Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Pattern of Ovulation in Korean Women with Premature Ovarian Failure

한국인 조기난소부전 여성의 배란양상

  • Kim, Hye-Min (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Kim, Jae-Ryoung (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Choi, Eun-Joo (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Park, Eun-Joo (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Hong, Seo-Yu (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Lee, Jin-Yong (Department of Obstetrics and Gynecology, School of Medicine, Eulji University) ;
  • Park, Won-Il (Department of Obstetrics and Gynecology, School of Medicine, Eulji University)
  • 김혜민 (을지대학교 의과대학 산부인과학교실) ;
  • 김재령 (을지대학교 의과대학 산부인과학교실) ;
  • 최은주 (을지대학교 의과대학 산부인과학교실) ;
  • 박은주 (을지대학교 의과대학 산부인과학교실) ;
  • 홍서유 (을지대학교 의과대학 산부인과학교실) ;
  • 이진용 (을지대학교 의과대학 산부인과학교실) ;
  • 박원일 (을지대학교 의과대학 산부인과학교실)
  • Published : 2008.09.30
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Abstract

Objective: Significant portion of premature ovarian failure patients ovulate intermittently and even can achieve pregnancy. The clinical features and reproductive potentials of Korean women with premature ovarian failure have never been elucidated. The purpose of this study is to assess ovarian follicular growth and ovulatory potential. Methods: Complete medical records of fifteen women with idiopathic premature ovarian failure were reviewed retrospectively. Subjects with more than 6 ultrasonographic scans and 36 months of follow-up period were included. Once the ovarian follicle was found by ultrasonography, the follicular growth was serially monitored. The result of ovulation induction of 6 cycles in 4 patients were also evaluated. Rate of positive ovarian follicle by ultrasound, rate of natural follicular growth and response of ovulation induction were assessed. Results: Among the 15 patients, 6 women (40%) had ovarian follicle in random ultrasonography. But the chance of positive follicle per ultrasonography scan was 7% (8 out of 115 scans). One out of 6 women eventually ovulated during the follow-up scan. In remaining 5 subjects, size of follicles remained unchanged. None of 6 ovulation induction cycles resulted successful ovulation. Conclusion: Incidence of positive ovarian follicle in Korean premature ovarian failure patients is lower than that of Western counterpart. This result, however, could not be directly compared because of the differences of study design. The ovulation rate by medical ovulation induction in this group is 0%, which is worse than the reported success rate of Western studies.

목 적: 조기난소부전 환자의 10$\sim$20%에서 난소기능이 회복될 수 있다고 하며 간헐적으로 배란이 되고 심지어는 임신이 가능할 수 있다는 보고가 있다. 그러나 한국의 조기난소부전 여성의 임상적 특징과 배란가능성은 논의된 적이 없다. 이 연구의 목적은 한국인 조기난소부전 환자에서 자연 난포의 발생 빈도와 배란유도의 가능성을 평가하는 것이다. 연구방법: 특발성 조기난소부전으로 진단된 15명 여성의 전체 진료기록을 후향적으로 연구하였다. 환자별로 6번 이상의 초음파 검사를 시행하였고 36개월 이상의 기간 동안 추적관찰을 하였다. 또한 4명의 환자에서 6주기의 배란유도시도를 하였다. 조사항목은 초음파 검사에서 난포의 발견율, 자연 난포 성장률과 배란유도를 시행한 경우에 그 반응을 평가하여 결과를 분석하였다. 결 과: 15명 중 6명은 초음파상 난포가 발견되었나 (40%) 초음파 검사 당 난포 발견 빈도는 7%였다 (115회 중 8회). 6명 중 한 명은 초음파 추적관찰 상 배란이 확인되었고 나머지 5명은 크기에 변화가 없었다. 배란유도를 시도한 6명 중 성공적인 난포 성장이 관찰된 예는 없었다. 결 론: 한국인 조기난소부전 환자에서 난포의 발견율은 이전 서양 연구에 비하여 낮다고 생각되지만 관찰 방법에 차이가 있어 직접비교는 불가능하다. 배란유도의 성공율은 0%로서 이전 연구에서 발표된 수준보다 낮았다.

Keywords

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