Genes invoked in the ovarian transition to menopause

Menopause and the associated declines in ovarian function are major health issues for women. Despite the widespread health impact of this process, the molecular mechanisms underlying the aging-specific decline in ovarian function are almost completely unknown. To provide the first gene–protein analysis of the ovarian transition to menopause, we have established and contrasted RNA gene expression profiles and protein localization and content patterns in healthy young and perimenopausal mouse ovaries. We report a clear distinction in specific mRNA and protein levels that are noted prior to molecular evidence of steroidogenic failure. In this model, ovarian reproductive aging displays similarities with chronic inflammation and increased sensitivity to environmental cues. Overall, our results indicate the presence of mouse climacteric genes that are likely to be major players in aging-dependent changes in ovarian function

Normal onset of puberty: Have definitions of onset changed?

Puberty is the sequence of events that culminates in the ability to procreate. It is widely accepted that the onset of puberty in girls occurs on average at 8 years of age and that onset prior to 8 years of age is precocious puberty. As a result of the cross-sectional study by the American Association of Pediatrics, a movement exists to change the age limit of the onset of puberty to 6 years of age in black girls and 7 years of age in white girls. We should be cautious in adhering to strict age limits when diagnosing precocious puberty. Also the rapidity and progression of puberty should be evaluated, and if appropriate, therapy to suppress pubertal development considered

Normal onset of puberty have definitions of onset changed?

Puberty is the sequence of events that culminates in the ability to procreate. It is widely accepted that the onset of puberty in girls occurs on average at 8 years of age and that onset prior to 8 years of age is precocious puberty. As a result of the cross-sectional study by the American Association of Pediatrics, a movement exists to change the age limit of the onset of puberty to 6 years of age in black girls and 7 years of age in white girls. We should be cautious in adhering to strict age limits when diagnosing precocious puberty. Also the rapidity and progression of puberty should be evaluated, and if appropriate, therapy to suppress pubertal development considered

HOXA10 mutations in congenital absence of uterus and vagina

Objective: To analyze the HOXA10 genes in CAUV patients for mutations. Congenital absence of the uterus and vagina (CAUV) is the most extreme female reproductive tract developmental defect known. The HOXA10 gene is expressed in the developing and adult uterus. Female mice with loss-of-function Hoxa10 gene mutations have anteriorly directed homeotic transformations of the uterus. Because the HOXA10 gene is expressed in the embryonic paramesonephric (Müllerian) ducts, abnormally low expression by mutant HOXA10 genes might cause CAUV. This hypothesis was tested by analyzing the HOXA10 genes in CAUV patients for mutations. Design: Case-control study. Setting: Academic reproductive endocrinology and infertility practice. Patient(s): Blood samples were obtained from 26 patients with CAUV and 30 normal controls. Intervention(s): DNA samples prepared from blood leukocytes were used as templates for polymerase chain reaction (PCR) amplification of DNA fragments from the HOXA10 gene. The gene fragments were tested for DNA sequence differences using denaturing gradient gel electrophoresis (DGGE). Main Outcome Measure(s): To detect DNA sequence differences between patients with CAUV and normal controls. Result(s): No DNA sequence differences were found in either patients with CAUV or normal controls in either of the two protein-coding exons of the HOXA10 gene. Conclusion(s): Because no HOXA10 gene mutations were found in 26 patients from 25 unrelated families, germ- line mutations in the HOXA10 gene are not a common cause of CAUV. © 2008 American Society for Reproductive Medicine

Variations within an in vitro fertilization program might be caused by patient demographics

Factors other than the embryology laboratory, protocol variations, and physician transfer rates might have significant influences on an IVF center\u27s success rates. Patient demographics might make the difference. © 2004 by American Society for Reproductive Medicine

Variations in individual physician success rates within an in vitro fertilization program might be due to patient demographics

Objective To determine whether there are variations in individual physician success rates in an IVF program, even with uniform laboratory and treatment protocols. Design Retrospective analysis. Setting Boston IVF, a private practice. Patient(s) Patients \u3c38 and 38-40 years of age who underwent non-donor egg, fresh embryo transfer (ET). Intervention(s) Retrospective analysis of IVF success rates for Boston IVF for the year 1999, as reported to the Society of Assisted Reproductive Technology. Main outcome measure(s) Each individual physician\u27s clinical pregnancy and live birth rates for patients aged \u3c38 and 38-40 years for the year 1999. Pregnancy rates were also obtained for an ideal patient group. Result(s) Among 13 physicians, the clinical pregnancy rate in the \u3c38-year age group ranged from 20.5% to 35.1% and the live birth rates from 17.8% to 31.1%. For the 38-40-year age group, the clinical pregnancy rate ranged from 10.6% to 29.8% and live birth rates from 7.0% to 25.5%. There was no statistical difference in the clinical pregnancy rate for the ideal patient group. Conclusion(s) In the ideal patient group, in which patient demographics are uniform, there are no statistical differences in individual physician performance within the same IVF program. Variation exists in the success rates between the physicians in the \u3c38- and 38-40-year age groups. Possibly this is owing to patient demographics. © 2004 by American Society for Reproductive Medicine

Subcutaneous versus intramuscular administration of human chorionic gonadotropin during an in vitro fertilization cycle

Objective: To confirm that hCG levels in follicular fluid and serum would be comparable between IM and SC administration of purified hCG. Design: In a prospective study, serum and follicular fluid levels of hCG after an IM or SC injection of 10,000 IU of hCG were evaluated 36 hours after injection, that is, at the time of oocyte retrieval. Setting: This study was carried out in a university-affiliated IVF program. Patient(s): Forty women undergoing oocyte retrieval were entered into the study at the time of egg retrieval, that is, 36 hours after hCG administration. Intervention(s): SC or IM injection of hCG. Main Outcome Measure(s): Serum and follicular fluid concentrations of hCG were evaluated 36 hours after injection at the time of oocyte retrieval. Result(s): There was a significantly higher serum hCG level in the SC group (348.6 ± 98 IU/L) vs. the IM group (259.0 ± 115 IU/L) and a significantly higher follicular fluid hCG level in the SC vs. the IM group (233.5 ± 85 vs. 143.4 ± 134 IU/L). Conclusion(s): After purified hCG administration via the SC route, both serum and follicular fluid levels are greater compared with the IM route. © 2003 by American Society for Reproductive Medicine