• Title/Summary/Keyword: Clinical pregnancy

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The Clinical Efficacy of the Low-dose FSH Regimen for Intrauterine Insemination (인공수정 시술시 저용량 FSH(Low-dose FSH) 용법의 임상적 효용성에 관한 연구)

  • Han, Myoung-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.28 no.1
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    • pp.47-53
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    • 2001
  • Objective: This study is to investigate the clinical efficacy of low-dose FSH regimen, comparing with clomiphene citrate and human menopausal gonadotropin (CC/hMG) regimen. Methods: Retrospective study of the ovulatory factor infertility 39 patients who had been treated by intrauterine insemination (IUI). The 31 cycles of 21 patients were stimulated by CC/hMG regimen, the 22 cycles of 18 patients were stimulated by low-dose FSH regimen. We compared the rate of clinical pregnancy, multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) of both group. Results: The rate of clinical pregnancy of the CC/hMG group was 25.7% per cycle, and that of the low-dose FSH group was 54.5% per cycle. The low-dose FSH group showed a higher rate of clinical pregnancy per cycle than CC/hMG group (p=0.028). However, no differences was found statistically in the rate of multiple pregnancy and OHSS between CC/hMG group (22.2%, 5.7%) and low-dose FSH group (33.3%, 13.6%). Conclusion: This study showed that the low-dose FSH regimen is superior to CC/hMG regimen in getting clinical pregnancy, but dose not reduce the ovulation induction complications.

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Associations of post-warming embryo or blastocyst development with clinical pregnancy in vitrified embryo or blastocyst transfer cycles

  • Hong, Yeon Hee;Lee, Jang Mi;Kim, Seul Ki;Youm, Hye Won;Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.140-146
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    • 2020
  • Objective: To investigate whether the degree of post-warming embryo or blastocyst development is associated with clinical pregnancy in vitrified embryo or blastocyst transfer cycles. Methods: Ninety-six vitrified cleavage-stage embryos and 58 vitrified blastocyst transfer cycles were selected. All transfer cycles were performed from February 2011 to March 2019, and all vitrified embryos or blastocysts were warmed from 4 PM to 6 PM and then transferred the next morning from 9 AM to 10 AM. The scores of the cleavage-stage embryos and blastocysts were assessed at warming and at transfer using the modified Steer method and the Gardner method, respectively. The mean embryo or blastocyst score, score of the single top-quality embryo or blastocyst, and the difference in the score between warming and transfer were compared between nonpregnant and pregnant women. Results: In the cleavage-stage embryo transfer cycles, both the top-quality embryo score at transfer and the difference in the score between warming and transfer were significantly associated with clinical pregnancy. A top-quality embryo score at transfer of ≥ 60.0 (area under the curve [AUC], 0.673; 95% confidence interval [CI], 0.531-0.815) and a difference in the score between warming and transfer of ≥ 23.0 (AUC, 0.675; 95% CI, 0.514-0.835) were significant predictors of clinical pregnancy. In blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor associated with clinical pregnancy. A top-quality blastocyst score at transfer of ≥ 38.3 was a significant predictor of clinical pregnancy (AUC, 0.666; 95% CI, 0.525-0.807). Conclusion: The top-quality embryo score at transfer and the degree of post-warming embryo development were associated with clinical pregnancy in vitrified cleavage-stage embryo transfer cycles. In vitrified blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor affecting clinical pregnancy.

A Clinical Study on the Effects of Herbal Medicine on the Fetus during Pregnancy (임신중 한약복용이 태아에 미치는 영향에 대한 실태분석연구)

  • 이인호;김인중;장준복;송병기;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.40-44
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    • 2000
  • Objectives: This study was conducted to find out whether herbal medication during pregnancy causes any deformity in the unborn fetus. Methods: Thirty-five gynecological outpatients of KyungHee Univ. Oriental Hospital (1996. 10 - 1999. 2) who had taken herbal medication during pregnancy were questioned about duration of pregnancy at the moment, chief complaints, kinds of herbal medicine taken and its dosage and they were asked to answer the questionnaire over the phone about duration of pregnancy at the time of delivery, the newborn’s weights, delivery methods and the condition of deformity. Results and conclusions: The results of this experiment in which 35 pregnant women with the experience of herbal medication during pregnancy confirm that herbal medication during pregnancy does not cause any deformity to the newborn. It is thought that more studies through clinical follow-up and experiments are needed in the future.

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Effect of prior cesarean delivery on the outcomes of intracytoplasmic sperm injection

  • Suzan Atteya Gewida;Mohamed Salah Eldeen Abd Rabbo;Mohammed Abd Elmoety El Samra;Hesham Mahmoud Adel Abdel Moneim
    • Clinical and Experimental Reproductive Medicine
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    • v.51 no.1
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    • pp.63-68
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    • 2024
  • Objective: This study was conducted to investigate the impact of previous delivery mode on pregnancy outcomes in patients with secondary infertility after frozen-thawed embryo transfer. Methods: This prospective observational study included 140 patients experiencing secondary infertility. Of these, 70 patients had a previous cesarean delivery (CD), while the remaining 70 patients had a previous normal vaginal delivery (NVD). The primary outcome was the implantation rate. The secondary outcomes included rates of clinical pregnancy, chemical pregnancy, miscarriage, and ectopic pregnancy. Results: The comparison of all fertility outcomes between the two groups revealed no statistically significant differences. The implantation rate was 40.4% in the CD group and 41.7% in the NVD group (p=0.842). The clinical pregnancy rate was 50% in the CD group and 49.3% in the NVD group (p=0.932), while the chemical pregnancy rate was 14.6% in the CD group and 19% in the NVD group (p=0.591). The miscarriage rates in the CD and NVD groups were 20% and 17.6%, respectively (p=0.803). One case of tubal ectopic pregnancy occurred in the NVD group (1.4%). Conclusion: The mode of prior delivery did not significantly impact pregnancy outcomes following frozen-thawed embryo transfer.

A Case of AML (M3) in Pregnancy

  • Shim, Moon-Jung;Kang, Yun-Jung
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.3
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    • pp.120-123
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    • 2013
  • Leukemia in pregnancy was first reported by Virchow in 1845, and acute Leukemia that occurs with pregnancy is extremely rare. About 350 pregnancies with leukemia have been reported in literature. The incident of acute leukemia during pregnancy has been reported in one case per 100,000 pregnancies case. A 40-year-old patient with 30 weeks of pregnancy, (by promyelocyte which is contained granules and auer rods in the bone marrow and biopsy) was diagnosed with acute promyelocyte leukemia WITH t (15;17) (q22;q12); PML-RARA. (M3) in peripheral blood and bone marrow examination, and gave a birth to the fetus normally, January 24, 2013, after receiving the complete remission decision from the bone marrow, complete blood cell count, PML-RARA PCR test, showed normal findings until March 2013. The treatment of acute leukemia during pregnancy should be considered as treatment of a pregnant mother and the impact on the fetus. Decisions about when and how birth takes place is difficult and has to consider both mother and fetus. It is preferable to start immediate treatment without delay so that the treatment time to achieve complete remission or full recovery of the pregnant mother is longer.

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Comparison of pregnancy outcomes using a time-lapse monitoring system for embryo incubation versus a conventional incubator in in vitro fertilization: An age-stratification analysis

  • Chera-aree, Pattraporn;Thanaboonyawat, Isarin;Thokha, Benjawan;Laokirkkiat, Pitak
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.174-183
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    • 2021
  • Objective: The aim of this study was to compare the pregnancy outcomes of in vitro fertilization with embryo transfer between embryos cultured in a time-lapse monitoring system (TLS) and those cultured in a conventional incubator (CI). Methods: The medical records of 250 fertilized embryos from 141 patients undergoing infertility treatment with assisted reproductive technology at a tertiary hospital from June 2018 to May 2020 were reviewed. The study population was divided into TLS and CI groups at a 1 to 1 ratio (125 embryos per group). The primary outcome was the live birth rate. Results: The TLS group had a significantly higher clinical pregnancy rate (46.4% vs. 27.2%, p=0.002), implantation rate (27.1% vs. 12.0%, p=0.004), and live birth rate (32.0% vs. 18.4%, p=0.013) than the CI group. Furthermore, subgroup analyses of the clinical pregnancy rate and live birth rate in the different age groups favored the TLS group. However, this difference only reached statistical significance in the live birth rate in women aged over 40 years and the clinical pregnancy rate in women aged 35-40 years (p=0.048 and p=0.031, respectively). The miscarriage rate, cleavage rate, and blastocyst rate were comparable. Conclusion: TLS application improved the live birth rate, implantation rate, and clinical pregnancy rate, particularly in the advanced age group in this study, while the other reproductive outcomes were comparable. Large randomized controlled trials are needed to further explore the ramifications of these findings, especially in different age groups.

Clinical Studies on 3 Cases of Bell's Palsy during Pregnancy (임신(姙娠) 중 구안괘사 환자 3례에 대한 임상적 고찰)

  • Choi, Jae-Ho;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.3
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    • pp.245-256
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    • 2008
  • Purpose: Bell's palsy is a peripheral facial palsy of unknown etiology. During pregnancy, there is an increased incidence of Bell's palsy. Due to the nature of pregnancy, it is unlikely to treat Bell's palsy during pregnancy. The purpose of this study is to report on 3 patients with Bell's palsy during pregnancy, who improved by oriental medical treatment. Methods: The patients who had Bell's palsy during pregnancy were treated with oriental medical treatment such as herbal medication and acupuncture therapy. House-Brackmann facial nerve grading system was used to estimate the efficacy of these treatments. Results: After the oriental medical treatment, the clinical symptoms of Bell's palsy during pregnancy were improved. Conclusion: This case study shows that the oriental medical therapy is effective in treating Bell's palsy during pregnancy. Further systematic studies and specific guidelines of Bell's palsy during pregnancy would be of much value.

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Predictive value of sperm motility before and after preparation for the pregnancy outcomes of intrauterine insemination

  • Jeong, Mina;Kim, Seul Ki;Kim, Hoon;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.255-261
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    • 2021
  • Objective: This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods: In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results: The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6% ±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner's age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion: Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.

Effect of in vitro testicular spermatozoa culture on pregnancy outcomes: an experience at a single university hospital

  • Lee, Jisun;Yoo, Jung Hyeon;Lee, Jae Hun;Ahn, Hyun Soo;Hwang, Kyung Joo;Kim, Miran
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.53-59
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    • 2021
  • Background: There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles. Methods: This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups. Results: There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p= 0.017). Group B showed higher fertilization rate (72.4%±32.1% vs. 59.2%±21.7%, p=0.045), implantation rate (35.0%±34.1% vs. 14.0%±21.5%, p=0.010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A. Conclusion: Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.

Pregnancy Rate by Intrauterine Insemination (IUI) with Controlled Ovarian Hyperstimulation (COH) (자궁강내 인공수정에 의한 임신율)

  • Hong, Jeong-Eui;Lee, Ji-Sam
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.217-231
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    • 1998
  • The effectiveness of intrauterine insemination (IUI) combined with controlled ovanan hyperstimulation (COH) in the treatment of infertility with various etiologies was compared in a total of 152 cycles. Patients received a maximum of three IUI cycles for the treatment. Severe male ($<2\times10^6$ motile sperm) or age factor (> 39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac was seen on ultrasound. The overall clinical pregnancy rate was 7.9% per cycle (12/152) and 9.7% per patient (12/124). The pregnancy rates were 0% in unstimulated natural (0/18), 7.5% in CC (3/40), 8.2% in CC+hMG (4/49), 5.9% in GnRH-a ultrashort (1/17), 5.9% in GnRH-a long (1/17) and 27.3% in dual suppression cycles (3/11), respectively. The pregnancy rate was higher in dual suppression cycle than other stimulated cycles, but this was not significant. The multiple pregnancy rates were 25.0% (2 twins and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rates were 66.7% in CC (2/3) and 100% in ultrashort cycles (1/1). The livebirth rate was 5.9% per cycle (9/152) and 7.3% per patient (9/124). There were no differences in age, duration of infertility, follicle size, total ampules of gonadotropins and days of stimulation between pregnant and non-pregnant groups. However, significant(P<0.05) differences were observed in the level of estradiol $(E_2)$ on the day of hCG injection ($3,266.6{\pm}214.2$ vs $2,202.7{\pm}139.4$ pg/ml) and total motile sperm count ($212.1{\pm}63.4$ vs $105.1{\pm}9.9\times10^6$) between pregnant group and non-pregnant group. These results suggest that IUI combined with successful ovarian stimulation tends to improve the chance of pregnancy as compared to IUI without COH and a total motile sperm count may be considered predictive of the success for pregnancy.

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