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Biomedical subjects

Yu-Shih Yang

Publications and source records attributed to Yu-Shih Yang.

36 records · Page 2Linked to original sources

Decreased expression of killer cell inhibitory receptors on natural killer cells in eutopic endometrium in women with adenomyosis.

BACKGROUND: Increased expression of killer cell inhibitory receptors (KIRs) has been found on natural killer (NK) cells in peritoneal fluid in women with endometriosis. In this study, we tried to measure the expression of KIRs on NK and T cells in women with adenomyosis, in an attempt to find the possible role of KIRs in the development of adenomyosis. METHODS: A total of 10 women with adenomyosis (study group) and 12 women with uterine myoma (control group) were included in this study. The expression of KIRs, including NKB1, GL183, EB6 and CD94, on NK and T cells in myometrium and endometrium was examined by flow cytometry. RESULTS: There was a decreased expression of NKB1 and GL183 on NK cells in the endometrium, but not in the myometrium, in women with adenomyosis. However, the expression of KIRs on T cells, either CD4+ or CD8+, was not different in either myometrium or endometrium between women with and without adenomyosis. CONCLUSIONS: The expression of KIRs on NK cells was decreased in eutopic endometrium in women with adenomyosis. It may be a compensatory effect in which the NK cytotoxicity is activated in order to eradicate the abnormal endometrial cells that might exit of the eutopic site of the endometrium.

Adult↗

Expression of leukemia inhibitory factor and its receptor is not altered in the decidua and chorionic villi of human anembryonic pregnancy.

BACKGROUND: Uterine expression of leukemia inhibitory factor (LIF) is absolutely essential for mouse, and critical for human, embryo implantation. However LIF is not required for post-implantation development of mouse embryo. The objective of this study was to examine the role of LIF system in post-implantation stage of human pregnancy. METHODS: Tissues from 25 patients with anembryonic pregnancy (AP; blighted ovum) and 25 matched patients with normal pregnancy (NP) were collected. LIF and its receptor beta (LIF-Rbeta) expression in the decidua and chorionic villi were analyzed by semi-quantitative reverse transcription and polymerase chain reaction (RT-PCR), real-time quantitative PCR and immunohistochemical study. RESULTS: LIF mRNA levels were not different either between different tissues (decidua vs chorionic villi) or between different patients (NP vs AP). LIF-Rbeta mRNA levels were significantly higher in chorionic villi than in decidua but were not different between NP and AP. Immunohistochemical staining supported these findings and showed a predominate expression of LIF-Rbeta in the trophoblast cells. CONCLUSIONS: This study concluded that at early human post-implantation stage, LIF is produced from both decidua and chorionic villi and may exert its major action on trophoblasts. A baseline expression of LIF and LIF-Rbeta is probably needed for early pregnancy, but AP cannot be accounted for by the defective expression of either LIF or LIF-Rbeta in most circumstances.

Adult↗

Microtubular spindle dynamics and chromosome complements from somatic cell nuclei haploidization in mature mouse oocytes and developmental potential of the derived embryos.

BACKGROUND: The aim of this study was to investigate haploidization of somatic cell nuclei in non-enucleated mature oocytes regarding spindle formation, chromosomes and developmental potential. METHODS: Mouse cumulus cells were injected into metaphase II oocytes. Some injected oocytes were examined for morphological changes of chromosomes and the spindle immediately, and at 30 min, 1 h or 2 h after the injections. The remaining oocytes were activated by Sr(2+) after various incubation periods and observed for formation of a second polar body and pseudo-polar body. Cytogenetic analysis was performed for some of the resulting zygotes. The progress to blastocysts in vitro and the possibility of conception in vivo were assessed. RESULTS: Immediately after injection, the cumulus cell nucleus was still in interphase without spindle formation. The occurrence of premature chromosome condensation (PCC) and spindle formation increased as the incubation time increased. The percentages of activated oocytes increased with the incubation time after nuclear transfer, but the difference was not significant between 1 (58%) and 2 h (62%). The incidence of chromosomal aberrations was high for the derived embryos. Development in vitro was poor, and no procreation of pups occurred after transfer of the 324 embryos. CONCLUSIONS: The PCC and spindle formation induced by cumulus cell nuclei in mature oocytes was time dependent, as was the chance for successful activation. The chromosomal abnormalities from segregation errors presented one obvious cause, apart from the potential epigenetic defects, of developmental failure of the semi-cloned embryos.

Animals↗

Technical aspects of the piezo, laser-assisted, and conventional methods for nuclear transfer of mouse oocytes and their efficiency and efficacy: Piezo minimizes damage of the ooplasmic membrane at injection.

Assessment of the advantages and disadvantages of the piezo, laser, and conventional methods for nuclear transfer has remained elusive. Furthermore, although the piezo method had been used by some investigators for research of sperm injection and nuclear transfer for several years, many researchers have failed to operate the technique smoothly and achieve reproducible results. The procedures of nuclear transfer using piezo were ascertained and described in detail. Mouse oocytes were enucleated, and injected with cumulus cells using the piezo, laser, or conventional methods. We investigated the time needed and survival of nuclear transfer. Development was compared among the three methods and parthenogenetic control specimens. The average time of nuclear transfer for each oocyte was significantly shorter using the piezo (118 +/- 9 s) and laser methods (120 +/- 11 s) than using the conventional method (170 +/- 11 s). The damage rate was smaller for the piezo group (10%) than the laser (37%) and conventional (40%) groups. The percentages of blastocyst formation (14%, 12%, and 11%) and the number of nuclei of blastocysts (54 +/- 13, 51 +/- 11, and 52 +/- 12) were similar among the piezo, laser, and conventional groups, but significantly lower than for the control group (83%, 105 +/- 14). The piezo technique is more efficient than the conventional method for nuclear transfer. The laser method is easy to operate, but the equipment is expensive. In addition, piezo induced fewer traumas while breaking the membrane than the aspiration techniques used in the laser and conventional methods.

Animals↗

Nitric oxide is associated with poor embryo quality and pregnancy outcome in in vitro fertilization cycles.

OBJECTIVE: To evaluate the association between follicular and serum nitric oxide (NO) levels and embryo development and outcome in IVF. DESIGN: Prospective, case-control study. SETTING: University hospital, tertiary medical center. PATIENT(S): Eighteen patients with tubal or peritoneal factor infertility and 18 female partners from couples with male factor infertility underwent controlled ovarian stimulation and IVF/intracytoplasmic sperm injection (ICSI). INTERVENTION(S): Controlled ovarian stimulation and oocyte retrieval followed by IVF/ICSI and embryo culture. MAIN OUTCOME MEASURE(S): Degree of fragmentation of embryos and pregnancy rate. RESULT(S): Higher follicular NO levels were associated with advanced fragmentation of embryos. Follicular soluble Fas could not prevent embryo fragmentation. Higher serum NO levels were found among nonpregnant patients with tubal or peritoneal factor infertility. No elevated serum NO levels were found in the female partners from couples with male factor infertility. CONCLUSION(S): Up-regulation of serum NO is associated with implantation failure in patients with tubal or peritoneal factor infertility.

Adult↗

Cryopreserved sibling oocytes and intracytoplasmic sperm injection rescue unexpectedly poor fertilization in conventional in vitro fertilization.

PURPOSE: To report a successful pregnancy from cryopreserved sibling oocytes and intracytoplasmic sperm injection (ICSI) for an infertile couple with an unexpectedly low fertilization rate in the fresh in vitro fertilization (IVF) cycle. METHODS: The woman had bilateral tubal obstruction and polycystic ovarian syndrome. The man had normal semen parameters. The couple underwent a cycle of controlled ovarian hyperstimulation in that 20 oocytes were retrieved. Twelve oocytes were conventionally inseminated and eight were cryopreserved using a slow freezing method. However, only one oocyte was fertilized, and no pregnancy was achieved. In the next cycle, the frozen oocytes were thawed and ICSI was performed. RESULTS: After thawing, seven oocytes (88%) survived and one was damaged. Six were at the metaphase II stage and were injected. Five (83%) achieved normal fertilization, and all of them cleaved (100%). After replacement of the embryos, a singleton pregnancy developed. A healthy female baby was delivered at term. Karyotyping revealed 46, XX. CONCLUSIONS: In addition to well-known indications, cryopreservation of excess sibling oocytes for patients receiving IVF has a possible advantage of preventing unexpectedly low fertilization rate or fertilization failures.

Adult↗

Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization.

OBJECTIVE: To analyze to what extent the parameters of ovarian functional reserve including female age and basal FSH levels will affect the results of ovarian hyperstimulation and IVF outcome. DESIGN: Retrospective cohort study. University hospital infertility center. PATIENT(S): One thousand forty-five women undergoing their first cycle of IVF with ovarian stimulation after pituitary desensitization. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Cycle parameters, cancellation rate, implantation rate, and pregnancy rate. RESULT(S): Both increasing age and basal FSH were associated significantly with reduced numbers of oocytes collected, oocytes fertilized, and embryos transferred. The combined use of age and basal FSH significantly improves the predictive power for these parameters. Increasing age, but not basal FSH, was associated significantly with reduced implantation rate and pregnancy rate. Logistic regression analysis revealed that age, but not basal FSH, was an independent predictor of pregnancy rate. Neither age nor basal FSH had significant association with fertilization rate, miscarriage rate, or ectopic pregnancy rate. CONCLUSION(S): Both basal FSH and age contributed to the prediction of the quantitative ovarian reserve as reflected by the number of oocytes collected. However, age is a better predictor of pregnancy potential for women undergoing IVF.

Adult↗

Comparison of coasting and intravenous albumin in the prevention of ovarian hyperstimulation syndrome.

OBJECTIVE: To compare the efficacy of coasting to prevent ovarian hyperstimulation syndrome (OHSS) with i.v. albumin and to determine if different timing of gonadotropin coasting would affect the IVF outcomes. DESIGN: Retrospective study. SETTING: University hospital-based IVF program. PATIENT(S): One hundred sixty-two women undergoing IVF treatment cycles who were considered to be at high risk for developing OHSS. INTERVENTION(S): Gonadotropin administration was withheld in 60 patients: either coasting occurred before follicular maturation (early coasting subset, n = 28) or follicular maturity was attained before coasting (late coasting subset, n = 32). Outcomes were compared in 102 patients at risk for OHSS who received i.v. albumin on the day of oocyte retrieval. MAIN OUTCOME MEASURE(S): Incidence of OHSS and outcome parameters. RESULT(S): Although the fertilization rates and the incidence of OHSS did not differ significantly between the coasting and i.v. albumin groups, the mean number of oocytes retrieved, the pregnancy rates, and implantation rates were significantly lower in the coasting group. There is no statistical difference in the entire outcome examined and the incidence of OHSS between the early and late coasting subsets. CONCLUSION(S): Coasting is as effective as i.v. albumin in preventing OHSS in high-risk patients but yields inferior pregnancy rates. Early coasting is as successful as late coasting in preventing OHSS with similar IVF outcome.

Adult↗

A protocol of electroejaculation and systematic assisted reproductive technology achieved high efficiency and efficacy for pregnancy for anejaculatory men with spinal cord injury.

OBJECTIVE: To help anejaculatory men with spinal cord injury (SCI) to procreate. DESIGN: Prospective, clinical study. SETTING: A team of physiatrists, urologists, and gynecologists at a university hospital in Taiwan. PARTICIPANTS: Ten infertile men with SCI seen at our hospital between 1995 and 2001. INTERVENTIONS: Electroejaculation induced their seminal emission. Depending on semen parameters, the couples were treated with intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), surgical retrieval of sperm, cryopreservation of sperm, or donor sperm. MAIN OUTCOME MEASURES: Fertilization and pregnancy. RESULTS: Ten couples underwent assisted reproductive technology (ART). One couple achieved pregnancy after the second cycle of electroejaculation and IUI. Seven couples underwent 8 cycles of ICSI, 4 cycles with fresh electroejaculates, 2 with cryopreserved samples, and 2 with cryopreserved samples with addition of pentoxifylline. Seven (88%) clinical pregnancies were achieved, 2 of which ended with spontaneous abortion. One couple accomplished pregnancy by ICSI with cryopreserved sperm from vasal aspiration. The percentages of fertilization and pregnancy of ICSI cycles using sperm from men with SCI were comparable to men without SCI. One couple attained pregnancy by using donor sperm. The cumulative successful pregnancy rate per couple was 80% (8/10). CONCLUSION: Electroejaculation and systematic ART are highly efficient for achieving pregnancy with the spouses of men with SCI. The neurologic deficit and electroejaculation did not affect the outcome of ICSI. Using cryopreserved sperm for ICSI may reduce risk from electroejaculation or surgery.

Adult↗

Nitric oxide synthesis is increased in the endometrial tissue of women with endometriosis.

BACKGROUND: Previous studies have shown that peritoneal macrophages from women with endometriosis produce excess nitric oxide (NO). This study was designed to quantify the amount of NO and determine the expression of endothelial (eNOS) and inducible NO synthases (iNOS) in women with and without endometriosis. METHODS: An enzyme-linked immunosorbent assay (ELISA) was performed on endometrial tissues obtained from controls (myoma, n = 30) and on eutopic/ectopic endometrial tissues from endometriosis patients (n = 34) to evaluate eNOS and iNOS protein concentrations in these endometrial tissues. A rapid-response chemiluminescence analyser was used to measure NO directly in fresh endometrial tissues. RESULTS: Mean (+/- SEM) levels of NO were significantly increased in the endometrial tissues of women with endometriosis (13.2 +/- 7.8 versus 19.8 +/- 12.6 nmol/g tissue; P = 0.016). Apparently higher levels of NO were found in ectopic compared with eutopic endometrium (P = 0.057). Endometrial tissues of women with endometriosis appeared to contain more iNOS than those of controls (3.6 +/- 2.2 versus 8.6 +/- 12.2 pg/ microg protein; P = 0.06), but no significant difference was found in eNOS levels. CONCLUSIONS: Greater amounts of NO and NOS are present in the endometrial tissues of women with endometriosis, implying a possible role for NO in the pathogenesis of endometriosis.

Endometriosis↗

The significance of cytokines, chemical composition, and murine embryo development in hydrosalpinx fluid for predicting the IVF outcome in women with hydrosalpinx.

BACKGROUND: The aim of this study was to determine whether differences in cytokine concentrations, chemical composition, and murine embryogenesis in hydrosalpinx fluid could be observed between women with hydrosalpinx who achieved and did not achieve pregnancy. METHODS: Hydrosalpinx fluids were collected from 39 infertile women participating in an IVF-embryo transfer programme at a university teaching hospital. The fluids were analysed for concentrations of cytokine concentration (epidermal growth factor, interferon-gamma, leukaemia inhibitory factor, and tumour necrosis factor-alpha) and chemical composition. Mouse embryos were cultured in medium with various concentrations (0, 10, 50, 100%) of hydrosalpinx fluid. RESULTS: Logistic regression demonstrated that a murine blastocyst formation rate >or=53.3% in 50% hydrosalpinx fluid (OR = 16.6, 95% CI 2.4-116.1, P = 0.005) and patient age (OR = 0.778, 95% CI 0.61-0.99, P = 0.045) were independent predictors of IVF outcome. The diagnostic accuracy did not significantly improve when age and number of good quality embryos transferred was taken into account. The chemical composition and cytokine concentrations of hydrosalpinx fluid were not predictive of subsequent IVF outcome. CONCLUSIONS: The mouse embryo assay of hydrosalpinx fluid might potentially serve as a predictor of subsequent IVF outcome in women with hydrosalpinx. This technique may be useful in selecting appropriate treatment options for patients with hydrosalpinx undergoing IVF treatment.

Adult↗

Expression of the interleukin-2 receptor alpha (CD25) is selectively decreased on decidual CD4+ and CD8+ T lymphocytes in normal pregnancies.

In a previous study, we demonstrated that the proportion of activated T cells (CD69+CD3+ and HLA-DR+CD3+) is higher in the endometrium and decidua after the luteal phase and throughout early pregnancy compared with in the peripheral blood. However, there was no difference in the proportion of CD25+CD3+ lymphocytes between the endometrium and peripheral blood. In this study, we further verify that the levels of CD25 on CD4+ and CD8+ T lymphocytes are not increased in normal pregnancy, although the levels of CD69 and HLA-DR are markedly increased. We also elucidate that the amounts of all three activation molecules on local T lymphocytes are down-regulated in pregnancy compared with that during the luteal phase. Nevertheless, these decreases are significantly lessened in anembryonic pregnancies with both normal and abnormal karyotyping. However, in peripheral blood, the down-regulation of activation molecules levels in pregnancy is only demonstrated on CD4+ cells and for HLA-DR on CD8+ cells. Furthermore, dual activation marker analysis demonstrated that the expression of CD25 appears to be dissociated from CD69 and HLA-DR on the same decidual lymphocytes. Because IL-2Ralpha plays a pivotal role in the development and propagation of functional T cells, its depressed expression may result in maternal tolerance of the fetal allograft.

Adult↗

Defective production of interleukin-11 by decidua and chorionic villi in human anembryonic pregnancy.

Previous study demonstrated that IL-11 receptor alpha knockout female mice (IL-11Ralpha(-/-)) were phenotypically normal but infertile due to defective decidualization. However, the role of IL-11 signaling in human reproduction remains unclear. This study examined the expression of IL-11, IL-11Ralpha, and signal transduction factor glycoprotein 130 in different phases of endometrium (six in proliferative phase and four in secretory phase), and the decidua and villi of normal pregnancy (NP; n = 25) and anembryonic pregnancy (AP; n = 25) in the first trimester (gestational week 7-9). RT-PCR showed IL-11, IL-11Ralpha, and glycoprotein 130 mRNA expression in all samples, except the absence of IL-11 signal in the unstimulated MRC-5 cell and the proliferative phase endometrium. Real-time quantitative PCR showed that the relative level of IL-11Ralpha mRNA was not significantly different among proliferative phase endometrium (relative level; mean +/- SEM, 1.4 +/- 0.5), secretory phase endometrium (1.3 +/- 0.1), or decidua from NP or AP (1.7 +/- 0.3 and 1.9 +/- 0.4, respectively), but was significantly greater in chorionic villi either from NP or AP (7.6 +/- 1.3 and 10.6 +/- 1.9, respectively; both P < 0.05, compared with decidua or endometrium). No difference of IL-11Ralpha mRNA level was found between NP and AP (1.7 +/- 0.3 vs. 1.9 +/- 0.4 in deciduas; 7.6 +/- 1.3 vs. 10.6 +/- 1.9 in villi; both P > 0.05). In situ hybridization localized IL-11Ralpha mRNA expression in proliferative phase endometrium (stroma only), secretory phase endometrium (stroma and gland), decidua (stroma and gland), and villi (trophoblast and stroma). The staining intensities were not distinctly different between different groups of samples or between different cell types in a sample. No difference in IL-11Ralpha expression was found between NP and AP when either decidua or chorionic villi was analyzed. IL-11 mRNA level was not detected in the proliferative phase (relative level, 0.0 +/- 0.0), was barely detectable in the secretory phase (0.03 +/- 0.02), and was significantly increased in decidua (1.7 +/- 0.2 and 0.1 +/- 0.1, respectively, for NP and AP) and chorionic villi (13.0 +/- 2.2 and 0.2 +/- 0.1). In addition, IL-11 mRNA level was higher in NP than in AP both in decidua (1.7 +/- 0.2 vs. 0.1 +/- 0.1; P = 0.03) and in villi (13.0 +/- 2.2 vs. 0.2 +/- 0.1; P < 0.001). Immunohistochemistry study showed that IL-11 was nearly absent in endometrium in both phases, but clearly detectable in decidua and villi. Consistent with the results of quantitative PCR, the staining intensity was stronger in villi and decidua from NP than those from AP. The spatial and temporal changes in IL-11 and its receptor observed in this study suggest that IL-11 may be produced both by the embryo (predominantly) and the decidual cells and exerts its action on chorionic villi and decidua in an autocrine or paracrine manner. In the presence of a baseline level of IL-11Ralpha, IL-11 may subsequently regulate placentation and decidualization for the maintenance of a NP. The finding of decreased IL-11 expression in the absence of any change in IL-11Ralpha in AP suggests that defective expression of IL-11 but not IL-11Ralpha may account for certain cases of AP.

Adult↗

Neonatal outcome of infants born after in vitro fertilization at National Taiwan University Hospital.

BACKGROUND AND PURPOSE: This study compared the neonatal outcome between infants born after in vitro fertilization (IVF) and after natural conception at National Taiwan University Hospital. METHODS: All medical records of women who underwent IVF and gave birth at our hospital from January 1995 to December 1996 were reviewed. The charts of their offspring were also reviewed. We compared the neonatal outcome of infants born after IVF with that of infants born after natural conception. Neonatal outcome was evaluated based on preterm birth, very low birth weight (VLBW), perinatal morbidity, and neonatal mortality. RESULTS: A total of 75 women underwent IVF and gave birth to a total of 100 live newborns and two fetuses with intrauterine death during the 2-year study period. Among these newborns, the prevalence of preterm birth was 28%, of perinatal morbidity was 17%, and of neonatal mortality was 3%, which were significantly higher than those among the 7,736 neonates born after natural conception. However, the rate of VLBW was similar between the two groups. The rate of preterm birth for twin pregnancies were higher than that for singleton pregnancies in both groups. CONCLUSION: This study showed that infants born after IVF had a higher risk of preterm birth and higher perinatal morbidity and neonatal mortality.

Female↗

Extended estrogen administration for women with thin endometrium in frozen-thawed in-vitro fertilization programs.

PURPOSE: To evaluate the effect of extended estrogen administration for women with thin endometrium in frozen-thawed in-vitro fertilization (IVF) programs. METHODS: Thirty-six women undergoing IVF program had thin endometrium (<8 mm). Among them, 23 received fresh embryo transfer (control group), but 13 canceled embryo transfer and underwent frozen-thawed embryo transfer in the subsequent cycle after extended administration of exogenous estrogen (study group). RESULTS: In the study group, the mean endometrial thickness increased significantly from 6.7 mm in controlled ovarian hyperstimulation cycles to 8.6 mm after an extended estrogen therapy for 14 to 82 days (P=0.031). Their pregnancy rate was significantly higher than that in the control group (38.5% vs. 4.3%, P=0.016). Among 5 women achieving pregnancies in the study group, one was complicated with placenta accreta, and the other 4 had uneventful pregnancies. CONCLUSIONS: Extended estrogen administration followed by frozen-thawed IVF programs is beneficial for women with thin endometrium. However, the risk of abnormal placentation and peripartal complication should be kept in mind.

Drug Evaluation↗