 5 IU/L and over. Girls with the initial positive results (n = 375) showed accelerated growth, advanced bone age and higher serum basal LH, follicle-stimulating hormone, and estradiol levels, compared to those with the initial negative results (n = 199). Girls with the follow-up positive results (n = 64) showed accelerated growth and advanced bone age, compared to those with the follow-up negative results. In the binary logistic regression, the growth velocity ratio was the most significant predictive factor of positive results. We suggest that the rapid growth velocity is the most useful predictive factor for positive results in the GnRH stimulation test in girls with suspected precocious puberty.
Age Determination by Skeleton ; Breast/growth & development ; Child ; Estradiol/blood ; Female ; Follicle Stimulating Hormone/blood ; Follow-Up Studies ; Gonadotropin-Releasing Hormone/*analysis ; Humans ; Logistic Models ; Luteinizing Hormone/blood ; Predictive Value of Tests ; Puberty, Precocious/*diagnosis ; ROC Curve ; Retrospective Studies

PURPOSE: As the survival rate of children with malignancies has increased over past decades, the follow-up in adult long-term survivors of childhood malignancies should focus on late effects of disease and treatment. This study was undertaken to find out whether sexual development was affected by the previous chemotherapy and reproductive function could be evaluated by Tanner stage and serum sex hormone level. METHODS: Pubertal stage and gonadal function were studied in 15 male adults survived 4.3~14.3 years after treatment for acute lymphoblastic leukemia, malignant lymphoma or lymphoma-leukemia during childhood or adolescence. RESULTS: All patients showed more than stage IV sexual maturity rating. Patients treated with cyclophosphamide including maintenance (CY group) had lesser testicular volume (P=.0001). All patients except one who has testicular involvement at diagnosis, showed normal follicle-stimulating hormone, leutenizing hormone, and testosterone level. Semen analysis was done in 2 patients. One patient with Non-CY group showed normal, whereas one with CY group showed azoospermia. It seemed that treatment period (before or during puberty) or prophylactic cranial radiation therapy did not affect sexual development. CONCLUSION: Previous chemotherapy did not affect sexual development. Physical examination, sex hormone level, bone age were not sufficient for detecting reproductive impairment. Semen analysis and GnRH or hCG hormone stimulation test should be done in high risk patients treated with chemotherapeutic agents affecting germ cell function or testicular radiation therapy.
Adolescent ; Adult* ; Azoospermia ; Child ; Cyclophosphamide ; Diagnosis ; Drug Therapy ; Follicle Stimulating Hormone ; Follow-Up Studies ; Germ Cells ; Gonadotropin-Releasing Hormone ; Gonads ; Humans ; Lymphoma* ; Male* ; Physical Examination ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Semen Analysis ; Sexual Development* ; Survival Rate ; Survivors ; Testosterone

It is well known that the clinical test for responsibility of accurate fertilization capacity in male partners is very important to diagnose and treat the infertility. However, it has been reported that the traditional semen analysis cannot accurately predict fertilization and pregnancy potential. The present study was performed to evaluate the acrosomal reaction to ionophore challenge (ARIC) test as a prognostic indicator for fertilization of sperm and oocyte in an in vitro fertilization and embryo transfer (IVF-ET) program. From March 1996 to Februry 1997, 30 couples undergoing IVF program were allocated to this study group. All female partners in the study group were 35 years old or less and their serum level of basal follicle stimulating hormone (FSH) and estradiol (E2) were normal. All the male partners have normal parameters of semen analysis. The ARIC tests were performed on the day of ovum pick up and in vitro insemination in all the male partners. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone (GnRH) agonist was used in all couples for IVF-ET. The acrosomal reaction with 10microliter of 10% DMSO was induced spontaneously in 10.1+/-9.8%, and acrosomal reaction with calcium ionophore A 23187 was induced in 27.4+/-18.1%, and the ARIC value was 17.4+/-16.2%. There were no significant correlation between the ARIC value and the fertilization rate (r2=0.044, p=0.268). There were also no significant correlation between the ARIC value and the percentage of the grade I, II embryos (r2=0.046, p=0.261). On the basis of above results, it was suggested that ARIC test might not be a useful prognostic indicator for fertilization in IVF-ET in male partners with normal parameters of conventional semen analysis. We guessed that IVF-ET could be performed to the patients primarily without universal appilcation of ARIC test to all male partenrs, and if fertilization failure occurs, the microassisted fertilization (MAF) such as intracytoplsmic sperm injection (ICSI) might be used as an alternative mode of treatment with acceptable success rate.
Acrosome Reaction* ; Acrosome* ; Adult ; Calcimycin ; Calcium ; Dimethyl Sulfoxide ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Family Characteristics ; Female ; Fertilization ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Insemination ; Male ; Oocytes ; Ovum ; Pregnancy ; Semen Analysis ; Spermatozoa