• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.111-119
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• 2009

Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

• 대한생식의학회:학술대회논문집
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• 1997.11a
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• pp.45.2-46
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• 1997

• 대한생식의학회:학술대회논문집
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• 2004.11a
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• pp.100-100
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• 2004

• 대한생식의학회:학술대회논문집
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• 2004.11a
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• pp.101.1-101.1
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• 2004

• 대한생식의학회:학술대회논문집
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• 2007.11a
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• pp.95-95
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• 2007

• 대한생식의학회:학술대회논문집
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• 2007.11a
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• pp.139-139
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• 2007

• 대한생식의학회:학술대회논문집
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• 2007.11a
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• pp.144-144
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• 2007

• Journal of Embryo Transfer
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• v.11 no.1
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• pp.51-69
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• 1996

본 실험은 촉진 및 호르몬 측정으로는 알기 힘든 난소의 정상 혹은 병리학적 형태 및 변화를 알아보기 위하여 실시하였다. 실험에서 도살장으로부터 채취된 난소 100개를 수침법으로 초음파 사진을 찍고 그 실제 단면과 비교하였다. 그리고, 홀스타인 50두에서 직장 벽을 통해 난소를 초음파로 관찰하여 난소의 정상 상태 및 병적 상태를 조사하였다. 이 기초 실험을 바탕으로 하여 홀스타인 소 1두를 과배란 처리하여 42일간 난소의 형태 및 변화를 직장 벽을 통해 초음파로 관찰하고 난포의 크기를 측정하였다. 수침법을 통한 난소의 관찰로 난포와 황체의 정상적 . 비정상적인 구조를 관찰할 수 있었고, 과배란 처리한 소 난소의 관찰로 난포와 황체의 능동적 상호작용을 관찰할 수 있었다.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.69-76
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• 2008

Objective: The purposes of this study were to determine the distribution of follicle-stimulating hormone receptor (FSHR) genotypes in infertile Korean women and to evaluate the relationship between FSHR genotypes and clinical outcomes of IVF-ET cycles. Methods: Genomic DNA was extracted from peripheral blood in 1, 020 of infertile Korean women. Genotypes of FSHR at Thr307Ala (T/A) and Asn680Ser (N/S) were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Clinical outcomes related to the genotypes of FSHR were evaluated in IVF-ET cycles (n=302) with controlled ovarian hyperstimulation (COH) of infertile women under 40 years old. Results: In a population of 1, 020 infertile Korean women, the frequency of TT/NN, TA/NS and AA/SS for the major variant Thr307Ala and Asn680Ser was 44.80%, 41.96% and 10.49%, respectively. There was no significant difference in characteristics of ovarian response and clinical pregnancy rate among the major genotypes of FSHR in IVF-ET cycles with COH. However, implantation rate of AA/SS patients was significantly higher than that of TT/NN patients (24.5% vs 15.7%, p<0.05). Conclusion: This study showed that FSHR genotype was not directly associated with ovarian response in IVF-ET cycles with COH. The relationship between clinical outcomes and FSHR genotypes of patients should be substantiated by further studies.

• Clinical and Experimental Reproductive Medicine
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• v.34 no.3
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• pp.197-205
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• 2007

Objective: This study evaluated the pregnancy and implantation rates in fresh IVF-ET cycles or frozen-thawed ET (F-ET) cycles based on serum estradiol concentrations of controlled ovarian hyperstimulation (COH). Methods: Clinical outcomes of 1,565 cycles of fresh IVF-ET with COH and 670 cycles of F-ET were retrospectively analyzed. Serum estradiol levels on the day of human chorionic gonadotropin (hCG) administration were categorized into Group-A (1,000$\sim$2,000 pg/ml), Group-B (2,000$\sim$3,000 pg/ml), Group-C (3,000$\sim$4,000 pg/ml) and Group-D (> 4,000 pg/ml). Clinical pregnancy (CPR), implantation (IR) and delivery rates (DR) were compared among four groups subdivided into younger (< 35 years) and older ($\geq$ 35 years) women. Statistical analysis was performed by Student's t-test and chi-square test. Results: Overall clinical outcomes with fresh IVF-ET and F-ET cycles were similar: 41.2% vs 44.8% of CPR, 18.8% vs 19.6% of JR, and 33.2% vs 34.5% of DR, respectively. There were no significant differences in the clinical outcomes of all four groups between fresh IVF-ET and F-ET cycles of younger women according to the estradiol levels. However, the clinical outcomes of F-ET cycles of older women in Group-D were significantly higher than those of fresh IVF-ET cycles (51.3% vs 25.0% of CPR*, 18.6% vs 9.9% of IR and 33.3% vs 19.4% of DR;* p<0.05). Conclusion: Our results demonstrated that supraphysiological levels of estradiol during COH in fresh IVF-ET cycles of older women ($\geq$ 35 years) may be detrimental to implantation environments of endometrium and clinical outcomes, which could be improved by F-ET cycles.