Steroid cell tumor of ovary, first described as lipid cell tumor, is rare lesions composed entirely of cells resembling typical steroid hormone - secreting cells, that is lutein cells, Leydig cells, and adrenal cortical cells. Steroid cell tumors oftcn secret androgen and manifest themselves with symptoms of virilization. Other presentations include abdominal swelling or pain, menstrual dysfunction, postmenopausal bleeding, or rarely ascites. We experienced a case of right ovarian steroid cell tumor, not otherwise specified(NOS), manifested hirsuitism and amenorrhea in 49 - year - old patient. The tumor was about 5 cm in size, and associated with huge ascites (l3,000 ml), both pleural effusion, and elevated serum CA 125. We present a case of Meigs syndrome associated with benign ovarian steroid cell tumor with a brief review of the literature.
Amenorrhea ; Ascites* ; Dysmenorrhea ; Female ; Hemorrhage ; Humans ; Leydig Cells ; Luteal Cells ; Male ; Meigs Syndrome ; Ovary ; Pleural Effusion ; Virilism

OBJECTIVE Clomiphene citrate is one of the most commonly used drugs in the treatment of infertility, but the pregnancy rate achieved with clomiphene citrate is significantly lower than the ovulation rate due to its antiestrogenic effect on the endometrium. Endometrial prolactin is considered to be a marker and an inducer of predecidualization that is characteristic of secretory endometrium. The purpose of this study was to evaluate the association of clomiphene citrate and unsatisfactory endometrial differentiation to secretory endometrium by examining the endometrial expression of prolactin in clomiphene citrate-treated infertile women with luteal phase defect. METHODS: The endometrial samples from infertIle women wIth luteal phase defect (n=27) were examined. Five cases during secretory phase and six cases during proliferative phase were obtained by biopsy. Sixteen cases were obtained by biopsy during secretory phase after clomiphene citrate treatment. By immunohistochemical staining for prolactin, all obtained endometrial tissues were examined. The differences in the endometrial expression of prolactin were evaluated between proliferative phase and secretory phase, and between clomiphene citrate treated group and no treatment group during secretory phase. RESULTS: The staining of endometrial prolactin was significantly more intense in the glandular epithelial cells and stromal cells in the secretory endometrium than in the proliferative endometrium. The glandular expression of prolactin in the secretory endometrium was not significantly different between the clomiphene citrate-treated group and no treatment group (p=0.719), but the staining of prolactin in the stromal cells was significantly less intense in the clomiphene citrate-treated group than no treatment group (p=0.019). CONCLUSION: in this investigation, we demonstrated that the endometrial stromal expression of prolactin in the secretory phase was significantly lower in the clomiphene citrate-treated group campared with no treatment group in infertile women with luteal phase defect. And our finding suggests that clomiphene citrate may have an adverse effect on the endometrial predecidualization in infertile women.
Biopsy ; Clomiphene* ; Endometrium ; Epithelial Cells ; Estrogen Receptor Modulators ; Female ; Humans ; Infertility ; Luteal Phase* ; Ovulation ; Pregnancy Rate ; Prolactin* ; Stromal Cells

AIMTo study the effects of L-tyrosine on 3beta-HSD activity of rat luteal cells in vitro.

METHODSLuteal cells were isolated from ovary tissues of female rats pretreated with PMSG and hCG. Luteal cells were cultured with 95% oxygen and 5% carbon dioxide in 37 degrees C. 3beta-HSD activity was measured by radioimmunoassay (RIA).

RESULTS(1) 0.2 mmol x L(-1) and 2.0 mmol x L(-1) L-tyrosine significantly inhibited 3beta-HSD activity. (2) 0.2 mmol x L(-1) L-tyrosine exerted different effects on 3beta-HSD activity at different concentrations of pregnenolone (Ph). It increased 3beta-HSD activity at 0.1 micromol x L(-1) and 1 micromol x L(-1) of Pn concentration. With further increase in the concentration of Pn to 100 micromol x L(-1), the stimulating effect of L-tyrosine was switched to suppression effect. (3) L-tyrosine and L-tyrosine hydrazide both inhibited 3beta-HSD activity induced by hCG.

CONCLUSIONL-tyrosine affects 3beta-HSD activity of rat luteal cells in vitro. L-tyrosine and tyrosine hydrazide inhibits hCG induced 3beta-HSD activity.

3-Hydroxysteroid Dehydrogenases ; metabolism ; Animals ; Cells, Cultured ; Female ; Luteal Cells ; drug effects ; enzymology ; Rats ; Rats, Wistar ; Tyrosine ; pharmacology

OBJECTIVE: GnRH-agonist (GnRH-Ag) used in controlled ovarian hyperstimulation (COH) for IVF-ET has been known to affect directly on apoptosis of human ovarian cells, but its mechanism is not clearly understood. Therefore, the purpose of the present study was to investigate whether caspase-3 and -9 activation and poly-(ADP-ribose)-polymerase (PARP) cleavage are involved in the mechanism(s) by which GnRH-Ag induces apoptosis in human granulosa-luteal cells. METHODS: Human granulosa-luteal cells collected from IVF-ET patients were cultured and treated with 10(-6) M GnRH-Ag or saline as a control. To access apoptosis in the cells, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labeling (TUNEL) assay and DNA fragmentation analysis were preformed 24 h after the treatment. Activity of caspase-3 and -9 in the cells was examined by using a fluorogenic substrate. Caspase-3 and -9 activation and poly (ADP-ribose) polymerase (PARP) cleavage were analyzed by Western blotting. RESULTS: DNA fragmentation in the cells increased in the higher concentration over 10(-6) M GnRH-Ag. In the result of TUNEL assay, the rate of apoptotic cells in GnRH-Ag treatment increased significantly compared with that of saline treatment (p<0.05). The activity of caspase-3 and -9 investigated by using a fluorogenic substrate increased only in the apoptotic cells. In Western blot analysis, the cells treated with GnRH-Ag revealed an increase in active forms of caspase-3 and -9 compared with those of the saline treatment. In addition, cleavage of PARP also increased in the cells treated with GnRH-Ag. CONCLUSION: These results suggest that activation of caspase-3 and -9 and cleavage of PARP might be involved in apoptosis of human granulosa-luteal cells induced by GnRH-Ag.
Apoptosis* ; Blotting, Western ; Caspase 3* ; DNA Fragmentation ; DNA Nucleotidylexotransferase ; Female ; Fluorescent Dyes ; Humans* ; In Situ Nick-End Labeling ; Luteal Cells*

OBJECTIVE: The treatment with low-dose aspirin in the patients with unexplained infertility has been reported to improve the pregnancy rate and implantation rate via increasing the blood flow in the endometrium. But there are little known about the relationships between low-dose aspirin and cell adhesion molecules, NCAM. The aim of this study was to evaluate the effect of low-dose aspirin and clomiphene citrate treatment on the expression of NCAM in the endometrium. METHODS: The patients with unexplained infertility (N=37) were grouped into 3 groups: clomiphene citrate and low-dose aspirin treated group (N=8), clomiphene citrate treated group (N=10), and natural cycle group (N=10, no treatment). As control group, the proliferative and menopausal endometrium was used. Each endometium was obtained by endometrial biopsy performed in late luteal phase and immunohistochemical staining with NCAM was performed. RESULTS: In the stromal cells, the staining intensity of NCAM expression and the number of vessels were significantly increased in the endomterium treated with clomiphene citrate and low-dose aspirin compared with other groups (p<0.05). And the expression of NCAM in the prolifertive and menopausal endometrium showed very weak staining. CONCLUSION: The expression of NCAM in the stromal cells and the number of vessels were increased in the endometrium of unexplained infertility patients treated with clomiphene citrate and low-dose aspirin. These findings may suggest low-dose aspirin has an important role during the secretory phase of endometrium to improve the implantation via increasing the expression of cell adhesion molecules, especially NCAM and increasing the number of vessels.
Aspirin* ; Biopsy ; Cell Adhesion Molecules ; Clomiphene* ; Endometrium* ; Female ; Humans* ; Infertility ; Luteal Phase ; Neural Cell Adhesion Molecules* ; Pregnancy Rate ; Stromal Cells

BACKGROUNDThe mechanisms of endometriosis with infertility have not been fully studied. The present study aimed to assess the follicular fluid (FF) levels of prostaglandin E2 (PGE2), which plays a critical role within the ovary, and to investigate the effect of PGE2 on steroidogenesis in granulosa-lutein cells (GLCs) from women with and without endometriosis.

METHODSThirty-three women with laparoscopically documented endometriosis and 40 controls undergoing in vitro fertilization (IVF) were studied. We assayed the concentrations of PGE2 in FF, the production of E2 and progesterone in FF and in culture medium, and the expression of steroidogenic acute regulatory protein (StAR) and CYP19A1 in GLCs with the intervention of PGE2.

RESULTSPGE2 and progesterone concentrations were increased and displayed positive correlation in endometriotic FF. PGE2 induced the expression of StAR and the production of progesterone in GLCs from women with endometriosis, and the expression of StAR and the production of progesterone were increased in GLCs from women with endometriosis. However, there were no significant effects of PGE2 on promoting the production of E2 or the expression of CYP19A1 in GLCs. Moreover, the production of E2 and the expression of CYP19A1 in GLCs from women with endometriosis were significantly decreased compared to the controls.

CONCLUSIONSPGE2 concentrations are increased in endometriotic FF, along with concomitant increases in progesterone and StAR. In contrast, the E2 and CYP19A1 are decreased in GLCs, which may delay the development of the follicles and cause an imbalance in the follicular steroid hormone levels. These changes may have close relationship with endometriosis-associated infertility.

Adult ; Dinoprostone ; metabolism ; Embryo Transfer ; Endometriosis ; metabolism ; Female ; Fertilization in Vitro ; Follicular Fluid ; metabolism ; Humans ; Luteal Cells ; Pregnancy

Within the corpus luteum, macrophages exert luteotropic and luteolytic actions through secretion of TNF-alpha. However, the mechanisms of luteotropic actions on the development and maintenance of pregnant and nonpregnant corpora lutea are thoroughly unknown.In this experiment, TUNEL, macrophage, and TNF-alpha immunohistochemistry on the corpora lutea of pregnant and nonpregnant rats (Sprague-Dawley strain) were carried out to reveal the role of macrophages in the developing corpora lutea. The results were as follows; 1) In the nonpregnant corpora lutea, the number of macrophages was increased significantly, and the degree of ED1-immunoreactivity of macrophages was increased moderately. But lutein cells showed low-degree TNF-alpha-immunoreactivity. 2) In the pregnant corpora lutea, the number of macrophages was decreased significantly, and the degree of ED1- immunoreactivity of macrophages was low. But lutein cells showed moderate-degree TNF-alpha-immunoreactivity. Based on the above results, it was considered that macrophages in the nonpregnant corpora lutea exert phagocytic action mainly, and the macrophages in the pregnant corpora lutea exert TNF-alpha-secreting action to maintain the structure and function of lutein cells.
Animals ; Corpus Luteum* ; Female ; Immunohistochemistry ; In Situ Nick-End Labeling ; Luteal Cells ; Macrophages* ; Rats* ; Tumor Necrosis Factor-alpha

This study was aimed to examine the expression and function of Slit/Robo family members in mouse ovary. Real-time PCR was used to assess the mRNA expression levels of Slit/Robo family members, and immunohistochemistry was used to examine the location of Slit2 and Robo1 in the ovary. The mRNA and protein expression levels of Slit2 and Robo1 in early-, middle- and late-phase corpus luteum (CL) were examined by real-time PCR and immunohistochemistry, respectively. Blocking agent ROBO1/Fc chimera was used in the luteal cells in vitro to examine the function of Slit/Robo signaling pathway in mouse CL. The results showed that, among the Slit/Robo family members, the expression levels of ligand Slit2 and receptor Robo1 were the highest in mouse ovarian tissue. Moreover, both of them were specifically expressed in mouse luteal cells. Compared with proestrus ovaries, the expression levels of Slit2 and Robo1 mRNA in the ovaries during diestrus were significantly up-regulated (P < 0.01, P < 0.001). The mRNA expression levels of Slit2 and Robo1 in late-phase CL were significantly increased when compared with pregnant CL. Furthermore, blocking Slit/Robo signaling pathway with ROBO1/Fc chimera in the luteal cells in vitro significantly decreased the apoptotic rate of late luteal cells. These results suggest that Slit/Robo family members are mainly expressed in the late-phase CL of ovary and participate in luteal cells apoptosis.
Animals ; Apoptosis ; Female ; Intercellular Signaling Peptides and Proteins ; physiology ; Luteal Cells ; cytology ; Mice ; Nerve Tissue Proteins ; physiology ; Pregnancy ; Receptors, Immunologic ; physiology

OBJECTIVE: Our object is to evaluate the detailed mechanisms of support and regression of the human corpus luteum. METHODS: To investigate the regulation of luteal function by gonadotropins, cytokines, and prostaglandins, the frequency of apoptosis and expression of Fas, Fas-L, Bcl-2, Bax, p53, caspase-8 were examined in cultured human luteal cells after treatment with various doses of FSH (30, 100, or 300 ng/mL), LH (30, 100, or 300 ng/mL), TGFbeta1 (1, 10, or 100 ng/mL), TNFalpha (1, 10, or 100 ng/mL), or PGF2alpha (1, 10, or 100 ng/mL) for 24 h. Cells were tested for apoptosis by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-digoxigenin nick end labeling TUNEL) method and cell death detection ELISA. Immunostaning was performed using anti-Fas, Fas ligand, Bcl-2, Bax, and p53 antibodies. RESULTS: Incidence of apoptosis determined by TUNEL method in the group without treatment was 1.7+/-0.5% (0 h), 10.8+/-1.6% (24 h), and 12.9+/-1.2% (48 h), respectively. Spontaneous increase was significant at the latter time points. Significant suppression of incidence of apoptosis was observed with LH and TGFbeta1 (P<0.05). On the other hand, significant induction of incidence of apoptosis was observed with TNFalpha and PGF2alpha (P<0.05). Immunostaining revealed that p53 and Bax expressions after treatment with LH or TGFbeta1 were significantly lower than those without treatment. Bcl-2 and caspase-8 expressions were not significantly affected by any substance addition. Also we found that inductions of apoptosis by TNFalpha and PGF2alpha were not correlated with the expression of Fas, Fas ligand, Bcl-2, Bax, p53 and caspase-8. CONCLUSION: Our results suggest that LH and TGFbeta1 may be involved in the support of luteal function via suppression of apoptosis, and that TNFalpha and PGF2alpha may contribute to luteal regression via its induction in human corpus luteum during early luteal phase. Also, Fas, Fas-L, Bax and p53 may play roles in this apoptosis controlled by LH, and TGFbeta1.
Antibodies ; Apoptosis* ; Caspase 8 ; Cell Death ; Corpus Luteum ; Cytokines* ; Deoxyuridine ; Dinoprost ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein ; Female ; Gonadotropins* ; Hand ; Humans* ; In Situ Nick-End Labeling ; Incidence ; Luteal Cells* ; Luteal Phase ; Luteolysis ; Prostaglandins ; Tumor Necrosis Factor-alpha

There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-rosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged 11.09+/-8.75 and 10.33+/-4.53 per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental ,ate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.
Animals ; Apoptosis* ; DNA ; DNA Fragmentation ; Female ; Fertilization ; Follicular Atresia ; Gonadotropin-Releasing Hormone* ; Granulosa Cells ; Hand ; Humans* ; Luteal Cells ; Oocytes ; Ovary ; Ovum ; Rats