Risk of ovarian cancer after treatment for infertility.
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Biomedical subjects
Publications and source records attributed to E E Wallach.
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OBJECTIVE: To clarify the role of P in ovulation, fertilization, and early embryonic development using RU486, a potent P receptor blocker. DESIGN: Ovulatory efficiency, IVF, and early embryonic development were evaluated after RU486 administration in vivo and in vitro. SETTING: Research laboratory of a university hospital. PARTICIPANTS: Mature male and female New Zealand white rabbits. INTERVENTIONS: Animals were treated with RU486 or vehicle for 3 days before hCG-induced ovulation. Ovaries treated with hCG to induce ovulation were perfused for 6 hours in vitro with RU486 or vehicle. In vitro fertilization was performed in the presence or absence of RU486. MAIN OUTCOME MEASURES: The percentage of mature follicles ovulating (ovulatory efficiency) was determined after in vivo and in vitro treatment. Fertilization, morula, and blastocyst development were evaluated every 24 hours for 120 hours. RESULTS: RU486 significantly inhibited ovulation, fertilization, and early embryonic development. CONCLUSIONS: Progesterone plays a significant role in ovulation, fertilization, and preimplantation embryonic development.
The objectives of these experiments were to determine (i) the role of calcium/calmodulin-dependent protein kinase II-mediated signal transduction in hCG-induced ovulation and (ii) whether there is an association between arachidonic acid metabolites, nitric oxide and calcium/calmodulin-dependent protein kinase II in the overall scheme of ovulation induction. Ovarian arteries were cannulated in situ, and the ovaries were excised and perfused in vitro. Ovulatory efficiency ([number of ovulated follicles/number of mature follicles > 1.5 mm] x 100) was calculated for each experiment. Calcium/calmodulin-dependent protein kinase II substrate induced ovulation in the absence of gonadotrophin (calcium/calmodulin-dependent protein kinase II substrate: 66.3%; control: 0%). In the next experiment, perfusion medium of the experimental ovary was supplemented with KN 62, a potent inhibitor of calcium/calmodulin-dependent protein kinase II, while the contralateral ovary served as control. Ovulations were induced in both ovaries with hCG (50 iu (150 ml)-1) and perfusion was continued for 8 h. In the third experiment, ovaries were perfused with prostaglandin F2 alpha (PGF2 alpha) with and without KN 62, while the contralateral ovary was perfused with medium alone. KN 62 reduced the ovulatory efficiency of hCG-treated ovaries in vitro during perfusion (hCG + 10(-7) mol KN 62 l-1: 32.9%; hCG: 80.9%). Furthermore, it significantly reduced the ovulatory efficiency of PGF2 alpha-treated ovaries (PGF2 alpha + KN 62 = 21.5%; PGF2 alpha = 59.9%).(ABSTRACT TRUNCATED AT 250 WORDS)
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OBJECTIVE: To review milestones in the care of the infertile couple over the past five decades. DATA RESOURCES: All issues of Fertility and Sterility were reviewed beginning with the first issue published in 1950 through volume 61, number 1 (January 1994). Other significant articles from the literature were reviewed as identified by directed Medline searches. RESULTS: This historical review gives the reader a sense of the evolution of modern reproductive technology--how the past has shaped the present--through the development of modern surgical techniques, methods of ovulation induction, laparoscopy, ultrasound, endocrine assays, in vitro fertilization, cryopreservation of sperm and preembryos, and microscopic procedures on gametes and preembryos. CONCLUSIONS: The remarkable capabilities of modern reproductive technologies are only possible because of the culmination of decades of innovative research.
To evaluate the lipid and lipoprotein changes induced by a triphasic oral contraceptive (OC) containing ethinyl estradiol and gestodene, 25 healthy women from the Baltimore metropolitan area were enrolled in an open-label, noncomparative study. Serum lipids were measured prior to starting the OCs and again during the 3rd, 6th and 12th treatment cycles. Mean lipid concentrations in each treatment cycle were compared to baseline levels using the t test for paired samples. Small but statistically significant (P < or = .05) increases in the mean concentrations of total cholesterol, total triglycerides, total high density lipoprotein (HDL) cholesterol, HDL3 cholesterol, apolipoprotein A1 and apolipoprotein B were noted. Although the increases were statistically significant, the mean lipid concentrations were still within the normal range. The mean HDL2 and low density lipoprotein cholesterol concentrations were unchanged, as was the mean total cholesterol/HDL ratio. Healthy women taking a triphasic OC containing ethinyl estradiol and gestodene have minimal changes in lipids and should not be at increased risk of atherosclerosis due to OC-induced lipid alterations.
The objective of this study was to determine whether removal of corpora lutea (CL) from one ovary (unilateral luteectomy; ULL) or removal of the entire ovary (unilateral ovariectomy; ULO) of pseudopregnant rabbits would cause compensatory growth and progesterone production by the contralateral ovary. Pseudopregnancy was induced in rabbits with hCG (Day 0). On the first day of pseudopregnancy, one group of rabbits received a sham operation (controls), another group underwent ULL, and a third group underwent ULO. On Day 11 of pseudopregnancy, each rabbit underwent laparotomy, the ovarian artery and vein were cannulated, and the ovary(ies) was removed and perfused in vitro for 6 h. The mean CL weight increased by 33% in the ULL group and by 28% in the ULO group as compared to sham-operated controls. Peripheral estradiol and progesterone levels in sham-operated control, ULL, and ULO groups were similar. Ovarian venous estradiol levels were similar in the control and ULL groups, but were significantly increased in the remaining ovary of the ULO group. Both ovarian venous progesterone in vivo and progesterone secretion in vitro increased significantly in contralateral ovaries from ULL and ULO rabbits as compared to sham-operated controls. Progesterone secretion by ovaries perfused in vitro increased significantly in the contralateral ovary of the ULL and ULO groups. Mean number of luteal cells per CL increased significantly in the ULL group, but not in the ULO group. In contrast, luteal cell volume increased significantly in the ULO, but not in the ULL group. The stimuli responsible for increased progesterone production following ULL and ULO result in morphological changes in the remaining CL.(ABSTRACT TRUNCATED AT 250 WORDS)
Epidermal growth factor (EGF) affects follicular steroidogenesis and expression of gonadotropin receptors. The effects of EGF on hCG-induced estradiol and progesterone secretion and ovulation were examined in the in vitro perfused rabbit ovary. We also examined the effects of EGF on hCG-induced progesterone secretion by isolated granulosa cells. In addition, distribution of hCG within the follicle was probed by immunohistochemical means 30 min after its administration to the in vitro perfused ovary. EGF significantly (P less than 0.05) reduced hCG-induced secretion of estradiol (control, 117 +/- 12 pg/min.follicle; 10 ng/ml EGF, 55 +/- 10) and progesterone (control, 18.2 +/- 1.2 ng/min.follicle; 10 ng/ml EGF, 11.9 +/- 0.8) by the perfused ovary. In contrast, EGF did not inhibit hCG-induced progesterone secretion by isolated granulosa cells. Ovulatory efficiency (number of ovulated ova per number of mature follicles x 100) when EGF was given 30 min before hCG was reduced dose-dependently from 58.2% with no EGF to 8.3% with 10 ng/ml EGF (P less than 0.001). Ovulation was not inhibited by EGF when it was given 30 min after hCG. Distribution of hCG in the preovulatory follicle was confined to the basement membrane, thecal cell layer, and a small fraction of the outer granulosa cell layer. These observations suggest that gonadotropin stimulates the follicle through the release of a secondary signal(s) from ligand-bound granulosa cells near the follicle wall to unexposed cells of the inner avascular area. EGF may inhibit the follicular response to hCG by attenuation of this cell to cell communication.
Tumor-promoting phorbol esters are believed to affect ovarian granulosa cell progesterone and prostaglandin (PG) production and possibly ovulation by activating protein kinase-C (PKC). The effects of phorbol esters and PKC inhibitors on ovulation, progesterone, and PG production were examined in an in vitro perfused rabbit ovary. The effect of tranexamic acid, an inhibitor of the conversion of plasminogen activator to plasmin, on phorbol ester-induced ovulation was also examined. Phorbol 12,13-dibutyrate (PdBU), a PKC stimulator, induced ovulation in a dose-related manner in the absence of gonadotropins (56%, 200 nM PdBU; 0%, 0 nM PdBU; P < 0.05). Perfusate progesterone levels were increased only after 600 nM PdBU treatment, and perfusate PGF2 alpha, PGE2, and 6-keto-PGF1 alpha were increased in a dose-dependent fashion (P < 0.05). Staurosporine, a potent inhibitor of the catalytic domain of PKC, and calphostin-C, a specific inhibitor of the diacylglycerol-binding region, inhibited hCG-induced ovulation in a dose-related manner. Gonadotropin-induced ovulation decreased from 73% without staurosporine to 19% with 1.0 microM staurosporine (P < 0.01). Calphostin-C reduced ovulatory efficiency from 60% to 24% (P < 0.01). However, neither inhibitor decreased progesterone or PGF2 alpha production by ovaries exposed to hCG. hCG-induced oocyte maturation was also unaffected by exposure to either staurosporine or calphostin-C. Tranexamic acid reduced phorbol ester-induced ovulatory efficiency from 67% to 37% (P < 0.05). These findings demonstrate that the calcium-dependent PKC pathway is instrumental in gonadotropin-mediated follicular rupture in the rabbit. Although PGs may play an important role in ovulation, they do not appear to be directly responsible for PKC-mediated follicular rupture.
The relationship of oxygen free radicals to corpus luteum function in rabbits was explored during various stages of pseudopregnancy, including natural and induced luteal regression. Induced luteolysis was achieved during mid-pseudopregnancy by removal of an oestradiol capsule placed at the onset of pseudopregnancy, which suppressed ovarian oestradiol production. Activity of manganese superoxide dismutase (Mn SOD) was significantly and positively correlated with ovarian progesterone production (P < 0.01) throughout pseudopregnancy and during natural regression. Oestradiol deprivation for 12, 24 or 72 h resulted in declines in Mn SOD activity and progesterone secretion, although Mn SOD rose and corpus luteum steroidogenesis was restored to normal when the capsule was replaced for 48 h before assessment, having been removed for 24 h. Lipid peroxide and progesterone concentrations were not correlated, although a significant rise in lipid peroxides in the luteal tissue was detected after deprivation of oestradiol for 72 h. Changes in progesterone production and Mn SOD activity were not associated with alterations in concentration of prostaglandin F metabolite. These data suggest that Mn SOD may be involved in regulating function of the corpus luteum during pseudopregnancy in rabbits and that oxygen free radicals may play a role in regression of corpus luteum in this species.
A dramatic increase in the use of crack cocaine by young women has resulted in the exposure of a substantial number of fetuses to the drug in utero. The goal of these experiments was to investigate the effects of intravenous cocaine (a model for crack) on reproductive function in the female rabbit. We used two protocols: (1) single daily injections over the course of pregnancy ("single daily" protocol), with animals examined on day 1, 8, 15, 22, or 29, and (2) six hourly injections on the day of mating ("binge" protocol). The maximum tolerated dose of cocaine, 4 mg/kg, was administered at 0.5 ml/min. The single daily protocol increased ovulation but had no effect on fetal and placental weights or preterm delivery. The binge protocol significantly reduced in vitro development of retrieved embryos but did not affect implantation assessed on day 8 of pregnancy.
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OBJECTIVE: To determine if prostaglandins (PGs) have a direct effect on the ovarian proteolytic enzyme system by examining ultrastructure of the follicle wall and the microvasculature in the presence and absence of indomethacin and by using the isolated perfused rabbit ovary. DESIGN: Nine hours after administration of human chorionic gonadotropin (hCG) or hCG plus indomethacin, follicles were removed and processed for scanning and transmission electron microscopy. Isolated perfused rabbit ovaries were induced to ovulate with PGF2 alpha (100 ng/mL) in the presence and absence of tranexamic acid (0.1, 1.0, or 10 mM), a plasminogen activator inhibitor. RESULTS: The addition of indomethacin to hCG inhibited ovulation and production of PGs without affecting the follicular microvasculature. However, the changes in follicle wall architecture were less pronounced after treatment with indomethacin. Ovulatory efficiency in response to PGF2 alpha (the percent of follicles greater than 1.5 mm that ovulate) was significantly reduced (P less than 0.01) by 10 mM tranexamic acid. CONCLUSIONS: These results suggest that PGs induce follicular rupture by activation of proteolytic enzymes located in the follicle wall.
The objective of this study was to determine whether estradiol has a direct effect on progesterone secretion by the rabbit corpus luteum. Empty or estradiol-filled Silastic capsules were implanted sc into pseudopregnant rabbits (day 0). Ten days later (day 10), peripheral blood was obtained via the marginal ear vein, and Silastic capsules were removed. Twenty-four hours after capsule removal (day 11), blood samples were obtained and ovaries removed for in vitro perfusion. The artery and vein of each ovary were individually cannulated, and ovaries were perfused in vitro for 6 h. Mean progesterone secretion rates were determined from perfusate samples taken every 30 min. On day 10, serum progesterone concentrations were similar in control and estradiol-treated animals. On day 11, 24 h after withdrawal of Silastic capsules, serum progesterone concentration in the estradiol-treated rabbits decreased significantly compared to controls. The withdrawal of estradiol also significantly reduced the secretion of progesterone by in vitro perfused ovaries in estradiol-withdrawn rabbits compared to empty capsule controls. Addition of estradiol or 25-hydroxycholesterol (25-OH) to the perfusion medium significantly increased progesterone secretion by ovaries from estradiol-withdrawn rabbits but not to control values. In contrast, a combination of estradiol plus 25-OH restored progesterone secretion to control levels. Although estradiol together with 25-OH stimulated progesterone secretion 24 h after estradiol withdrawal, progesterone secretion in vitro was unaffected 48 h after capsule removal, whereas pregnenolone stimulated secretion 5-fold. These results demonstrate that estradiol has a direct and acute stimulatory effect on progesterone secretion by the rabbit corpus luteum.
The potential role of oxygen free radicals in hCG-induced ovulation was investigated using the free radical scavenging enzymes superoxide dismutase (SOD) and/or catalase with the in-vitro perfused rabbit ovary preparation. SOD (25 micrograms/ml) and SOD + catalase (25 micrograms/ml) significantly reduced the % of large follicles that ovulated during perfusion (P less than 0.005). Neither maturity nor degeneration of ovulated ova and follicular oocytes was affected by SOD and/or catalase. Progesterone concentration in the perfusate was significantly increased in the SOD + catalase treatment group (P less than 0.01). These results indicate a significant role for oxygen free radicals in the process of ovulation.
The effects of angiotensin II (AII) and its receptor blocker, saralasin (SAR), on ovulation and oocyte maturation were investigated in an isolated, in-vitro perfused rabbit ovary. Ovulation and oocyte maturation were induced by AII in the absence of human chorionic gonadotrophin (hCG). SAR inhibited ovulation induced by AII or hCG, but not oocyte maturation. AII appears to play a critical role in follicle rupture, but not in resumption of oocyte meiosis.
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