To investigate whether female fertility decreases with age due to poor oocyte quality, we examined the presence of DNA fragmentation in ovulated oocytes from young, mature and aged mice. Oocytes from three age groups of female mice (7-8, 20-24 and 40-48 weeks) were retrieved from the oviducts 15 h after human chorionic gonadotrophin (HCG) injection. Oocytes from each mouse were incubated in a CO2 incubator for 0-60 h in human tubal fluid (HTF). After incubation, each oocyte was stained with the terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL) method. The rate of DNA fragmentation (interpreted as apoptotic changes) was significantly higher for oocytes from aged mice, and the fertilization rate was significantly lower, compared with oocytes from young and mature mice. Our results suggest that DNA fragmentation of oocytes might be one of the reasons for poor oocyte quality and lower fertility in the aged group.
Abstract. A pregnant 26-year-old woman was referred for evaluation and management of progressive hypertension and hypokalemia at 14 weeks of gestation. Her plasma aldosterone level was markedly elevated and magnetic resonance imaging showed a right adrenal tumor. Primary aldosteronism due to an aldosterone producing-adenoma was diagnosed. Because of progressive severe hypertension, a laparoscopic adrenalectomy was performed at 17 weeks of gestation. The procedure was completed without complication, and plasma aldosterone and potassium levels rapidly improved postoperatively. However, her hypertension persisted and the growth retardation of the fetus was found. Regrettably, intrauterine fetal death was confirmed at 26 weeks of gestation. Histological examination of the placenta revealed that the placental artery had very thick walls which had apparently caused a critical failure in fetal blood flow. The optimal timing of laparoscopic surgery during pregnancy and perioperative management were subsequently discussed. PRIMARY aldosteronism is not a rare cause of hypertension [1], and its association with pregnancy has been reported. However, we found that only 23 cases have been described in the literature published in English since the first report of primary aldosteronism in pregnancy described by Crane et al. in 1964 [2]. A recent evolution in adrenal surgery, including minimally invasive laparoscopic surgery, has largely improved modality and QOL of patients with primary aldosteronism. As of yet, however, there has been little discussion of performing laparoscopic adrenalectomy on a pregnant woman. We report a case of primary aldosteronism during pregnancy that was treated by a laparoscopic adrenalectomy and discuss the feasibility of this procedure on pregnant women. Case ReportA 26-year-old Japanese woman was hypertensive when she registered for prenatal care at 14 weeks and 4 days of gestation. She had been healthy before becoming pregnant; however, the initial laboratory assessment revealed low potassium and high plasma aldosterone levels. She was told three years ago that she had mild hypertension that could be controlled
Although apoptosis is believed to play an important role in the ontogenetic development of animals, the molecular mechanism that triggers the regression of liver hemopoiesis during the perinatal period is not known. Apoptosis is induced by many factors such as a decrease in growth factors and increased oxygen stress. Since hepatic gamma-glutamyl transferase (GT) levels change markedly during the perinatal period in rodents, the metabolism of glutathione (GSH), a naturally occurring major antioxidant, might change significantly in and around liver cells. Hemopoietic cells but not hepatocytes exhibit significant apoptosis in thiol-free medium and the hemopoietic apoptosis can be inhibited by various thiols, such as L-cysteine, N-acetyl-L-cysteine, and GSH. The contribution of GSH levels in and around fetal liver cells in the triggering of apoptosis in hemopoietic cells is discussed.
Postpuerperal amenorrheic women should be managed with care because of the increased risk of occlusion of the cervical duct after conization.
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