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Biomedical subjects

H N Ho

Publications and source records attributed to H N Ho.

At least 73 records · Page 4Linked to original sources
PubMed1996

The value of human growth hormone as an adjuvant for ovarian stimulation in a human in vitro fertilization program.

The purpose of this study was to evaluate whether the combined treatment of growth hormone (GH) and gonadotropins can improve ovulation stimulation in previously poor responders. Twelve patients who, had suboptimal responses in previous in vitro fertilization cycle were enrolled. They underwent 1 cycle with gonadotropin-releasing hormone analogue (GnRH-a) and gonadotropins and another cycle with GnRH-a, gonadotropins, and GH. Serum gonadotropins, insulin-like growth factor-1 (IGF-1), and sex steroids, including estradiol (E2), progesterone (P4), testosterone, and androstenedione were measured on Day 2 and during ovulation induction. The serum IGF-1 level was higher in the GH cycle. There were no significant differences in the levels of the serum luteinizing hormone, E2, P4, testosterone, and androstenedione between the 2 cycles, so was IGF-1, E2 and P4 in follicular fluid. Co-treatment with GH did not improve the ovarian response. However, the GH cycles had better performance in terms of the number of oocytes fertilized and the pregnancy rate.

Androstenedione↗
PubMed1996

The suppression of peritoneal cellular immunity in women with endometriosis could be restored after gonadotropin releasing hormone agonist treatment.

PROBLEM: Our previous study reported that peritoneal natural killer (NK) cytotoxicity and CD3+CD25+ lymphocyte subpopulation were suppressed in women with advanced endometriosis. Whether these phenomena are general for all stages of endometriosis and whether these alterations could be restored by long-term use of gonadotropin releasing hormone agonist (GnRHa) are further tested in this study. METHOD: Lymphocyte subpopulations (B cells, NK cells, T cells, and T-cell activation markers such as CD69, HLA-DR, and CD25) and NK cell cytotoxicity of peripheral blood and peritoneal fluid by dual-color flow cytometry and 51Cr release assay in 30 cases of endometriosis were compared with those in 26 controls. We also compared these changes before and after 6-month treatment with GnRHa for advanced endometriosis. RESULTS: Compared with the controls, only those women with advanced endometriosis showed lower NK cytotoxicity in peritoneal fluid mononuclear cells (PFMC). The CD3+CD69+ lymphocyte subpopulation decreased in peripheral blood mononuclear cells (PBMC) of advanced endometriosis, while the CD3+CD25+ lymphocyte subpopulation decreased in both PBMC and PFMC of mild and advanced endometriosis. After GnRHa treatment, the CD3+CD69+ lymphocyte subpopulation increased in both PBMC and PFMC and the CD3+CD25+ lymphocyte subpopulation increased in PFMC, but not in PBMC. CONCLUSION: Impaired local immunological function in the PF of endometriosis was confirmed by this study and the impairments could be restored after long-term GnRHa therapy.

Ascitic Fluid↗
PubMed1996

How many embryos should be transferred in in vitro fertilization and tubal embryo transfer?

In order to achieve higher pregnancy rates, more than one embryo is usually transferred in in vitro fertilization (IVF) programs. Tubal embryo transfer (TET) produces an even higher pregnancy rate. However, the number of embryos that should be transferred in TET programs remains to be clarified. We studied a series of 241 consecutive TET cycles and analyzed their clinical characteristics, embryo numbers, cumulative embryo score (CES), and pregnancy outcomes. The results demonstrated that 1) four embryos was an adequate number to obtain a satisfactory pregnancy rate and fewer multiple pregnancies, 2) older patients and cases with male factor had less chance of pregnancy and more than four embryos could be transferred, and 3) CES values > 40 were preferred, but for young patients with unusually high anxiety about multiple pregnancies, a CES of 21 to 40 was optimal. A policy of transfer that limits transfer to a maximum of two, three or four embryos is not suitable in all cases and other factors (eg, repeated IVF failure or older age) should be individually considered. Therefore, two equations utilizing CES, age and failure of previous TET as the factors were developed to help practitioners to evaluate how many embryos should be transferred on an individual basis.

Adult↗
PubMed1996

Delayed delivery of surviving triplet after fetal reduction and spontaneous abortion.

In multiple pregnancies, survival of remaining fetuses after premature death and delivery of one fetus is uncommon. We report a case of a triplet pregnancy that was reduced to twins at the 14th gestational week and then had preterm premature rupture of membranes and intrauterine fetal death of one twin at the 17th gestational week. To save the surviving fetus, delivery of the dead fetus and ligation of the umbilical cord at the cervical level were performed. We also performed McDonald cervical cerclage to keep the placenta of the dead fetus as well as that of the surviving one in the uterine cavity. After a series of aggressive procedures, including immediate administration of tocolytic agents, and antibiotic prophylaxis to prevent infection and preterm labor, the surviving fetus was delivered vaginally 73 days later due to intractable uterine contractions. After a 10-week hospital stay, the infant boy, weighing 2,500 g, was discharged without any sequelae. To our knowledge, this was the longest interval between deliveries in a triplet pregnancy reported in Taiwan. With adequate intensive management, a satisfactory outcome of the fetus and mother in such cases is possible.

Abortion, Spontaneous↗
PubMed1995

Cytomegalovirus infection and viral shedding in the genital tract of infertile couples.

The prevalence of cytomegalovirus (CMV) infection and viral shedding in infertile couples in Taiwan and its role in infertility were studied. Two hundred fifty couples were enrolled in this study. Anti-CMV IgG was measured in serum samples from these infertile couples. Viral shedding examined by DNA hybridization was detected in semen from the husband and cervical mucus from the wife. Anti-CMV IgG was detected in 249 (99.6%) of the 250 male serum samples and in 247 (98.9%) of the 250 female serum samples. Viral shedding was detectable in 83 (33.5%) of 248 semen samples and 83 (33.7%) of 246 cervical mucus samples by dot-blot DNA hybridization assay. Semen quality was not apparently affected by the existence of viral shedding. The co-shedding rate in semen and cervical mucus was high (15.9%). It is concluded that the seroprevalence and genital tract viral shedding were relatively high in infertile couples in Taiwan. Viral shedding did not affect the semen quality. Nevertheless, screening of donor semen is recommended.

Adolescent↗
PubMed1995

Comparison between a two-layer discontinuous Percoll gradient and swim-up for sperm preparation on normal and abnormal semen samples.

PURPOSE: This work was to compare the effects of Percoll gradient and swim-up treatments for sperm preparation on the percentage of progressive motility, recovery of motile sperm, removal of debris, percentage of normal forms according to strict criteria, and movement characteristics of sperm using computer-assisted velocity analysis. RESULTS: In total, 50 semen samples from 50 patients were tested and divided into two groups: a normal group (n = 27) with normal parameters and an abnormal group (n = 23) with abnormal parameters. The results in both the normal and abnormal groups revealed that the sperm concentration in the Percoll samples was significantly greater than that in the swim-up samples. Although the percentage of progressive motility was greater in the swim-up samples than in the Percoll samples, the number of motile sperm, reflecting the percentage of motile sperm recovery, was till greater in the Percoll samples. The debris of semen was equally removed by both methods and the percentage of normal forms was also similar in the samples treated according to these two procedures. Both curvilinear velocity (VCL) and straight-line velocity (VSL) of sperm were significantly greater in the swim-up samples than in the Percoll samples. Sperm from the swim-up procedure also showed a greater mean amplitude of lateral head displacement than that from the Percoll gradient procedure, but the distinction was insignificant. CONCLUSION: The Percoll gradient technique, by recovering more motile sperm, may be applied to prepare oligospermic samples. The swim-up method may become the standard choice to prepare normal semen which could obtain sufficiently motile sperm, due to its simplicity and recovered sperm with superior motility.

Centrifugation, Density Gradient↗
PubMed1995

Increased expressions of CD69 and HLA-DR but not of CD25 or CD71 on endometrial T lymphocytes of nonpregnant women.

To investigate lymphocyte subpopulations and the status of T-cell activation at different phases of the menstrual cycle, lymphocytes in endometrial tissue were analyzed by dual-color flow cytometry in 39 patients. Compared with peripheral blood, the lymphocytes in the endometrium had a higher CD3-/(CD56+ or CD16+) ratio (25.2% +/- 6.8% vs 11.1% +/- 7.0%), but an inverted CD3+ CD8-/CD3+ CD8+ ratio (0.5 vs 1.8) and a minimal amount of B cells (3.3% +/- 3.1%). TcR gamma delta + T cells accounted for a minor proportion (7.8% +/- 5.1%) in endometrium. The proportions of TcR alpha beta + (85.0% +/- 6.6%) and CD3+ CD56+ (7.4% +/- 4.4%) endometrial T lymphocytes were found significantly different from those in peripheral blood (89.1% +/- 5.6% and 3.8% +/- 3.4%, respectively). As the endometrium proceeded from proliferative phase to luteal phase, the proportion of CD3+ CD8+ T cells in peripheral blood increased from 35.6% +/- 6.9% to 41.3% +/- 8.4% and CD3+ CD8- T cells decreased from 64.4% +/- 6.9% to 58.7% +/- 8.4%. The endometrial T cells expressed high levels of CD69 (84.1% +/- 18.9%) and DR (75.9% +/- 9.7%), but rarely expressed CD25 (7.0% +/- 5.4%) and CD71 (2.8% +/- 1.8%). The patterns of expression of these activation markers were similar in both proliferative and luteal phases. Our observations suggest that endometrial T lymphocytes are in a state of recent and persistent activation. Lymphocytes expressing the NK cell markers (CD56 or CD16) and CD8+ accounted for a significant proportion, suggesting that they may play important roles in local defense.

Adult↗
PubMed1995

Peritoneal natural killer cytotoxicity and CD25+ CD3+ lymphocyte subpopulation are decreased in women with stage III-IV endometriosis.

We examined the lymphocytes of peripheral blood (PB) and peritoneal fluid (PF) of women with or without endometriosis to investigate the alteration of cytotoxic activity of natural killer (NK) cells and activation of T cells in the peritoneal cavity of women with endometriosis. A total of 16 control women and 14 patients with stage III-IV endometriosis were selected on the basis of laparoscopic examination in National Taiwan University Hospital. The lymphocyte subpopulations (B cell, NK cell and T cell), including T-cell activation markers (CD69, CD25, HLA-DR), in PB and PF were analysed by dual-colour flow cytometry. The NK cytotoxicity of PB and PF mononuclear cells was evaluated by 51Cr release assay. There was a significant decrease of NK cytotoxicity and CD25+ CD3+ lymphocyte subpopulation in PF of women with endometriosis compared with those without endometriosis. However, there was no difference in the proportion of NK cells in both PB and PF between women with and without endometriosis. Therefore, the decreased NK cytotoxicity in PF of women with endometriosis was due to the functional defect, but not quantitative defect, of NK cells. The concomitant reduction of activated T cells in women with endometriosis might suggest its possible role in the defect of NK cytotoxicity.

Ascitic Fluid↗
PubMed1995

Predictive factors in recurrent spontaneous aborters--a multicenter study.

PROBLEM: Compare data from several centers relating to success rates in recurrent spontaneous miscarriage and assess the significance of indicators of subsequent pregnancy loss. METHOD: Data from 777 couples with unexplained recurrent spontaneous abortion from independent studies at seven centers were analyzed using logistic regression analysis. The following covariates were considered: age of patient, number of previous spontaneous abortions, length of previous abortions history, sub-fertility index (defined as the product of the number of spontaneous abortions and the abortion history), whether a patient was a primary or secondary aborter, and whether a patient had received leukocyte immunotherapy. RESULTS: There was a highly significant difference between the seven centers in success rates in the subsequent pregnancy and a highly significant association between success rate and each of the following covariates: the number of previous abortions, the length of the previous abortion history and the sub-fertility index. In particular, for each increase of 10 units in the value of the sub-fertility index, up to a value of 30, the odds in favor of a successful pregnancy decreased by a factor of 0.6, i.e., 40%. There was, however, little evidence of an association between the success rate in the subsequent pregnancy and age, parity, or immunization with cells from the husband. CONCLUSIONS: The sub-fertility index may be a useful measure of likelihood of success in a subsequent pregnancy.

Abortion, Habitual↗
PubMed1995

Gonadotropin releasing hormone (GnRH) agonist induces down-regulation of the CD3+CD25+ lymphocyte subpopulation in peripheral blood.

PROBLEM: To test whether GnRH agonist could alter in vivo human immune cells and whether the alteration is related to the success of pregnancy in an in vitro fertilization-embryo transfer (IVF-ET) program. METHODS: Thirty-six infertile patients were enrolled under the long protocol of GnRH agonist (buserelin acetate) and superovulation with gonadotropin from our IVF-ET program. Peripheral B cells, NK cells, CD4+ and CD8+ T cells, and the expression of CD69, CD25, HLA-DR, and CD71 antigens on the T cells were serially examined by dual-color flow cytometry. RESULTS: B cells, NK cells, CD8+ T cells, and CD71+ T lymphocyte subpopulations were not changed throughout the whole course of treatment. CD4+ T cell and CD25+ T cell subpopulations were significantly down-regulated when the GnRH agonist was used for approximately 2 wk. CD3+CD69+, CD3+CD25+, and CD3+DR+ lymphocyte subpopulations were increased at 7 days (during implantation) and at 14 days after embryo transfer in pregnant patients, but not in patients who failed to get pregnant. CONCLUSIONS: The GnRH agonist had a transiently immunosuppressive effect on CD4+ and CD25+ T cells, but CD69+, CD25+, and HLA-DR+ T cells were activated during and after successful implantation.

Adult↗
PubMed1995

Decidual natural killer cytotoxicity decreased in normal pregnancy but not in anembryonic pregnancy and recurrent spontaneous abortion.

PROBLEM: The natural killer (NK) cell activity is depressed in the decidua of early normal pregnancy. Recently Morii et al. (Am J Reprod Immunol 1993;29:1-4) found that all early intradecidual CD3+ T cells expressed either T cell receptor (TCR) alpha/beta or gamma/delta but that the expression of the CD3+/TCR complex was down-regulated. METHOD: To test whether these changes in decidual cellular immunity are different among normal pregnancy, anembryonic pregnancy and recurrent spontaneous abortion, we examined the immune cell subpopulations in the decidua from these three types of pregnancy using flow cytometry and an NK cytotoxicity assay. RESULTS: Intradecidual CD3+ T cells expressed either TCR alpha/beta or gamma/delta, and the level of expression of the CD3/TCR complex was down-regulated in normal pregnancy, anembryonic pregnancy, and recurrent spontaneous abortion. Although the relative proportion of decidual NK cells was increased to approximately the same extent in all three types of pregnancy, decidual NK activity was higher in anembryonic pregnancies and in recurrent spontaneous abortions than it was in normal pregnancies. CONCLUSION: Decidual NK cell responses are different in anembryonic pregnancies and in recurrent spontaneous abortions than in normal pregnancies. Whether this difference is pathogenic or is the response to a dead embryo remains to be elucidated.

Abortion, Habitual↗
PubMed1995

Interleukin-1 beta (IL-1 beta) is increased in the follicular fluids of patients with premature luteinization.

PROBLEM: Most, but not all, studies indicate that premature luteinization correlates with poor pregnancy outcome in in-vitro fertilization (IVF) programs. It remains unclear whether cytokines (IL-1 beta, TNF alpha), the established immune mediators, play a role in regulation or initiation of an abnormal follicular or embryo development in patients with premature luteinization. METHODS: Levels of cytokines (IL-1 beta, TNF alpha), estradiol (E2) progesterone (P4), and androstenedione (A'ione) were examined in 18 preovulatory follicular fluid (FF) samples from patients with premature luteinization (group 1) and 3 FF samples from patients without premature luteinization (group 2). The number of oocytes recovered, fertilization rate, and pregnancy outcome were evaluated in these two groups. RESULT: IL-1 beta (25.4 +/ 11.9 pg/ml, mean +/ SD) and TNF alpha (13.4 +/ 10.7 pg/ml) were present in these FF samples. The mean level of IL-1 beta in group 1 was significantly higher than that in group 2 (37.3 +/ 12.3 vs. 20.0 +/ 7.6 pg/ml; P < 0.00001) and the mean level of E2 was significantly lower in group 1 than that in group 2 (1064 +/ 686 vs. 1570 +/ 641 ng/ml; P = 0.02). The levels of TNF alpha, P4, and A'ione showed no distinction between these two groups. There was no correlation between the levels of either IL-1 beta or TNF alpha and P4, E2 or A'ione. The fertilization rate in group 1 (62/77; 80%) was similar to that in group 2 (124/160; 78%). Five of 7 patients in group 1 and seven of 20 patients in group 2 achieved pregnancy following embryo transfer. One of five pregnancies in group 1 aborted. CONCLUSION: The exaggerated levels of IL-1 beta in patients with premature luteinization may arise from accumulation of this cytokine owing to sustained high LH stimulation, and this may be a protective response to the abnormal LH surge and function to inhibit prematurely increased secretion of P4. These data indicate the important role of LH in the induction of IL-1 beta secretion and the possible regulatory action of IL-1 beta in luteinization. According to the diminution of E2 in group 1, there may be a subtle atretic process progressing in follicles primed with prematurely elevated LH. However, the detrimental effect of premature luteinization, if it exists, may work at the stage ¿during or after implantation.

Abortion, Spontaneous↗
PubMed1995

In vivo CD3+CD25+ lymphocyte subpopulation is down-regulated without increased serum-soluble interleukin-2 receptor (sIL-2R) by gonadotropin releasing hormone agonist (GnRH-a).

PROBLEM: To test further whether the suppression of the CD3+CD25+ lymphocyte subpopulation by gonadotropin-releasing hormone agonist (GnRH-a) is related to the change in levels of cytokines and soluble interleukin-2 receptor (sIL-2R). METHOD: Twenty-seven infertile patients were enrolled under the long protocol of GnRH-a agonist (buserelin acetate) and superovulation with gonadotropin from our IVF-ET program. Peripheral B cells, NK cells, CD4+ and CD8+ T cells and the expression of CD69, CD25, HLA-DR, and CD71 antigens on the T cells were serially examined by dual-color flow cytometry. Serum levels of cytokines and sIL-2R were measured. RESULTS: The B cells, NK cells, T cells, CD4+, CD8+ T cells, CD3+DR+, and CD3+CD71+ lymphocyte subpopulations were not changed after the use of GnRH-a. The CD25+ T cell subpopulation was significantly down-regulated, but the CD69+ T cell subpopulation was increased when the GnRH-a was used for approximately 2 wk. The serum levels of interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), interleukin-4 (IL-4), interferon-gamma (IFN-gamma), and sIL-2R were not changed. CONCLUSION: The GnRH-a had a transiently suppressive effect on CD25+ T cells, but a stimulatory effect on CD69+ T cells. However, the serum level of cytokines or sIL-2R did not change. These immunological modulations seems to be the result of interaction between GnRH-a and estrogen.

Antigens, CD↗
PubMed1995

Rapid detection and biovar differentiation of Ureaplasma urealyticum in clinical specimens by PCR.

On the basis of the nucleotide sequence of the multiple-banded (MB) antigen genes of Ureaplasma urealyticum, a polymerase chain reaction (PCR) technique was developed for rapid detection and biovar differentiation of U. urealyticum in a total of 100 urogenital specimens from 50 female patients. Positive PCR UM-1 amplification was found in 28 cervical swabs and 31 urine samples. Overall agreement between PCR and culture was 95%. Members of the two biovars of U. urealyticum could be distinguished by the size of the PCR UM-1 amplification products. Biovar differentiation was also demonstrated by two additional sets of PCRs: PCR UM-2 and UM-3. The PCR UM-2 was used to amplify biovar 1, while PCR UM-3 amplified biovar 2 specifically. The results indicated that use of the MB antigen gene as a target for PCR amplification could provide rapid and specific detection and biotyping of ureaplasma DNA in urogenital samples.

Bacterial Typing Techniques↗
PubMed1995

Effect of assisted hatching by partial zona pellucida dissection on mouse embryos in vitro.

The zonae pellucida of mouse embryos were dissected to examine the effect of partial zona dissection (PZD) at the four-cell stage on embryonic development and the hatching process in vitro. Micropipettes were used to create a gap of one-sixth the zona circumference, to avoid damage to the blastomere. A total of 484 embryos at the four-cell stage (defined as day 2 embryos) were randomly divided into two groups, the PZD group (n = 238) and the control group (n = 246). Embryos of both groups were cultured in vitro under identical conditions and examined on the following day. The hatching rates were as follows: day 3, 11/238 (4.6%) in the PZD group and 0/246 (0%) in the control group; day 4, 105/238 (44.1%) in the PZD group and 54/246 (22.0%) in the control group; day 5, 71/238 (29.8%) in the PZD group and 36/245 (14.5%) in the control group. On day 4 the rates of complete hatching were 7/238 (2.9%) in the PZD group and 2/246 (0.8%) in the control group. On day 6 they were 88/238 (37.0%) in the PZD group and 66/246 (26.8%) in the control group. A significantly higher percentage of PZD embryos than controls initiated and completed hatching in similar culture conditions. The present study indicates that the creation of an opening in the zona pellucida is not harmful to embryonic development and may facilitate hatching. Whether the enhanced hatching ability of embryos in vitro caused by PZD can improve the implantation rate requires further study.

Animals↗