Biomedical subjects

E A Kennard

Publications and source records attributed to E A Kennard.

8 recordsLinked to original sources

PubMed1998

Dimeric inhibin: a direct marker of ovarian aging.

OBJECTIVE: To investigate whether luteal secretion of inhibin-a is altered in the perimenopausal transition and to evaluate whether luteal inhibin secretion is correlated with other markers of ovarian reserve such as FSH and inhibin-b. DESIGN: Prospective study. SETTING: Reproductive Endocrinology Laboratories at The Ohio State University. PATIENT(S): Twenty-five women 39-52 years of age with regular menstrual cycles. INTERVENTION(S): Daily urine samples were monitored (LH predictor kit) to identify the day of ovulation. Blood samples obtained on days 6 and 8 after the LH surge and on day 3 of the subsequent follicular phase were assayed for FSH, E2, progesterone. inhibin-a, and inhibin-b. MAIN OUTCOME MEASURE(S): Serum levels of inhibin-a, inhibin-b, FSH, E2, and progesterone. RESULT(S): Luteal phase inhibin-a and follicular phase inhibin-b were correlated inversely with age in perimenopausal women. In addition, luteal phase inhibin-a and follicular phase inhibin-b levels were correlated inversely with follicular phase FSH levels. CONCLUSION(S): Both luteal phase inhibin-a and follicular phase inhibin-b levels are correlated inversely with age during the fifth decade of life. These findings suggest that corpus luteum function is altered during the perimenopausal transition. Moreover, these direct measures of ovarian function may be more sensitive indicators of "ovarian reserve" than indirect indicators such as pituitary FSH secretion.

Adult↗

PubMed1998

Elevated level of follicular fluid vascular endothelial growth factor is a marker of diminished pregnancy potential.

OBJECTIVE: To evaluate whether differences in follicular fluid vascular endothelial growth factor (FF VEGF) concentrations are observed between women achieving a clinical pregnancy and those failing to conceive. DESIGN: Retrospective chart review and analysis of FF VEGF concentrations. SETTING: University teaching center. PATIENT(S): Fifty-seven women < or =42 years of age undergoing follicular aspiration in preparation for IVF or GIFT. INTERVENTION(S): Analysis of FF VEGF concentrations and chart review of a single IVF or GIFT cycle. MAIN OUTCOME MEASURE(S): Follicular fluid VEGF concentrations, clinical pregnancy rate, age, ampules of gonadotropins used, oocytes retrieved, peak estradiol serum concentrations, day 3 FSH levels, and fertilization rate. RESULT(S): Women who did not conceive had higher FF VEGF concentrations than women achieving a clinical pregnancy (4.409 + 2,387 versus 2.793 +/- 1,180 pg/mL: P < .001). A negative correlation was observed between FF VEGF concentrations and peak estradiol levels and number of oocytes retrieved. A positive correlation was found for FF VEGF and patient's age and ampules of gonadotropins used. CONCLUSION(S): Elevated FF VEGF concentrations are associated with poor conception rates after IVF or GIFT.

Adult↗

PubMed1998

Effects of ovarian source, patient age, and menstrual cycle phase on in vitro maturation of immature human oocytes.

OBJECTIVE: To determine the efficiency of in vitro maturation, expressed by nuclear maturation, of oocytes aspirated during gynecologic surgeries or collected from excised ovaries. To assess the effect of patient age and cycle phase at collection on the oocyte's ability to mature in vitro. To examine the time course of oocyte maturation in vitro. DESIGN: Nuclear maturation based on patient criteria compared. SETTING: University-based IVF program and research center. PATIENT(S): Consented patients undergoing gynecologic surgeries or patients undergoing oophorectomy. INTERVENTION(S): Oocytes were maintained in culture for 48 hours and evaluated for maturation. MAIN OUTCOME MEASURE(S): Nuclear maturation evaluated as germinal vesicle breakdown (GVBD) or progression to the metaphase II (MII) stage. RESULT(S): A significantly higher percentage of oocytes collected during the follicular phase of the menstrual cycle underwent GVBD than did oocytes collected during the luteal phase (60% versus 48%, respectively). The percentage of oocytes reaching the MII stage, from these two groups, was not different. No statistically significant differences in maturation were observed in oocytes from different ovarian sources or from patients >40 or <40 years of age. CONCLUSION(S): These data suggest that oocytes collected during the follicular phase are more likely to undergo GVBD than oocytes collected during the luteal phase. In this study, ovarian source, age, or cycle phase did not influence the final meiotic maturation of oocytes to metaphase II.

Adult↗

PubMed1998

Activin A stimulates meiotic maturation of human oocytes and modulates granulosa cell steroidogenesis in vitro.

OBJECTIVE: To test the hypothesis that activin A promotes in vitro human oocyte meiotic maturation while inhibiting steroid secretion by nonluteinized antral granulosa cells. DESIGN: Prospective randomized controlled study. SETTING: A university medical center. PATIENT(S): Nine women ranging in age from 31-44 years who were undergoing oophorectomy for nonovarian pathology. INTERVENTION(S): Analysis of meiotic maturation of oocytes and steroid secretion by granulosa cells cultured in the presence or absence of activin A. MAIN OUTCOME MEASURE(S): Germinal vesicle breakdown (GVBD) and attainment of metaphase II (MII) in oocytes, and progesterone and E2 secretion by granulosa cells. RESULT(S): Activin A significantly enhanced GVBD (91% vs. 65%) for control and maturation to MII (56% vs. 35% for control) of immature oocytes. Activin A significantly suppressed basal, and inhibin A-and FSH-stimulated progesterone and E2 secretion by nonluteinized granulosa cells. CONCLUSION(S): Activin A is a promoter of oocyte maturation in vitro and a modulator of granulosa cell steroidogenesis in culture.

Activins↗

PubMed1995

Interleukin-1 beta induces cyclooxygenase-2 in cultured human decidual cells.

PROBLEM: The purpose of this study was to examine the hypothesis that interleukin-1 beta (IL-1 beta)-elicited increases in decidual prostaglandin E2 and F2 alpha (PGE2 and PGF2 alpha) biosynthesis are due to the de novo expression of the inducible isoform of cyclooxygenase (i.e., COX-2). METHOD: Primary human decidual cell cultures were established from term placentas delivered by cesarean section. After 8 days in vitro, when the cultures secreted immunoreactive prolactin, the cells were incubated for 24 h in serum-free medium, and then challenged with IL-1 beta from 1 to 48 h. PGE2 and PGF2 alpha content in the media were measured by specific radioimmunoassays. RESULTS: IL-1 beta stimulated a time-dependent enhancement in PGE2 and PGF2 alpha production, with PGF2 alpha synthesis predominating over PGE2. IL-1 beta also induced a dose-dependent increase in the output of both arachidonic acid metabolites. When Northern blots of IL-1 beta-treated and control cells were probed with cDNAs encoding either COX-1 or COX-2 isoforms or an oligonucleotide probe encoding a portion of the human beta-actin, we detected a time- and dose-dependent increase in the steady-state levels of COX-2, but not COX-1 or beta-actin mRNA transcripts. Moreover, the expression of COX-2 mRNA in IL-1 beta-stimulated cells was superinduced by preincubation with cycloheximide, but completely abolished by actinomycin D. CONCLUSIONS: Taken together, the data suggest that COX-2 mRNA expression is largely responsible for the robust increase in PG formation seen in IL-1 beta-treated decidual cells.

Cells, Cultured↗

PubMed1994

Juxtaposition of contralateral ovary and fallopian tube to allow pregnancy in unicornuate uterine anomaly.

Infertile patients who have undergone unilateral oophorectomies or salpingectomies or those with uterine anomalies may require juxtaposition of a remaining fallopian tube and contralateral ovary. A 28-year-old woman with previous left oophorectomy for endometriosis was found to have a left unicornuate uterus during subsequent infertility evaluation. Laparotomy and resection of a right rudimentary horn and juxtaposition of the left fallopian tube and the right ovary was performed. A large endometrioma was also resected from the right ovary. The patient conceived during the second month postoperatively. A simple procedure for juxtaposing a contralateral fallopian tube and ovary is described. Careful evaluation of the pelvic organs should be performed before removal of an ovary in a young woman.

Adult↗

PubMed1994

Novel human endometrial cell line promotes blastocyst development.

OBJECTIVE: To test and contrast the embryotrophic potential of an established human endometrial cell line to that of two other epithelial cell types: human oviduct and African monkey kidney (Vero) cells. DESIGN: Mouse IVF was performed. Subsequent development of embryos cocultured with our endometrial cell line was contrasted to that seen with oviductal and Vero cell coculture systems. Percent blastocyst transformation, expansion, and hatching were compared. SETTING: University-based research laboratory associated with clinical IVF program. RESULTS: All three epithelial cell monolayers tested significantly improved the rate of blastocyst transformation of in vitro fertilized murine oocytes. The overall percent blastocysts obtained was highest with endometrial cells (69%), followed by oviductal cells (52%), Vero cells (45%), and the medium-alone controls (29%). Only 13% of oviduct cocultured embryos were able to reach the hatched blastocyst stage compared with a 30% hatching rate with endometrial cells and a 21% hatching rate with Vero cells. Only 3% of control embryos hatched in vitro. CONCLUSION: We have described a novel continuous endometrial cell line with excellent embryotrophic potential. This cell line is technically easy to use and is of human origin. As a coculture system it appears to be superior to both oviductal and Vero cells in correcting for defects in culture environment during in vitro development up to the blastocyst stage.

Aneuploidy↗

PubMed1989

A program for matched, anonymous oocyte donation.

The authors' program for matched, anonymous oocyte donation has resulted in two successful pregnancies among the first eight oocyte recipients. All oocyte recipients to date have had ovarian failure or absence with premature ovarian failure the most common cause. All recipients were cycled on a program of incremental oral micronized estradiol and intramuscular progesterone-in-oil. Thirteen candidates for oocyte donation were screened to obtain 8 donors. One donor candidate was excluded because of her medical history. The psychological screening of 2 of the other donor candidates (who subsequently did not complete the donation cycle) revealed a primary motive of financial gain. In general, the psychological profiles of donor candidates revealed a high incidence of troubled families and either reproductive loss or loss of a parent. Ovarian stimulation of the donors followed our standard in vitro fertilization protocol. The recipients' exogenous steroid replacement continued until days 97 and 101, respectively, of the two gestations. Both pregnancies resulted in the delivery of normal singleton males--the first at 40 weeks, the second at 35 weeks.

Adult↗