• Clinical and Experimental Reproductive Medicine
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• v.40 no.3
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• pp.122-125
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• 2013

Objective: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.109-114
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• 2011

Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intrauterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

• Korean Journal of Animal Reproduction
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• v.11 no.2
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• pp.132-138
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• 1987

This study was carried out to evaluate the ability of clinical application of pregnancy diagnosis based upon the determinatin of progesterone in milk, utilizing a chymosin inhibitor labelled with progesterone and monoclonal antibody to progesterone, and its compared with progesterone concentrations in the milk were assayed by radioimmunoassay. 1. The progesterone concentration of the pregnant cows (2.07$\pm$0.54ng/ml) were significantly higher than those of non-pregnant cows (1.04$\pm$0.19 ng/ml), and thereafter began to increase and maintained high levels. 2. During 20 to 22 days after artificial insemination, the accuracy of pregnancy diagnosis from monoclonal antigen of progesterone were 92.9% for non-pregnant cows, and 88.5% for pregnant cows. 3. During 20 to 22 days after artificial inseminatin, the accuracy of pregnancy diagnosis from milk progesterone concentrations were 92.9% for non-pregnant cows(<3.4ng/ml), and 92.3% for pregnant cows( 4.0ng/ml). The average overall accuracy of pregnancy prediction for pregnant and non-pregnant cows were 92.6%. 4. Accordingly, the pregnancy diagnosis from monoclonal antigen of progesterone is thought to be recommendable because this early diagnostic means are simple with accurate result.

• Journal of Korean Neurosurgical Society
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• v.45 no.1
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• pp.39-42
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• 2009

We report a supratentorial primitive neuroectodermal tumor (sPNET) in 17-year-old primipara in the second trimester her pregnancy. Magnetic resonance imaging revealed a left frontoparietal mass with solid and cystic component. Gross-total resection was achieved via a left frontoparietal craniotomy. It was decided to suspend the radiotherapy and chemotherapy until the 30 weeks of gestation. But, a sudden uncal herniation was developed due to the reccurrence of the tumor and bleeding into the tumor at the 25 weeks of gestation and the patient died after urgent decompressive surgery. sPNETs is an extremely rare brain tumor in pregnancy and only two cases were reported in the literature to date. There is no universally agreed treatment protocol for sPNETs during pregnancy and a multidisciplinary approach is required in treatment. In the present study, the clinical, histopathological features and therapeutical difficulties of sPNETs diagnosed during pregnancy was discussed with the literature review.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.1
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• pp.258-267
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• 2007

Purpose : Generally dermatitis is treated by corticosteroids, antihistamines ect, but the use of these drugs may affect pregnant women adversely. In this case Oriental medical therapy can be very useful. The purpose of this study is to report clinical management of dermatitis patients during pregnancy by oriental medicine including Hwa-acupuncture and herbal-combined extraction. Methods : We experienced two cases of dermatitis patient during pregnancy. In the beginning of treatment, they had severe itching, burning sensation, bulls, papule. We teated them with Hwa-acupuncture, herbal-combined extraction. Results : After quite short oriental treatment including Hwa-acupuncture and herbal-combined extraction, the symptoms of patients are remarkable alleviated. Conclusion : We think that many case of dermatitis during pregnancy can be managed effectively by Hwa-acupuncture and herbal-combined extraction. If we make more studies about disease under pregnancy condition, it will bring the high satisfaction of patient and the elevation of treatment rate.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.1
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• pp.193-205
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• 2014

Purpose: This study was aimed to report the effect of oriental treatment on Bell's palsy during pregnancy with Sasang Constitutional method. Methods: 4 patients who had Bell's palsy during pregnancy were treated with Sasang constitutional prescriptions. After treatments we evaluated the effects by House-Brackmann facial nerve grading system. Results: As a result, the clinical symptoms of Bell's palsy during pregnancy were improved. Conclusions: This case studies show that Sasang constitutional method can be effectively used on Bell's palsy during pregnancy. Especially the diagnostic results by using Diagnosis System of Oriental Medicine (DSOM) revealed that some of patients were in a very weak condition. We could apply these results to choose prescription and get good therapeutic effects.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.198-202
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• 2021

Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.3
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• pp.157-163
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• 2016

Objective: The decision to use in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or split insemination (IVF-ICSI) in the first cycle is based on the number of motile sperm. Hence, total fertilization failure (TFF) often occurs during IVF cycles, despite normozoospermia. To investigate whether the cumulative motile swim-up spermatozoa percentage at 22 hours post-insemination (MSPPI) is an indicator for ICSI, we analyzed TFF, fertilization, blastocyst development, chemical pregnancy, clinical pregnancy, and live birth rates. Methods: This prospective study was performed using data obtained from 260 IVF cycles. At 22 hours after insemination, the remaining swim-up spermatozoa were observed and divided into six groups according to MSPPI (<10%, 10% to <30%, 30% to <50%, 50% to <70%, 70% to <90%, and 90% to 100%). Results: Regardless of the ejaculated motile sperm concentration ($0.6-280{\times}10^6/mL$ motile spermatozoa), the incidence of TFF significantly increased when MSPPI was <10%, and the fertilization rate significantly decreased when MSPPI was <30%. We found that cumulative MSPPI correlated with the cumulative fertilization rate (Spearman correlation, 0.508, p<0.001). Regarding embryo development, we observed no significant differences in the rates of blastocyst development, chemical pregnancy, clinical pregnancy, or live birth among all groups. Conclusion: Our findings suggest that MSPPI is a viable indicator for split IVF-ICSI and ICSI. Taken together, by employing the MSPPI test in advance before IVF, ICSI, or split IVF-ICSI cycles, unnecessary split IVF-ICSI and ICSI may be avoided.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.1
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• pp.31-37
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• 2016

Objective: The aim of this study was to investigate associations between the morphology score of blastocysts and blastocoele re-expansion speed after warming with clinical outcomes, which could assist in making correct and cost-effective decisions regarding the appropriate time to vitrify blastocysts and to transfer vitrified-warmed blastocysts. Methods: A total of 327 vitrified-warmed two-blastocyst transfer cycles in women 38 years old and younger were included in this retrospective study. Results: The clinical pregnancy rate (CPR) and implantation rate (IR) of transfers of two good-morphology grade 4 blastocysts vitrified on day 5 (64.1% and 46.8%, respectively) were significantly higher than the CPR and IR associated with the transfers of two good-morphology grade 3 blastocysts vitrified on day 5 (46.7% and 32.2%, respectively). No significant differences were found in the CPR and IR among the transfers of two good-morphology grade 4 blastocysts regardless of the day of cryopreservation. Logistic regression analysis showed that blastocoele reexpansion speed after warming was associated with the CPR. Conclusion: The selection of a good-morphology grade 4 blastocyst to be vitrified could be superior to the choice of a grade 3 blastocyst. Extending the culture of grade 3 blastocysts and freezing grade 4 or higher blastocysts on day 6 could lead to a greater likelihood of pregnancy. Since re-expansion was shown to be a morphological marker of superior blastocyst viability, blastocysts that quickly re-expand after warming should be prioritized for transfer.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.1
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• pp.57-64
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• 2003

Objective : We investigate the effects of multiple attempts of embryo transfer because of retained embryos in the catheter and of contaminated mucus on the transferred catheter. Materials and Methods: We respectively analysed data between November 1998 and August 2002 from 305 patients of 369 cycles who underwent IVF-ET. Of these patients, 47 patients of 50 cycles (Group 2) were required multiple trial of embryo transfer. They were compared with an age-matched control groups (Group 1) with female factor infertility. Pearson's $?^2$ and Fisher's tests were used to compare proportions between discrete variables. Noncategorical data were compared using t-test. Statistical significance was set at p<0.05. Results: Embryos were significantly more likely to be retained when catheter was contaminated with mucus (Group 1: 22.4%; Group 2: 44.0%). The clinical pregnancy rates, however, for the contaminated mucus or not, were 46.8%, 43.5% respectively. There was no significant difference clinical pregnancy rate between those who had all their embryos transferred at the first attempt (45.4%) and those who required more than one attempt (48.0%). Conclusions: Contaminated mucus in the catheter is associated with failed embryo transferred at the first attempt. Embryo transfers, however, that are repeated attempts do not adversely affect pregnancy rates following IVF-ET.