Thioredoxin, an antioxidant redox protein, in ovarian follicles of women undergoing in vitro fertilization.

Oxidative stress has a bidirectional role in the development and maturation of zygotes and embryos. Reduction-oxidation reactions and regulatory proteins, such as thioredoxin (TRX) and thioredoxin reductase (TRXR), are intimately involved in the regulation of oxidative stress. The aim of this study was to determine the levels of TRX mRNA and protein in ovarian follicles collected from women undergoing in vitro fertilization (IVF) and to assess these levels relative to follicle size, presence of oocytes, and responsiveness to superovulation. Follicular fluid (FF) and/or granulosa cells (GCs) from large and small follicles were collected at the time of ovum pick-up from 42 IVF patients enrolled in this study. We divided the patients into normal and poor responders (NR and PR, respectively) based on the serum estradiol levels on the day of human chorionic gonadotropin (hCG) administration. We also compared the TRX concentration in FF (FF-TRX) between oocyte-containing follicles (Oc+) and empty follicles (Oc-). The transcript levels of TRX, but not TRXR, were significantly higher in GCs derived from follicles collected from NR than PR, as determined by semi-quantitative RT-PCR analysis. In NR, the FF-TRX was significantly higher in Oc+ follicles than in Oc- follicles and also in large Oc+ follicles than in large Oc- follicles. Unlike NR, PR exhibited no positive association with elevated FF-TRX and presence of oocytes. Based on its collective anti-oxidative, cytoprotective, and cytokine-like properties of TRX, TRX is likely to be involved in the optimal growth and maturation of ovarian follicles and responsiveness to hyperstimulation.

A case of recurrent hyperreactio luteinalis.

Hyperreactio luteinalis (HL) in normal pregnancy has been reported previously. However, only a few cases of HL recurrence have been reported. The present report describes HL in a normal singleton pregnancy presenting with an acute abdomen requiring surgical intervention. In a subsequent normal singleton pregnancy, HL recurred and was treated conservatively.

Treatment of endometrial hyperplasia with a danazol-releasing intrauterine device: a prospective study.

The purpose of the present study was to assess the effect of a danazol-releasing intrauterine device (D-IUD) in the treatment of endometrial hyperplasia. Twenty patients with endometrial hyperplasia including 14 with simple endometrial hyperplasia and 2 with complex endometrial hyperplasia (group A), and 4 with atypical endometrial hyperplasia (group B) were enrolled in the prospective study between August 1999 and December 2003. During and just after the treatment, improvement was seen in all patients. Simple or complex endometrial hyperplasia (group A) demonstrated regression to a normal secretory endometrium (38% of group A), pseudodecidual stromal change (31%) and glandular atrophy (25%), and miscellaneous change (inflammation, necrosis, etc.) (38%). Atypical hyperplasia (group B) demonstrated regression to a normal secretory endometrium (25% of group B), pseudodecidual stromal change (75%), glandular atrophy (50%) and miscellaneous change (granulation) (25%). In group A, 2 women conceived after completion of the treatment. The recurrence rate in patients with endometrial hyperplasia (groups A and B) in the follow- up was 20% and acceptable as compared with other studies. The pretreatment menstrual interval patterns of the patients were maintained peri- and post-treatment. These data indicate that D-IUD therapy might be a novel and effective method for the treatment of endometrial hyperplasia.