• 제목/요약/키워드: 난관 임신

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Combined Tubal and Interstitial Pregnancies after IVF-ET: a Case Report (체외수정 및 배아 이식 후 난관과 반대편 간질 부위에 동시에 생긴 복합성 자궁외 임신 1예)

  • Oh, Yoe-Un;Kim, Mi-Kyoung;Lee, Seo-Yeong;Kim, You-Shin
    • Clinical and Experimental Reproductive Medicine
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    • 제36권2호
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    • pp.129-136
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    • 2009
  • The incidence of ectopic pregnancy is increased since in vitro fertilization-embryo transfer (IVF-ET) has started. And because of the possibility of combined pregnancy after IVF-ET, bilateral adnexal area and other portion of pelvis should be examined carefully by transvaginal ultrasonography during follow-up period. The rate of combined pregnancy after IVF is estimated to be as high as 0.2~1%. Since the incidence of combined pregnancies is markedly higher with IVF, special attention to this possibility after ET is warranted. According to a recent report, the occurrence of interstitial pregnancy is estimated to be 1:3600 for all pregnancies achieved with IVF. The prevalence of interstitial pregnancies is 2~4% of ectopic pregnancies. Interstitial pregnancies tend to be diagnosed later than most other ectopic pregnancies, and if uterine rupture occurs, the resulting hemorrhage can be severe. Currently, about 2% to 3% of interstitial pregnancies are thought to carry a maternal death, which is twice that of other tubal gestations. We report a case of simultaneous left tubal and right interstitial pregnancies after IVF-ET with a brief review of literature.

Diagnostic Value of Serum Beta-hCG Measured by EIA in Suspected Ectopic Pregnancy (EIA로 측정한 혈청 ${\beta}$-hCG치의 자궁외 임신에 대한 진단적 가치)

  • Park, Yoon-Ki;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.221-227
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    • 1985
  • Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty-four patients with suspected ectopic pregnancy comprised twenty- eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and, one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21,980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100mIU/ml and high serum hCG level above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy, respectively. 4. Mean serum hCG levels (${\pm}SD$) of twelve patients with tubal pregnancy who had intra-abdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intra-abdominal free blood of more than 500ml were 4,131 (${\pm}7,801$) mIU/ml and 3,208 (${\pm}5,081$) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (${\pm}SD$) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (${\pm}5,448$) mIU/ml and 4,449 (${\pm}6,938$) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59-933 mIU/ml.

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Can Endometriosis Affect the Clinical Outcomes in Patients Undergoing IVF-ET ? (자궁내막증을 갖는 불임환자의 체외수정시술에 관한 연구)

  • Jung, Byeong-Jun;Song, Hyun-Jin;Oh, Ik-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • 제29권3호
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    • pp.223-227
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    • 2002
  • 연구목적: 전반적인 자궁내막증이 체외수정시술에 미치는 영향을 알아보고, 특히 stage III-IV 자궁내막증을 갖는 불임환자 체외수정시술 결과에 대하여 알아보고자 본 연구를 시행하였다. 연구재료 및 방법: 1998년 9월부터 2001년 9월까지 진단복강경을 통해 자궁내막증으로 진단된 환자 중 체외수정시술을 시행 받은 91명 131주기를 대상으로 하였으며 이중 stage III-IV의 자궁내막증을 갖는 환자는 27명 34주기였다. 비교군은 이시기에 진단된 순수 난관원인으로 체외수정시술을 시행한 40명 56주기를 대상으로 하였다. 통계학적 검사는 Student's t-test와 Chi-square test를 시행하였고, p<0.05를 유의성이 있는 것으로 판정하였다. 결 과: 전체 자궁내막증 환자와 난관인자의 체외수정시술에서 두 군간의 나이는 $31.6{\pm}3.3$, $32.6{\pm}3.6$세로 비슷하였다. 채취된 난자의 수 ($10.3{\pm}6.6$ vs $11.7{\pm}5.1$), 성숙난자 수 ($7.4{\pm}4.7$ vs $7.7{\pm}4.9$), 수정율 ($70.2{\pm}32.4%$ vs $73.7{\pm}20.0%$), Good embryo quality rate (8세포 (G1+G2)를 2PN의 개수로 나눈 값) (32.6% vs 32.4%) 및 배아이식 수 ($4.6{\pm}1.4$ vs $4.8{\pm}1.1$)로 두 군간에 차이는 없었다. 또한 임상적 임신율의 경우도 각각 30.7%, 42.8%로 비슷하였다. 중등도 및 중증의 자궁내막증과 난관인자의 비교에서 성숙난자 및 채취된 난자의 개수는 각각 $8.8{\pm}4.9$, $7.7{\pm}3.9$, $11.3{\pm}7.0$, $11.7{\pm}5.1$개로 두 군간에 차이는 없었다. 수정율은 stage III와 IV 군에서 감소되는 경향을 보였으나 통계학적인 유의성은 없었다 ($66.2{\pm}30.0%$ vs $73.7{\pm}20.0%$). Good qulity embryo rate (GQER)는 stage III-IV 자궁내막증 환자군에서 22.0%로 순수 난관인자의 32.4%에 비하여 감소하는 경향을 보였으나 통계학적인 유의성은 없었다 (p=0.15, Chi-square test). 배아이식 수의 경우는 각각 $4.7{\pm}1.5$, $4.8{\pm}1.1$개로 차이가 없었다. 배아이식 주기당 임상적 임신율의 경우는 stage III-IV군에서 25.0% (8/32), 난관인자 군의 42.8% (24/56)로 통계학적인 유의성은 없었으나 (p=0.06, Chi-square test), 중등도 및 중증의 자궁내막증을 갖는 환자에서 임신율이 감소하는 경향을 보였다. 결 론: 체외수정시술시 자궁내막증이 임신율에 나쁜 영향을 미치지 않지만, 중등도 및 중증의 자궁 내막증을 갖는 불임환자의 체외수정시술에서는 임신율에 나쁜 영향을 끼칠 가능성이 있을 것으로 사료된다.

Heterotopic Pregnancy in Polycystic Ovary Syndrome Woman Conceived after Ovulation Induction by Clomiphene Citrate: A Case of Bilateral Tubal Pregnancies and Intrauterine Twin Pregnancy (클로미펜을 이용한 배란 유도 후 임신된 다낭성 난소 증후군 여성에서 발견된 병합임신: 양측 난관임신 및 쌍태아 임신 1예)

  • Woo, Jang-Hwan;Choi, Kyu-Hong;Kim, Bong-Seok;An, Gye-Hyeong;Kim, Yun-Young;Chae, Young-Hwa
    • Clinical and Experimental Reproductive Medicine
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    • 제37권3호
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    • pp.261-266
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    • 2010
  • Diagnosis of heterotopic pregnancy could be delayed because of insufficient clinical symptoms. Many clinician mistook the symptoms associated with ectopic pregnancy for the symptoms of complicated normal intrauterine pregnancy. The incidence of heterotopic pregnancies has been increased because of the use of various ovulation induction and assisted reproductive technologies. We experienced a case of bilateral tubal pregnancies and intrauterine twin pregnancy in polycystic ovary syndrome woman conceived after ovulation induction by clomiphene citrate. We report this case with a brief review of the literatures.

A Case of Heterotopic Pregnancy in a Natural Cycle (자연 생리주기에서 발생된 병합임신 1예)

  • Bae, Sung Jun;Kim, Ju Sun;Kim, Jin Hak;Yun, Yeon Jung;lee, Shin Ae
    • Clinical and Experimental Reproductive Medicine
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    • 제33권1호
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    • pp.69-69
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    • 2006
  • Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult due to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.

Efficacy of Transcervical Fallopian Tube Catheterization in Infertility Patients with Fallopian Tube Occlusion (난관 폐쇄에 기인한 불임 환자에서 난관 개통술의 효용성)

  • Park, Chan-Woo;Cha, Sun-Hwa;Yang, Kwang-Moon;Han, Ae-Ra;Yoo, Ji-Hee;Song, In-Ok;Kim, Hye-OK;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • 제37권4호
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    • pp.321-327
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    • 2010
  • Objective: To evaluate the significance and efficacy of trans-cervical fallopian tube catheterization (TFTC) in diagnosis and optimal treatment modality for tubal blockage. Methods: The retrospective study was performed in those underwent TFTC from January 2005 to December 2009. A total of 342 fallopian tubes in 215 patients which showed tubal blockage in hysterosalpingography (HSG), were subjected to TFTC. Recanalization rate (RR) was compared according to portion of tubal blockage; proximal, isthmic and distal portion and blockage type; tapering, concave, and convex type. Results: In total, RR was 72.5% (248/342 tube). According to the portion of tubal blockage, RR was 83.8% in proximal, 45.6% in isthmic and 100% in distal portion. RR was 92.3% in tapering, 80.2% in concave and 25.5% in convex type, respectively. There were 98 pregnancies in 156 patients after successful recanalization, which shows 62.7% pregnancy rate. Conclusio: TFTC were capable of recanalizing tubal blockage in 248 of 342 tubes in 156 of 215 patients (72.5%). The RR was increased with proximal portion and tapering type tubal blockage.

Co-culture with Buffalo Rat Liver(BRL) Cell for IVM-IVF Bovine Embryos (소 체외수정란의 공배양을 위한 BRL 세포의 이용)

  • 서태광
    • Korean Journal of Animal Reproduction
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    • 제18권4호
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    • pp.257-263
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    • 1995
  • 소 체외수정란의 체외배양 체계는 현재 완전히 확립되지는 않은 상태로서 8∼16 세포기 발육억제현상, 수정란의 파편하 현상, 성장지연 등 여러 가지 문제점들이 현 배양체계에서 나타난다. 그러나 hepler cell들과의 공배양에 의해 이러한 문제점들은 상당히 극복되며 또한 체외발생의 촉진 및 공배양된 수정란의 이식에 의해 임신율도 향상된다. 현재 소 체외수정란의 공배양에는 난관상피세포가 가장 널리 이용되나 이러한 시스템은 몇가지 문제점이 있다. 즉, primary culture를 확보하기 위하여 신선한 조직을 주기적으로 채취해야 하며 따라서 난관채취에 시간이 소요되고, 불편하며 또한 공배양에 이용되는 세포들이 균일하지 않은바 난관상피세포에 따라 배 발생 촉진작용에 변이를 나타내기도 한다. 그러나 확립된 cell line을 이용할 수 있다면 이러한 난관상피세포의 이용에서 나타나는 문제점들이 해결될 수 있다. Buffalo Rat Liver cell은 이러한 목적에 이용될 수 있는 cell line 중의 하나로서 이들은 여러 가지 성장인자(growth factor)를 분비하는 것으로 알려져 있다. 따라서 본고에서는 소 체외수정란의 공배양을 위한 BRL(Buffalo Rat Liver)cell의 이용성, 이용방법 및 이용에 있어서 고려하여야 할 요인들에 대하여 살펴보고자 한다.

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A Case Report of Pregnancy using Jogyeongjongok-tang and Cheongsimyeonja-eum in an Infertile Couple with Peritubal Adhesion and Teratospermia (난관 주위 유착과 기형정자증이 있는 난임(難姙) 부부에서 조경종옥탕(調經種玉湯)과 청심연자음(淸心蓮子飮)을 통한 임신의 증례 보고)

  • Henja Yun
    • Herbal Formula Science
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    • 제31권3호
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    • pp.193-201
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    • 2023
  • Objective : The purpose of this study is to report that herbal medicine administration has a pregnancy effect on infertility with both male and female factors. Methods : Jogyeongjongok-tang and Cheongshimyeonja-eum were administered to infertile couples who had no experience of pregnancy before and after marriage and who were diagnosed with right peritubal adhesion and teratospermia on examination. Herbal prescriptions were administered 30 minutes after meals, twice a day for 6 months. Result : A gestational sac was observed on ultrasonography 6 months after administration of herbal medicine prescription. Conclution : Jogyeongjongok-tang and Cheongsimyeonja-eum have been shown to have the effect of leading to pregnancy without harming infertile women, men and fetuses, so they are effective in women and men with peritubal adhesion and teratospermia. It shows that it is a prescription that can be used in parallel with infertility.

Effect of Hydrosalpingeal Fluid on the Implantation in-vitro in a Murine Model (생쥐 배아의 체외배양 시 착상과정에 대한 난관수종액의 영향)

  • Jun, Jin-Hyun;Koong, Mi-Kyoung;Lim, Chun-Kyu;Kim, Soo-Kyung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • 제27권2호
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    • pp.159-164
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    • 2000
  • 연구목적:인간의 체외수정 및 배아이식술에서 난관수종을 갖는 환자에서 임신율과 착상률이 감소된다는 보고들이 있지만 이에 대한 명확한 기작은 밝혀지지 않았다. 본 연구에서는 생쥐 배아를 이용한 체외 착상모델에서 인간의 난관수종액(HSF)이 착상과정에 미치는 영향을 알아보고자 하였다. 연구재료 및 방법 난관수종액은 난관수종으로 수술을 받은 8명의 환자로부터 채취하였으며, 실험에 사용하기 전까지 냉동고에 보관하였다. 생쥐의 포배기 배아는 2-세포기배아를 3일 동안 배양하여 그 중 상태가 양호한 포배기 배아만을 선별하여 투명대를 제거한 후 사용하였다. 기본 배양액으로는 Ham's F-10을 사용하였으며, 배양 시 기본 배양액만을 사용한 경우를 group Ⅰ으로 하였고, 기본 배양액에 0.5% FBS를 첨가한 경우를 group Ⅱ, 0.5% FBS와 50% HSF를 첨가한 경우를 group Ⅲ , 100% HSF에 0.5% FBS를 첨가한 경우를 group Ⅳ,100% HSF만을 사용한 경우를 group Ⅴ로 하였다. 투명대를 제거한 포배기 배아를 각각의 HSF에 대한 5종류의 배양액에서 48시간 동안 배양하였다. 체외 착상 유무는 부착 부위에서 크기가 커진 영양세포들을 관찰하여 판정하였으며, 착상 부위의 표면적은 화상분석기를 이용하여 산출하였다. 결 과: 생쥐 배아의 체외 착상률은 group Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ에서 각각 0%, 98.9%, 77.5%, 40.4%, 10.0%로 나타났으며, 착상 부위의 평균 표면적은 group Ⅱ, Ⅲ, Ⅳ, Ⅴ에서 각각 $74,675{\pm}25,201{\mu}m^2$, $59,024{\pm}25,877{\mu}m^2$, $45,156{\pm}22,654{\mu}m^2$, $38,254{\pm}17,115{\mu}m^2$이었다. 체외 착상률과 부위의 표면적은 HSF의 농도가 증가함에 따라 통계적으로 유의하게 감소하였다(p<0.001). 결론:인간의 난관수종액(HSF)은 생쥐 배아의 체외 착상과 영양배엽세포의 증식을 억제하는 것으로 확인되었으며, 이러한 원인이 난관수종을 갖는 환자에서 임신율이 낮은 것과 밀접한 관련이 있을 것으로 생각된다.

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Studies on the Efficient Embryo Transfer Methods using Inbred Embryos in Generation of Transgenic Mice (Inbred 마우스 수정란을 이용한 형질전환마우스 생산에 있어서의 효과적인 수정란 이식 방법에 관한 연구)

  • Wang A. G;Kim, S. U.;Y. H. Han;Kim, S. K.;D. Y. Yu
    • Korean Journal of Animal Reproduction
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    • 제27권1호
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    • pp.69-75
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    • 2003
  • The objective of this study is to improve the efficiency of embryo transfer in generation of transgenic mice using inbred mouse (C57BL/6J) embryos. The embryos of C57BL/6J and BCF1 mice were superovulated by the standard protocol. One-cell stage of embryos were microinjected and the resulted one-or two-cell were transferred into one-or two-side oviducts of foster mother, respectively. When one-cell stage of embryos were transferred into one-side oviduct of 0.75 d.p.c. foster mother, the results were not ideal because of showing pregnancy ratios of 68.8$\pm$7.83% for C57BL/6J and 48.3$\pm$14.22% for BCF1, and development ratios of pups vs transferred embryos of 11.9$\pm$5.51% for C57BL/6J and 10.5$\pm$8.03% fur BCF1 . However, when two-cell stage of embryos were transferred into two-side oviducts of 0.5 d.p.c. foster mother, we got better results of 94.4$\pm$9.64% and 100$\pm$0% pregnancy ratio, and 22.1$\pm$0.4% and 21.8$\pm$0.38% development ratio for C57BL/6J and BCF1, respectively. Therefore, transferring two-cell stage of C57BL/6J embryos into two-side oviducts of 0.5 d.p.c. foster mother may be competitive to the result in BCF1 embryos. Even if there are a lot of other factors affecting these results, we conclude from these experiments that transfer of two-cell embryos into two-side oviducts of 0.5 d.p.c. foster mother is a more efficient and safe method than others in generating transgenic mice using inbred mice embryos.