1.The Analysis of Methylenetetrahydrofolate Reductase Mutation in Recurrent Spontaneous Abortion.
Yoon Sung NAM ; Kwang Yul CHA ; Nam Keun KIM ; Sun Hee KIM ; Jin Woo LIM ; Geum Duk KANG ; Myung Seo KANG ; Se Hyun KIM ; Doyeun OH
Korean Journal of Fertility and Sterility 2001;28(3):247-
OBJECTIVE: To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: The blood samples of patients with recurrent spontaneous abortion were tested by PCR-RFLP method. RESULTS: Of 51 cases of study group, 14 (27.5%) were normal, 25 (49.0%) were heterozygosity, and 12 (23.5%) were homozygosity. Of 58 cases of control group, 20 (34.5%) were normal, 30 (51.7%) were heterozygosity, and 8 (13.8%) were homozygosity. But the difference between two groups was not significant (p=0.190). CONCLUSION: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the study for MTHFR mutation should be included in the workup of recurrent spontaneous abortion.
Abortion, Spontaneous*
;
Female
;
Humans
;
Hyperhomocysteinemia
;
Methylenetetrahydrofolate Reductase (NADPH2)*
;
Pregnancy
2.Comparative Study on Development of Mouse Embryos in Three Commercial Media and Hatching Rates of Mouse Embryos with/without Pronase.
Jeong Heon LEE ; Hee Jeong GO ; Geu Jeong CHAE ; Ki Suk LEE ; Jong Duk KIM
Korean Journal of Fertility and Sterility 2001;28(3):235-246
OBJECTIVE: The purpose of this present study was to compare mouse embryo development in 3 commercial media and hatching competence of mouse embryo with or without enzymatic treatment. METHODS: Collected 375 mouse embryos were divided into three groups, and then cultured in IVF-20 (G2), Medicult IVF (M3), P-1 (blastocyst M), respectively. Three day mouse morulae were cultured in G2 media treated with pronase. The results were analyzed using Chi-square test, and considered statistically significant when p<0.01. RESULTS: The developmental rate of 2 cell mouse embryo after 72 hours was highest in IVF-20 (G2) among conventional 3 media. The hatching rate of mouse morulae was low when clultured in G2 media without pronase during 48 hours. However, it was higher when cultured in media treated with l mg/ml, 2.5 mg/ml, 5 mg/ml pronase, respectively. CONCLUSIONS: Using good media and digestion of zona pellucida with enzymatic treatment improve development and hatching rate of embryo. Therefore, implantation and pregnancy rate could be improved.
Animals
;
Digestion
;
Embryonic Development
;
Embryonic Structures*
;
Female
;
Mental Competency
;
Mice*
;
Morula
;
Pregnancy
;
Pregnancy Rate
;
Pronase*
;
Zona Pellucida
3.The Efficacy of Low-dose Aspirin Therapy for Controlled Ovarian Hyperstimulation in IVF-ET.
Korean Journal of Fertility and Sterility 2001;28(3):225-234
OBJECTIVE: To evaluate the efficacy of low-dose aspirin on IVF outcome and endometrium in patients undergoing IVF-ET. MATERIALS AND METHODS: From February, 2001 to Jun, 2001, 60 infertile patients were randomly divided into study group (28 cycles) and control group (32 cycles). The study group received a daily oral dose of 25 mg of aspirin for at least 2 weeks from first visiting day. Controlled ovarian hyperstimulation was initiated in all patients with the GnRH agonist starting in the midluteal phase of the previous cycle. RESULTS: There were no significant differences in age of the patients, basal serum E2, LH, FSH level and endometrial thickness among two groups. There were no statistically significant differences between the study group and the control group respectively in dosage (26.5+/-4.8 vs 26.2+/-5.3 amples) and duration (10.4+/-4.2 vs 9.8+/-5.3 days) of gonadotropin administration, serum E2 level on the hCG administration day (1823+/-342 vs 1854+/-543), LH (14.5+/-2.7 vs 14.8+/-3.1), FSH (16.7+/-3.4 vs 18.3+/-4.7), the number of follicles p> 15 mm (13.2+/-6.3 vs 12.8+/-5.9), the number of oocytes retrieved (9.2+/-2.4 vs 8.4+/-1.7), the number of embryos transferred (4.7+/-2.0 vs 4.7+/-2.0), fertilization rate (68.4% vs 64.5%), implantation rate (21.3% vs 17.6%), and clinical pregnancy rate (28.4% vs 26.2%). The endometrial thickness and the percentage of endometrial trilaminar pattern on hCG day were significantly higher in study group than control group (12.9+/-3.7 mm vs 10.4+/-2.8 mm, 78.3% vs 64.5%). CONCLUSION: Many reports suggest that low-dose aspirin improve ovarian response, implantation rate, fertilization rate, implantation rate, and pregnancy rate by increasing the blood flow, but we couldn't prove the significant effect of low-dose aspirin on the IVF outcome except on endometrium. This may be affected by dose of aspirin, duration, and number of patients studied. This trial is small, so our results highlight the need for a large randomized controlled trial to identify the effect of low-dose aspirin on IVF-ET outcome.
Aspirin*
;
Embryonic Structures
;
Endometrium
;
Female
;
Fertilization
;
Gonadotropin-Releasing Hormone
;
Gonadotropins
;
Humans
;
Oocytes
;
Pregnancy Rate
4.Uterine Arterial Embolization for the Treatment of Leiomyomas Accompanying with Adenomyosis.
Jin Beum JANG ; Sang Wook BAI ; Jae Hak LIM ; Do Yeon LEE ; Jung Yeon KIM ; Kyung Ah JEONG ; Sei Kwang KIM ; Ki Hyun PARK
Korean Journal of Fertility and Sterility 2001;28(3):215-224
OBJECTIVE: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. MATERIALS AND METHODS: We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. RESULTS: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. CONCLUSION: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer desire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.
Adenomyosis*
;
Female
;
Fertility
;
Follow-Up Studies
;
Gelatin Sponge, Absorbable
;
Humans
;
Korea
;
Leiomyoma*
;
Menorrhagia
;
Myoma
;
Polyvinyl Alcohol
;
Retrospective Studies
;
Ultrasonography
;
Uterine Artery Embolization
5.A Study of Factor XII Deficiency in Recurrent Spontaneous Abortion.
Yoon Sung NAM ; Nam Keun KIM ; Su Man LEE ; Myung Seo KANG ; Doyeon OH ; Kwang Yul CHA
Korean Journal of Fertility and Sterility 2001;28(3):209-214
OBJECTIVE: To evaluate factor XII deficiency in patients with recurrent spontaneous abortion and its relation to aPTT. MATERIAL AND METHOD: Factor XII was analyzed by clotting method. RESULTS: Of 70 patients with recurrent spontaneous abortion, there were 35 cases of factor XII deficiency. Among them, there were only 3 cases of prolonged aPTT. CONCLUSIONS: It is still unclear whether factor XII deficiency is related to recurrent spontaneous abortion. Molecular approaches should be used to understand further the causal relationship. But based on this result, in the workup of patients with recurrent spontaneous abortion, factor XII should be included. aPTT is not likely to represent the abnormality of factor XII.
Abortion, Spontaneous*
;
Factor XII Deficiency*
;
Factor XII*
;
Female
;
Humans
;
Pregnancy
6.Effect of Magnesium Ion in the Culture Medium on the Development of Preimplantation Mouse Embryos In Vitro.
Soo Jin CHOI ; Jin Hyun JUN ; Yong Seog PARK ; In Ha BAE
Korean Journal of Fertility and Sterility 2001;28(3):199-208
OBJECTIVE: The present study was undertaken to examine the effects of magnesium ion in the culture medium on the development of mouse fertilized oocytes either before or after pronuclear formation, and to investigate whether the effect of magnesium ion is related with the redistributional change of mitochondria. METHODS: Fertilized oocytes obtained from the oviducts of mice at 15 hr after hCG injection before pronuclear formation (pre-PN) or 21 hr after hCG injection after pronuclear formation (post-PN) were used. The embryos were cultured for 3 days with basic T6 medium-magnesium free and various concentrations of magnesium ion, 0.0, 0.5, 1.0, 2.0, 4.0 or 8.0 mM, respectively. After culture, the developmental stages of embryos and the number of nuclei were evaluated. To observe the effects of magnesium ion on the mitochondrial distribution, fertilized oocytes were collected at 21 hr after hCG injection and cultured for 6 hr with various concentration of magnesium ion. As a control, fertilized oocytes with pronuclei at 27 hr after hCG injection were used. RESULTS: The concentration of magnesium ion to accelerate the in vitro development of mouse fertilized oocytes appeared to be at 2.0 mM for the pre-PN and the post-PN stage embryos. In the mitochondrial redistribution patterns, the embryos cultured in 2.0 mM concentration of magnesium ion showed the highest percentage (22.6%) of distinct perinuclear clustering pattern comparing to other experimental group. CONCLUSION: The effect of magnesium ion may be related to the cytoplasmic redistribution of mitochondria. This relationship seems to connect the developmental competence of preimplantation mouse embryos in vitro. These results can suggest that higher concentration of magnesium ion (2.0 mM) than those of conventional culture medium (0.2~1.2 mM) is more suitable for in vitro culture of preimplantation mouse embryos.
Animals
;
Cytoplasm
;
Embryonic Structures*
;
Magnesium*
;
Mental Competency
;
Mice*
;
Mitochondria
;
Oocytes
;
Oviducts
7.Comparison of Vitrification and Slow Freezing-thawing Method on 1-cell Zygotes.
Ji Hyang LEE ; Hyuck Dong HAN ; Hye Young KOO
Korean Journal of Fertility and Sterility 2001;28(3):191-198
OBJECTIVE: This study was conducted to examine the effect of vitrification on the survival and in vitro development of mice 1-cell zygotes. METHOD: Effects of exposure to vitrification solution and vitrification, with different concentrations of the cryoprotectant solution, were examined. The 1-cell zygotes were also subjected to a slow freezing- thawing method to compare with vitrification method. Solution composed of ethylene glycol (6.0 M, 5.0 M, 4.0 M) and sucrose (1.0 M) were used as cryopropectant. The experiments employed the method loading the embryos on electron microscope grids. RESULTS: I. The effects of exposure in vitrification solution 1-cell zygotes were non-toxic at all concentrations of the vitrification solution showing the survival rate between 88.1% and 97.5%. Development into 2-cell was more successful in the higher concentrations of the vitrification solution. Therefore, higher concentrations of the vitirification solution do not seem to cause any problems in vitrification procedure. II. The effects of vitrification method 1-cell zygotes showed the survival rate between 78.8% and 92.4%. The lowest and the highest survival rate was observed in the 6.0 M and 4.0 M vitrification solution, respectively. 2-cell development rates varied from 77.6% to 91.3%. Blastocyst development rate was shown highest in 5.0 M and the lowest in 4.0 M solution. Therefore, the highest 2-cell and blastocyst development rate was observed in 5.0 M solution. III. Comparison of vitrification and slow freezing-thawing method on 1-cell zygotes This experiment showed that 1-cell zygotes had the highest survival and development rates in 5.0 M vitrification solution. Vitrified group of 1-cell zygotes, in the 5.0 M vitrification solution, were compared with the group processed in slow freezing-thawing method. The development rate into 2-cell and blastocyst as well as the survival rate were higher in the vitrified group than in the slowly freezed group. CONCLUSION: 1. The results demonstrate that the best cryoprotectant is a 5.0 M vitrification solution for 1-cell zygotes. 2. Vitrification method significantly increases the survival rate of the 1-cell zygote and its development into 2-cell and blastocyst. Equilibration and exposure time during the vitrification was remarkerbly short in this experiment. Total time, from the exposure to vitirification solution to storage in the liquid nitrogen, was taken only 90 seconds. In contrast, the slow freezing-thawing method have taken more than four hours. Taken together, we presume that the overall time used for the procedure contributes to the results as an important parameter. 3. The loading of 1-cell zygotes on the EM grid is technically more simple and takes less time than the straw or cryo vial method.
Animals
;
Blastocyst
;
Embryonic Structures
;
Ethylene Glycol
;
Group Processes
;
Mice
;
Nitrogen
;
Sucrose
;
Survival Rate
;
Vitrification*
;
Zygote*
8.Analysis of the Gene Expression by Laser Captured Microdissection (I): Minimum Conditions Required for the RNA Extraction from Oocytes and Amplification for RT-PCR.
Chang Eun PARK ; Jung Jae KO ; Kwang Yul CHA ; Kyung Ah LEE
Korean Journal of Fertility and Sterility 2001;28(3):183-190
OBJECTIVE: Recently, microdissection of tissue sections has been used increasingly for the isolation of morphologically identified homogeneous cell populations, thus overcoming the obstacle of tissue complexity for the analysis cell-specific expression of macromolecules. The aim of the present study was to establish the minimal conditions required for the RNA extraction and amplification from the cells captured by the laser captured microdissection. METHODS: Mouse ovaries were fixed and cut into serial sections (7 micrometer thickness). Oocytes were captured by laser captured microdissection (LCM) method by using PixCell IITM system. The frozen sections were fixed in 70% ethanol and stained with hematoxylin and eosin, while the paraffin sections were stained with Multiple stain. Sections were dehydrated in graded alcohols followed by xylene and air-dried for 20 min prior to LCM. All reactions were performed in ribonuclease free solutions to prevent RNA degradation. After LCM, total RNA extraction from the captured oocytes was performed using the guanidinium isothiocyanate (GITC) solution, and subsequently evaluated by reverse transcriptase -polymerase chain reaction (RT-PCR) for glyceraldehyde-3-phosphate-dehydrogenase (GAPDH). RESULTS: With the frozen sections, detection of the GAPDH mRNA expression in the number of captured 25 oocytes were not repeatable, but the expression was always detectable from 50 oocytes. With 25 oocytes, at least 27 PCR cycles were required, whereas with 50 oocytes, 21 cycles were enough to detect GAPDH expression. Amount of the primary cDNA required for RT-PCR was reduced down to at least 0.25 microl with 50 oocytes, thus the resting 19.75 microl cDNA can be used for the testing other interested gene expression. Tissue-to-slide, tissue-to-tissue forces were very high in the paraffin sections, thus the greater number of cell procurement was required than the frozen sections. CONCLUSION: We have described a method for analyzing gene expression at the RNA level with the homogeneously microdissected cells from the small amount of tissues with complexity. We found that LCM coupled with RT-PCR could detect housekeeping gene expression in 50 oocytes captured. This technique can be easily applied for the study of gene expression with the small amount of tissues.
Alcohols
;
Animals
;
DNA, Complementary
;
Eosine Yellowish-(YS)
;
Ethanol
;
Female
;
Frozen Sections
;
Gene Expression*
;
Genes, Essential
;
Guanidine
;
Hematoxylin
;
Mice
;
Microdissection*
;
Oocytes*
;
Ovary
;
Paraffin
;
Polymerase Chain Reaction
;
Ribonucleases
;
RNA Stability
;
RNA*
;
RNA, Messenger
;
RNA-Directed DNA Polymerase
;
Xylenes
9.Influence of Transforming Growth Factor-alpha on Expression of Matrix Metalloproteinase-2, 9 and Epidermal Growth Factor Receptor Gene in the Mouse Blastocysts.
Jeong Hee KIM ; Seok Ho HONG ; Hee Young NAH ; Ji Yun LEE ; Hee Dong CHAE ; Chung Hoon KIM ; Byung Moon KANG ; In Ha BAE
Korean Journal of Fertility and Sterility 2001;28(3):173-182
No abstract available.
Animals
;
Blastocyst*
;
Epidermal Growth Factor*
;
Matrix Metalloproteinase 2*
;
Mice*
;
Receptor, Epidermal Growth Factor*
10.A Case of Pregnancy Using Recombinant Follicle Stimulating Hormone and Gonadotropin Releasing Hormone Antagonist.
Yoon Sung NAM ; Nam Keun KIM ; Eun Kyung KIM ; Hyung Min CHUNG ; Kwang Yul CHA
Korean Journal of Fertility and Sterility 2001;28(1):73-77
OBJECTIVE: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. MATERIAL AND METHOD: Case report. RESULTS: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. CONCLUSION: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.
Pregnancy
;
Female
;
Humans