Mi Kyoung Koong

Single nucleotide polymorphisms and haplotypes of the genes encoding the CYP1B1 in Korean women: no association with advanced endometriosis.

AbstractObjective: To investigate whether single nucleotide polymorphisms and its haplotypes of gene encoding CYP1B1 are associated with the risk of advanced endometriosis in Korean women.n Methods: We investigated 221 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 188 control group women who were surgically proven to have no endometriosis. The genetic distribution of four different CYP1B1 polymorphisms at Ala119Ser, Leu432Val, Asp449(C>T), Asn453Ser were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism of PCR products. Haplotype analysis was also performed.n Results: We found no overall association between each individual CYP1B1 genotype or haplotype and the risk of endometriosis. Also, the odds ratio of each haplotypes of CYP1B1 showed no association with the risk of endometriosis.n Conclusions: These results suggest that CYP1B1 genetic polymorphism may not be associated with development of advanced endometriosis in Korean women.

Effects of clomiphene citrate and leuprolide acetate on luteal-phase hyperprolactinemia during ovarian stimulation with menopausal gonadotropins

Hyperprolactinemia, a known modulator of reproductive function, occurs commonly in women undergoing ovarian stimulation with human menopausal gonadotropins (hMG). Clomiphene citrate (CC) and gonadotropin releasing hormone analogues (GnRHa), when administered during the luteal phase, attenuate the hyperprolactinemic response to hMG. We asked whether follicular-phase administration of CC and GnRHa, as employed clinically in women undergoing ovarian stimulation forin vitro fertilization or gamete intrafallopian transfer, would alter the incidence and severity of hMG-induced luteal-phase hyperprolactinemia. Seventy-five percent of all patients had at least one luteal prolactin level >25 ng/ml, and 40% had mean luteal-phase prolactin levels >25 ng/ml. The incidence of hyperprolactinemia was similar in pregnant and nonpregnant cycles. The incidence of hyperprolactinemia was similar for both the GnRH agonist-treated group and those given clomiphene citrate. The increase in mean luteal prolactin levels over the follicular-phase baseline level was significantly greater in the CC-treated group (P=0.03). This was due to the significant suppression of follicular-phase baseline prolactin levels in patients receiving CC. We conclude that neither CC nor GnRHa administration in the follicular phase prevents lutealphase hyperprolactinemia in women undergoing ovarian stimulation with hMG.

Decision making processes of women who seek elective oocyte cryopreservation

PurposeThe aim of this study is to analyze women’s opinions and their decision making processes regarding elective oocyte cryopreservation (OC).MethodsOne hundred twenty-four women who had elective OC counseling at the CHA Seoul Fertility Center were asked to complete a survey after their first visit. Data collection regarding age, marital status, monthly income, occupation, religion, reproductive history, questions about the participant’s view on their own fecundity, and future parenthood were included. The modified Reproductive Concerns After Cancer scale and the Decisional Conflict Scale were used for analysis.ResultsThe participants’ mean age was 37.1u2009±u20094.8xa0years old. Eighty-six percent of the participants had regular periods. Ninety-two percent thought it was important to have their own biological offspring, and 86% were willing to pursue OC. Forty-nine percent appeared to have high DCS scores regarding making a decision of OC. Sixty-eight percent pursued OC, and the mean number of oocytes cryopreserved per patient was 10.5u2009±u20098.3. Multivariate analysis revealed that age was the only factor associated with high DCS scores (Pu2009=u20090.002). Feeling less fertile than other women of same age and low DCS scores were the factors associated with pursuing OC (Pu2009=u20090.02 and 0.004, respectively) after adjusting for possible confounding factors, including age.ConclusionsOlder women had more difficulties in making decisions about OC. Adjusting for age, women who thought that they were less fertile than other women of same age and those with lower decisional conflict were more likely to pursue OC. Further studies should focus on the validation of older women’s decisional conflicts regarding OC.

Rabbit endosalpinx suppresses ectopic implantation*†Reprint requests: Carl J. Pauerstein, M.D., The University of Texas Health Science Center at San Antonio, Department of Obstetrics and Gynecology, 7703 Floyd Curl Drive, San Antonio, Texas 78284-7836.

This study was undertaken to elucidate the mechanism underlying the absence of oviductal ectopic pregnancies in infraprimates. Endosalpingeal circumferential grafts were substituted for endometrium in a group of rabbits. The endosalpingeal grafts interfered with implantation as evidenced by four observations: (1) The nidation indices were lowered, (2) no implantations occurred on the grafted endosalpinx, (3) unattached blastocysts were found in animals grafted with endosalpinx, and (4) the implantation sites were significantly smaller in uterine horns containing endosalpingeal grafts. These findings suggest the presence of a factor in rabbit endosalpinx that actively suppresses ectopic implantation in the oviduct.