• Title/Summary/Keyword: Clinical pregnancy

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Korean Medicine for Women Infertility (여성 난임과 한의학 (다낭성난소증후군으로 인한 난임의 한양방 치료))

  • Hwang, Deok-sang
    • Journal of East-West Nursing Research
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    • v.28 no.2
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    • pp.100-108
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    • 2022
  • Korean medicine has traditionally provided a lot of medical care for the treatment of infertility. The combination treatment of Korean medicine and Western medicine can be effective for infertility to improve the problems caused by the extremely low fertility rate and the aging of pregnant women. In relation to female infertility, we reviewed the evidence for Korean medicine treatment for polycystic ovary syndrome, which has recently been increasing interest in female infertility, and the evidence for the collaboration between Korean and Western medicine in the treatment of polycystic ovary syndrome and infertility. Because polycystic ovary syndrome is closely related to metabolic diseases related to endocrine abnormalities, hormone treatment alone has limited therapeutic effects and has side effects. In domestic and international research, herbal medicine and acupuncture in the treatment of infertility have shown good clinical effects based on the hypothesis of various mechanisms of effect, and many cases of successful pregnancy have been reported. Although continuous research through large-scale randomized clinical studies is needed to prove efficacy, the importance of combined treatment of Korean medicine and Western medicine in infertility treatment is increasing in order to solve the extremely low fertility rate. Combining artificial insemination or in vitro fertilization with Korean medicine treatment is highly likely to be effective in increasing pregnancy success and fertility rates. In women with polycystic ovary syndrome, which is recognized as a metabolic disease due to endocrine abnormalities among the causes of female infertility, Korean medicine treatment can increase the pregnancy rate with herbal medicines and acupuncture, etc. Although well-designed large-scale clinical studies are currently lacking and meta-analysis has not provided sufficient evidence, the combination treatment of Korean medicine and Western medicine is more active to increase the pregnancy rate for solving the problem of low fertility.

Prenatal and Perinatal Antibiotic Exposure and Long-Term Outcome

  • Thomas Gestels;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.3
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    • pp.135-145
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    • 2023
  • Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: A retrospective cohort study

  • Jun Woo Kim;So Young Lee;Chang Young Hur;Jin Ho Lim;Choon Keun Park
    • Clinical and Experimental Reproductive Medicine
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    • v.51 no.1
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    • pp.75-84
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    • 2024
  • Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

Association Between Infants Anthropometric Outcomes With Maternal AHEI-P and DII Scores

  • Zahra Roumi;Abolghassem Djazayery;Seyed Ali Keshavarz
    • Clinical Nutrition Research
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    • v.12 no.2
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    • pp.116-125
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    • 2023
  • The present study sought to examine the association between an infant's anthropometric outcomes with maternal Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index for Pregnancy (AHEI-P) scores during the third trimester of pregnancy. This prospective cohort study was applying 130 pregnant women, at the pregnancy training center in west Tehran, Iran (November 2020 to July 2021). The maternal dietary intake, and body mass index (BMI), and social economic level were evaluated. The data about birth weight, birth height, head circumference, and, gestational age at birth were extracted from each child's health records. The ultimate sample included 122 (93.8%) pairs of women/newborn children. The participants, mean age was 28.13 ± 4.66 years with gestational age between 28 to 40 weeks and the mean of BMI was 24.62 ± 3.51. Our outcomes, after adjustment for confounding factors, suggested that those newborn infants in the highest quartile of maternal DII score had a significantly lower weight (p < 0.001) and height (p = 0.05), in comparison to those in the lowest quartile, but not head circumference (p = 0.18). Moreover, after adjustment for confounding factors, results suggested that those newborn infants in the First quartile of maternal AHEI-P score had a significantly lower weight (p = 0.018) and, in comparison to those in the higher quartile. It appears that newborn infants with lower maternal DII and higher AHEI-P scores may have a better anthropometric outcome. Further longitudinal and in-depth qualitative and quantitative studies, with a longer-term follow-up, is warranted to support the integrity of our outcomes.

A Case of Combined Pregnancy Following GIFT with Microsurgery (나팔관 인공수정 및 미세난관 성형수술 후 발생된 병합임신 1례)

  • Kim, E.I.;Song, J.S.;Yoo, J.J.;Mok, Y.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.1
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    • pp.103-106
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    • 1989
  • Gamete intrafollopian transfer, a varient of IVF, is becoming increasingly popular as a treatment modality for infertility in women with at least one healthy follopian tube. Although GIFT has recently been poprlarized as a safe and effective treatment in selected infertile couples, little discussion of potential complications has been published. Whereas a tubal pregnancy rate of approximately 5% has been noted for IVF, early reports of GIFT have noted ectopic pregnancy to be relativiely rare. We experienced a case of combined pregnancy following GIFT with microsurgery and now present it with brief review of related literatures.

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A Clinical Study about Prolonging Pregnancy in Patient with Pre-eclampsia (임신중독증 임신부의 임신 연장에 대한 임상보고 1례)

  • Kim, Bo-kyun;Park, Sang-Yeon;Jeong, Dae-Seong;Han, Won-Ju
    • Journal of Korean Medical Ki-Gong Academy
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    • v.13 no.1
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    • pp.36-45
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    • 2013
  • Objective : We studied whether Antaeeum and Saahm Spleen-tonifying acupuncture had effects of prolonging pregnancy in pregnant women with pre-eclampsia. Methods : We have administered Antaeeum and applied Saahm Spleen-tonifying acupuncture for 8 weeks and the patient stopped taking steroids she had taken before. Furthermore, we observed edema, fatigue, albuminuria and hypertension. Results : In consequence of administering Antaeeum and applying Saahm Spleen-tonifying acupuncture for 8 weeks, edema and fatigue were improved and albuminuria and hypertension were not changed significantly. However pregnancy was prolonged from 28 weeks to 36 weeks and the patient could give birth successfully. Conclusions : In conclusion, Antaeeum and Saahm Spleen-tonifying acupuncture have effects of prolonging pregnancy in patients with pre-eclampsia.

A Clinical Study on One Case of a Spontaneous Pregnancy with Premature Ovarian Failure (조기난소부전 진단 후 한방치료를 통해 자연임신에 성공한 환자 1례의 임상증례보고)

  • Baek, Jong-Soon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.2
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    • pp.95-102
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    • 2018
  • Objectives: The purpose of this paper is to report the effects of herbal medicine on spontaneous pregnancy with premature ovarian failure. Methods: The 28-year-old patient who was diagnosed premature ovarian failure was treated with herbal medicine (Hyangbujapalmul-tang-gagam), acupuncture and moxibustion. Results: After the treatment, the symptoms of premature ovarian failure such as hot flushes, sweats were improved. The patient recovered menstruation and achieved spontaneous pregnancy. Conclusions: This case shows that Korean medical treatment including herbal medicine has effect on treating infertile female with premature ovarian failure.

Evaluation of Pregnancy and Thyroid Function (임신과 갑상선 기능의 평가)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.1
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    • pp.1-10
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    • 2018
  • During early pregnancy, before the development of a functioning thyroid gland, thyroid stimulating hormone (TSH) is a very sensitive marker of thyroid dysfunction during pregnancy. Normal values have been modified during gestation with a downward shift. The fetus is influenced by the TSH supplied by the mother. TSH and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. A downward shift of the TSH reference range occurs during pregnancy, with a decrease in both the lower and upper limits of maternal TSH, relative to the typical non-pregnant TSH reference range. Each laboratory produces its own reference TSH and FT4 concentrations because there are many different assays that yield different results in pregnancy. Therefore, automated immunoassays used for serum FT4 analysis are still used widely, but the important considerations discussed above must be noted. The use of population-based, trimester-specific reference ranges remains the best way to handle this issue The slight downward shift in the upper reference range of TSH occurring in the latter first trimester (7~12 weeks) of pregnancy, typically not observed prior to 7 weeks. Their use indicates high or low levels in a quantitative manner independent of the reference ranges. These data highlight the importance of calculating population-based pregnancy-specific thyroid parameter reference intervals. A precision medicine initiative in this area will require the collection and analysis of a large number of genetic, biological, psychosocial, and environmental variables in large cohorts of individuals. Large prospective randomized controlled trials will be needed to resolve these controversies.

Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

  • Han, Ae-Ra;Kim, Hye-Ok;Cha, Sun-Wha;Park, Chan-Woo;Kim, Jin-Yeong;Yang, Kwang-Moon;Song, In-Ok;Koong, Mi-Kyoung;Kan, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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    • pp.103-108
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    • 2011
  • Objective: To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods: Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/$m^2$, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results: There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups ($p$ <0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups ($p$ <0.02). Conclusion: Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

Current status of assisted reproductive technology in Korea, 2011

  • Lee, Gyoung Hoon;Song, Hyun Jin;Lee, Kyu Sup;Choi, Young Min
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.38-43
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    • 2016
  • Objective: The number of assisted reproductive technology (ART) clinics, ART cycles, clinical pregnancy rate (CPR), and number of newborns conceived using ART have steadily increased in South Korea. This aim of this study was to describe the status of ART in South Korea between January 1 and December 31, 2011. Methods: A localized online survey was created and sent to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized depending on whether standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI procedures were used. Thawed embryo transfer (TET) and other related procedures were surveyed. Results: Data from 36,990 ART procedures were provided by 74 clinics. Of the 30,410 cycles in which oocytes were retrieved, a complete transfer was performed in 91.0% (n=27,683). In addition, 9,197 cycles were confirmed to be clinical pregnancies in the FET cycles, representing a pregnancy rate of 30.2% per oocyte pick-up and 33.2% per ET. The most common number of embryos transferred in the FET procedures was three (38.1%), followed by two (34.7%) and one (14.3%). Of the 8,826 TET cycles, 3,137 clinical pregnancies (31.1%) were confirmed by ultrasonography. Conclusion: While the overall clinical pregnancy rate for the TET cycles performed was lower than the rate reported in 2010 (31.1% vs. 35.4%), the overall CPR for the FET cycles was higher than in 2010 (33.2% in 2011 and 32.9% in 2010). The most common number of embryos transferred in FET cycles was three, as was the case in 2010.