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E V YoungLai

Publications and source records attributed to E V YoungLai.

At least 19 recordsLinked to original sources
PubMed1995

Natural cycles for in-vitro fertilization: cost-effectiveness analysis and factors influencing outcome.

Improvements in oocyte culture technique, sperm preparation, oocyte retrieval method and ovarian stimulation regimens have produced higher pregnancy rates with in-vitro fertilization (IVF) treatment. However, because ovarian stimulation is expensive and not without risk, there is increasing interest in the option of using natural cycles for IVF. This study was performed to document the experience and outcome in 240 natural cycles. Cancellation occurred in 28 cycles (12%), and LH surge was observed in 56 (23%), leaving 156 (65%) cycles which progressed to oocyte retrieval. No oocytes were retrieved in 26 cycles. Among the successful oocyte retrievals, the majority yielded one oocyte. There was no evidence of fertilization in 26 cases, and triploid fertilization was observed in 12 cases. Embryos suitable for transfer were available in 92 cycles in which 11 (12%) clinical pregnancies were confirmed. Despite the high failure rate at each step in the process, natural cycles are more cost-effective than stimulated cycles which incur an incremental cost per live birth of $48,000. Natural cycles offer a low-cost alternative that may be more accessible to patients.

Adult↗
PubMed1994

Cigarette smoking and the outcomes of in vitro fertilization: measurement of effect size and levels of action.

OBJECTIVE: To assess whether cigarette smoking in women or men affects the outcomes of IVF-ET and at what functional levels smoking is active. INTERVENTIONS: Demographic and smoking data were collected by questionnaire at the onset of consecutive treatment cycles (n = 462) and at the time of ET. In addition to routine endocrine and clinical data, circulating immunoreactive inhibin, follicular fluid E2 endometrial thickness, and morphology were assessed. Reported exposure to cigarettes was validated using a serum cotinine assay. RESULTS: Serum cotinine level at the onset of treatment correlated strongly with the number of cigarettes reported (r = 0.68). The duration and dose of gonadotropin treatment was greater among active smokers than never smokers: 10.2 versus 9.2 days and 24.7 versus 19.8 ampules, respectively. Fertilization, pregnancy, and abortion rates were similar between groups. Multivariate analyses demonstrated negative correlation between female age, but no such effect was seen with female or male smoking. Sperm concentration was significantly reduced in male smokers (prewash: 108 versus 130 x 10(6); postwash: 17.1 versus 21.6 x 10(6)), although fertilization rate was unaffected (66% versus 62%). Follicular function, assessed using serum inhibin and E2, as well as follicular fluid E2 levels showed no significant difference between active smokers and never smokers. Endometrial thickness and morphology also were similar between groups. CONCLUSIONS: These data suggest that among couples undergoing IVF neither female nor male smoking has a measurable deleterious effect on conception rate. Female age remains a far more potent prognostic factor in the current study. However, when all the published data are combined, a significant deleterious effect of smoking on conception is suggested, with a common odds ratio of 0.540 (95% confidence interval 0.385 to 0.757).

Adult↗
PubMed1993

Frequency and predictive value of antisperm antibodies among infertile couples.

Although sperm-associated antibody could impair fertility through various mechanisms, the results of follow-up studies do not uniformly confirm that pregnancy rates are lower when one of the infertile partners demonstrates antibody to spermatozoa. We conducted a prospective double-blind cohort comparative analysis in which antibody assay results were not available to physicians or patients for clinical management. The diagnostic protocol included mid-luteal progesterone, semen analysis, hysterosalpingogram and laparoscopy. The serum of each partner was assayed by immunobead testing, tray agglutination testing and a gelatin agglutination test. Data on relevant clinical characteristics and events during follow-up were collected prospectively. Among 471 couples in whom both partners were evaluated, 42 (8.9%) tested positive for anti-sperm antibodies by one or more assays, including 38 (8.1%) male partners and 6 (1.3%) female partners. The number of conceptions was 118/429 (27.5%) in antibody negative couples, 9/38 (23.7%) in male partner-positive couples and 1/6 (16.7%) in female partner-positive couples. With proportional hazards analysis, antibody status in either partner was not a significant independent predictor of time to pregnancy.

Adult↗
PubMed1992

Developmental patterns of bioactive and immunoreactive FSH in the female rabbit: effects of ovariectomy.

A longitudinal study was performed to determine the relationship between immunoreactive and biologically active FSH in the serum of sham-operated and ovariectomized female rabbits. Twenty-two-day-old female rabbits, 8 per group, were sham-operated or bilaterally ovariectomized on day 23. Blood was taken every 3-4 days from each rabbit until they achieved a weight of 3 kg or age 100 days. Sera were analysed by radioimmunoassay for LH and FSH or for bioactive FSH. In sham-operated animals, immuno-FSH levels showed a 10-fold increase from 0.36 +/- 0.04 ng/ml to greater than 35 ng/ml between days 45 and 80. By contrast, bio-FSH levels increased more gradually from a baseline of 5.4 +/- 0.4 ng/ml to about 8 ng/ml. Bilateral ovariectomy resulted in a significant increase in both bio-FSH, 5.5 +/- 0.4 ng/ml to 12.6 +/- 1.5 ng/ml and immuno-FSH levels from 0.4 ng/ml to 5.2 +/- 1.4 ng/ml 24 h later. These levels of FSH remained elevated throughout the sampling period in both groups of animals and then decreased after day 100. Peripheral LH levels showed much more variation but were 2-fold higher in ovariectomized rabbits, 0.4-1.4 ng/ml in sham-operated vs. 0.8-2.4 ng/ml in ovariectomized rabbits. These results emphasize the marked variations in FSH levels according to the method of analysis. They also suggest that extra-ovarian factors may play a role in inhibiting gonadotropin release especially LH.

Aging↗
PubMed1992

Cigarette smoking and outcomes of in-vitro fertilization and embryo transfer: a prospective cohort study.

A prospective cohort study of 222 consecutive couples undergoing 297 cycles of in-vitro fertilization and embryo transfer (IVF-ET) was conducted to evaluate the impact of cigarette smoking in males and females. Compared with non-smokers, females smoking at the time of treatment had more previous pregnancies (1.16 versus 0.63, P less than 0.001), consumed more coffee per day (3.29 versus 1.85 cups, P = 0.001) and were less likely to hold a professional or skilled job (41% versus 66%). There was no difference in the response to ovarian stimulation in terms of the duration and dose of human menopausal gonadotrophin, peak oestradiol level or number of oocytes retrieved. The fertilization rate was actually higher in heavy smokers than in non-smokers (79.3% versus 61.3%, P = 0.007). The rate of embryo cleavage was retarded in a dose-dependent fashion. In smokers of 1-14 cigarettes/day, the likelihood of transferring an embryo at greater than or equal to 4-cell stage was 0.87 [95% confidence limits (CL) 0.56-1.4] and in smokers of greater than or equal to 15 cigarettes/day, the likelihood was 0.52 (95% CL 0.31-0.88). However, evaluation of interrelated factors using logistic regression suggested that a low socioeconomic status had a greater detrimental effect on embryo cleavage rate than female smoking. No significant difference was noted in the clinical outcome following embryo transfer. A study of larger sample size is required to evaluate whether the effects of cigarette smoking are independent of socioeconomic status and other related factors and whether they result in reduced ongoing clinical pregnancy and live birth rates.

Coffee↗
PubMed1992

The pituitary gonadotropin-releasing hormone (GnRH) receptor of the female rabbit: characterization and developmental aspects.

The aim of the present study was to characterize the pituitary gonadotropin-releasing hormone (GnRH) binding site in the rabbit and investigate its possible role in sexual maturation of the female rabbit. A radioligand binding assay was established, and the presence of specific 125I-labelled D-Ala6-des-Gly10-GnRH ethylamide (125I-DAl6EA) binding sites in the anterior pituitary gland of the rabbit was demonstrated. 125I-DAla6EA binding was saturable, specific, displaceable, reversible, correlated with increasing tissue concentrations, and susceptible to physiological manipulation. 125I-DAla6EA binding indicated the presence of two binding sites in the female adult rabbit pituitary: a high affinity, low capacity site (KD = 0.3-0.4 nM; Bmax = 100-200 fmol/mg protein) and a lower affinity, high capacity site (KD = 30 nM; Bmax = 5-8000 fmol/mg protein). Ontogeny of 125I-DAl6EA binding in the female rabbit (40-120 days of age) did not show a correlation between binding site number and serum luteinizing hormone (LH). In addition, the net serum LH response in female rabbits to a subcutaneous injection of DAla6EA (10 ng, 100 ng, and 1 microgram per kilogram body weight) was not significantly different between animals 40, 75, and 120 days of age. This suggests that a decrease in pituitary responsiveness to GnRH is not associated with sexual maturation in the female rabbit. Results indicate that factors other than and (or) in addition to GnRH binding site number, such as postreceptor events, play a role in gonadotropin secretion in the female rabbit.

Amino Acid Sequence↗
PubMed1991

The short-term reproductive toxicity of cyclophosphamide in the female rat.

Cyclophosphamide (CTX) is a potent ovarian toxicant. Previous studies of the acute effects of CTX in the rat have demonstrated widespread ovarian follicle atresia, reduced serum estradiol, and progesterone with normal serum LH and FSH. The present investigations demonstrate that a single injection of CTX induces ovarian toxicity that reflects the loss of growing ovarian follicles. CTX induces a sensitization of serum FSH in response to GnRH within 24 h; this sensitization is lost by 7 days, and after 14 days the animals are capable of normal mating behavior. The observed protection of primordial follicles from the acute administration of CTX under these experimental circumstances may be related to the stage of the granulosa cell cycle of these follicles.

Animals↗
PubMed1991

The agonist (d-leu-6,des-gly-10)-LHRH-ethylamide does not protect the fecundity of rats exposed to high dose unilateral ovarian irradiation.

Attempts to protect the ovary from the toxic effects of radiation and chemotherapy are relevant to the management of the young patient with cancer. Previous studies in a variety of animal species with several types of agonists of GnRH have shown promise in affording gonadal protection using indirect indices of reproductive function. The current investigations are based on these observations. Female rats were treated with (d-leu-6,des-gly-10) LHRH-ethylamide (GnRHa) from day 22 to day 37 of life. Sham-irradiation or unilateral irradiation of the left ovary was performed on day 30. The animals were mated following resumption of cycles and sacrificed on day 21 of pregnancy. There was no significant effect of ovarian artery ligation. Radiation reduced ovarian function ipsilateral to the radiation. GnRHa alone did not affect reproductive performance significantly. GnRHa and radiation combined resulted in no reproductive protection but augmented the damage done to the ipsilateral ovarian weight and to numbers of corpora lutea and fetuses. Under these experimental circumstances the agonist provided no protection.

Animals↗
PubMed1990

Effects of steroid implants on the prepubertal increase in circulating gonadotropins and sexual receptivity in the female rabbit.

The pubertal increase in gonadotropins in the female rabbit was inhibited 14-42-fold with Silastic implants of progesterone (P4) testosterone propionate (TP), estradiol benzoate (EB) or P4/EB placed subcutaneously on Day 24 of life. Rabbits with empty implants showed the normal prepubertal increase in circulating gonadotropins. By contrast, rabbits with implants of P4 only, had a 2-fold decrease in LH secretion when peak areas were compared. However, FSH secretion though slightly depressed was not significantly different from controls. The prepubertal increase in circulating gonadotropins was completely suppressed by implants of EB, TP and combined P4/EB. At 115-days-of-age, sexual receptivity and mating were absent in EB-treated animals and significantly suppressed in P4-treated ones when compared to controls, all of which mated. Mating was not completely inhibited in TP and combined P4/EB animals. Corpora lutea were found in all rabbits that mated. In the sexually non-receptive does, vaginal stimulation induced an LH surge in 2 of 15 animals. Ovarian weights and follicular development were significantly suppressed in rabbits with EB implants. Ovarian estradiol content was significantly increased in P4- and TP-treated rabbits. Maximum specific binding for [3H]naloxone was suppressed in the hypothalami of P4-treated rabbits. These results suggest that the prepubertal increase in circulating gonadotropins may have an essential role in the control of sexual maturation in the female rabbit.

Animals↗
PubMed1989

Immunoglobulin-mediated hypersensitivity in response to long-term treatment with gonadorelin hydrochloride (Factrel) in a female patient.

Recently a patient with severe hypogonadotropic hypogonadism who was given luteinizing hormone-releasing hormone (Factrel) through an infusion pump developed a wheat-and-flare reaction at the sites of injection. Treatment with luteinizing hormone-releasing hormone was discontinued and the immune response was characterized. Skin testing by skin prick test was positive for luteinizing hormone-releasing hormone but negative for vehicle. Radioallergosorbent testing was performed with allergic (patient serum with an elevated serum immunoglobulin E concentration and allergic to inhalant allergens including ragweed pollen) and nonallergic controls. Radioallergosorbent testing was negative for luteinizing hormone-releasing hormone-reactive immunoglobulin E antibodies. Radioimmunoassay of serum of the allergic patient antibody to luteinizing hormone-releasing hormone was positive only for immunoglobulin E. Maximum binding occurred at a dilution of 1:10. Sera from nonallergic and unchallenged patients were negative. It is concluded that this patient developed hypersensitivity reactions caused by IgE antibody to luteinizing hormone-releasing hormone.

Adult↗
PubMed1989

The effect of medroxyprogesterone acetate (Provera) on ovarian radiosensitivity.

Medroxyprogesterone acetate (Provera) is a drug that is commonly given to young women with cancer during chemotherapy and radiation to control heavy bleeding associated with anovulation. Because hypothalamic-pituitary-ovarian suppression has been associated with ovarian protection from the effects of chemotherapy and medroxyprogesterone acetate has been identified as a radiosensitizing agent, we explored the effects of medroxyprogesterone acetate on a rat model with known radiation injury characteristics. Sprague-Dawley rats were treated with medroxyprogesterone acetate or vehicle from day 22 to day 37 of life and were either irradiated or sham-irradiated on day 30 of life and then killed on day 44. Radiation with medroxyprogesterone acetate administration produced a greater loss in preantral and healthy control follicles than in control follicles. No suppression of luteinizing hormone or follicle-stimulating hormone had occurred by day 30 but ovarian glutathione content was reduced. These findings indicate that the administration of medroxyprogesterone acetate with radiotherapy may enhance ovarian injury.

Animals↗
PubMed1989

Opioidergic control of gonadotropin secretion in the female rabbit: divergent effects of morphine on secretion of follicle-stimulating hormone and luteinizing hormone.

The nature of secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was followed in female rabbits on a daily basis from age 36 to 60 days by sequential 5-min blood sampling over 1- to 2-h periods each day. Both LH and FSH were found to be secreted in a pulsatile manner. The mean LH pulse amplitude over the 25 days was 0.95 +/- 0.32 ng/mL and for FSH it was 10.15 +/- 1.11 ng/mL. Mean plasma LH levels were significantly increased from 1.46 +/- 0.08 ng/mL in 36 to 42-day-old rabbits to 1.89 +/- 0.12 ng/mL in 43 to 50-day-old rabbits and remained elevated from 50 to 60 days. FSH levels during the same periods also rose significantly from 14.93 +/- 0.79 to 19.57 +/- 2.05 ng/mL. To examine the influence of endogenous opioid peptides on the release of LH and FSH in 36 to 60-day-old female rabbits, morphine sulfate at 0.2, 0.5, 2.0, and 5.0 mg/kg was administered subcutaneously after 30 min baseline sampling, and blood was taken for another 60-120 min. Morphine at all doses and at all ages inhibited the amplitude and frequency of LH pulses but had no effect on FSH secretion. To determine whether the effects of morphine on LH secretion could be reversed with naloxone, females aged 82-114 days were used. Naloxone administered 1 h after morphine reversed the inhibitory effects of morphine, whereas the simultaneous administration of naloxone with morphine had variable effects but seemed to delay the LH increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1989

Effects of in-vivo administration of GnRH on the release of gonadotrophins in the female rabbit.

Developing female rabbits were studied weekly from Day 22 of life to Day 100. At all ages GnRH (1.5 micrograms/kg) induced a large increase in LH release 15 min later. By contrast, FSH was significantly increased only on Days 22, 29 and 72 and no significant increase was detected up to 2 h after GnRH administration at other ages. Functional corpora lutea were absent at the start of all treatments as indicated by circulating concentrations of progesterone less than 2 ng/ml. It is concluded that the immature rabbit pituitary is functionally capable of responding to GnRH with an increase in LH secretion, whereas the control of FSH secretion may be regulated by other factors.

Animals↗
PubMed1988

Effects of ovariectomy and estradiol replacement on naloxone induced LH secretion in the female rabbit.

The effects of an opioid antagonist, naloxone, on the secretion of gonadotrophins were investigated in the long term ovariectomized rabbit. In the intact and acutely ovariectomized rabbit (2 days p.o.) naloxone at 10 mg/kg induced an increase of 260-300% in LH secretion at 40 min post-injection. From days 33-66 post-surgery naloxone at 10 mg/kg caused significant elevations in LH release even when animals were treated with estradiol benzoate 24 h previously. By contrast, treatment with oestradiol benzoate 3 h before naloxone abolished the LH increase. An LH surge could be elicited in these rabbits with GnRH treatment. These studies indicated that long term ovariectomy in the female rabbit does not completely remove the opioid control of GnRH release and that the LH response to naloxone is influenced by circulating estradiol levels.

Animals↗
PubMed1988

Changes in 3 beta-hydroxysteroid dehydrogenase activity in the developing rabbit ovary.

The presence of 3 beta-hydroxysteroid dehydrogenase in the maturing rabbit ovary was demonstrated biochemically and histochemically. Enzyme activity was negligible to absent in ovaries from rabbits less than 44 days old. The greatest activity was located in the microsomal fraction of ovaries from mature rabbits. The enzyme characteristics were: Vmax = 33.1 +/- 9.6 nmol/min/mg protein and Km = 2.16 +/- 0.28 microM. Ovaries from pregnant hyperglycemic rabbits had enzyme which showed a Vmax of 51.4 +/- 8.2 nmol/min/mg protein and Km = 2.41 +/- 0.31 microM. These results indicate that rabbit ovarian tissue becomes steroidogenically active at a time when gonadotropin levels are elevated.

3-Hydroxysteroid Dehydrogenases↗
PubMed1988

Opioidergic control of luteinizing hormone secretion in the female rabbit: influence of age on the response to naloxone.

To examine the role of opioid neurons on luteinizing hormone (LH) secretion in the female rabbit, we determined LH release at timed intervals after naloxone administration to rabbits aged 25-150 days. The LH response to naloxone (10 mg/kg) was not significantly elevated until day 43 when LH rose 76-113% above basal levels at 40-80 min. In 56-day-old females the corresponding increase was 160% at 15 min and in 65- to 67-day-olds it was 154%. From 70 to 80 days of age the LH response was blunted and no significant elevations could be elicited. By contrast, naloxone-induced LH increases were again evident when rabbits were older than 100 days. At all ages no significant change in FSH concentrations was observed. In the adult females, naloxone at 2.5, 5, and 10 mg/kg caused increases in LH secretion which occasionally were high enough to induce ovulation as exemplified by elevated serum progesterone 4 days later. These data suggest that opioid peptides may be involved in the prepubertal rise in LH and in the normal inhibition of adult secretion in the female rabbit.

Aging↗