• 대한생식의학회:학술대회논문집
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• 대한불임학회 2005년도 제48차 춘계 학술대회
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• pp.110-111
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• 2005

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 제51차 추계학술대회
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• pp.151-152
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• 2006

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2002년도 제43차 추계학술대회
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• pp.69.1-69.1
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• 2002

• 한국생명과학회:학술대회논문집
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• 한국생명과학회 2001년도 10주년 기념 국제학술 심포지움 및 추계학술대회
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• pp.32-32
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• 2001

• Clinical and Experimental Reproductive Medicine
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• 제37권1호
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• pp.41-48
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• 2010

목 적: 체외수정시술 시 황체기 보강은 근주, 경질, 경구 등의 다양한 방법으로 이루어지고 있는데, 경구 투여법은 환자의 순응도가 높고 비교적 안전한 방법이다. 본 연구에서는 황체기 보강을 근주로 시작하여 경구 투여로 전환하는 방법의 효용성과 전환 시기에 따른 결과를 비교 분석하고자 하였다. 연구방법: 2003년 9월부터 2009년 6월까지 분당서울대학교병원에서 체외수정시술을 시행받은 환자에서 배아 이식 후 태아 심박동까지 확인된 76주기를 대상으로 하였다. 과배란유도는 GnRH agonist long protocol (n=7) 또는 GnRH antagonist protocol (n=66)을 이용하였으며 3주기에서는 냉동배아 이식을 시행하였다. 황체기 보강을 위하여 난자 채취일부터 매일 progest in oil 50 mg을 근주하였고, 태아 심박동이 확인된 후 임신 6~7주 (n=17) 또는 8주 이후 (n=59)에 micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg을 매일 경구로 투여하였다. 결 과: 대상군 전체의 유산율은 3.9% (3/76)이었으며, 경구 투여 전환시의 임신 주수는 평균 8주 4일 (난자 채취일로부터 $46{\pm}5.8$일)이었다. 황체기 보강을 임신 6~7주 사이에 경구 투여로 전환한 17주기 중에서 1례의 자연유산이 확인되었으며 유산 시 주수는 9주 4일이었다. 8주 이후에 경구 투여로 전환한 59주기 중에서는 2례의 자연유산이 확인되었으며 (11주 3일, 11주 4일), 두 군의 자연유산율은 각각 5.6%와 3.4%로 두 군 간에 통계적으로 유의한 차이는 없었다 (p=0.678). 결 론: 체외수정시술 후 황체기 보강을 시행하는 경우 태아 심박동이 확인된 이후에 근주 투여를 경구 투여로 전환하는 방법은 비교적 낮은 유산율을 보임을 확인하였으며, 특히 8주 이전에 전환하는 것도 유용한 방법이라 사료된다.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.552-557
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• 2006

목 적 : 최근 성조숙증에서 사춘기를 중단시킴으로써 성인신장을 증가시킬 수 있으리라는 기대로 조기 사춘기로 인하여 신장에 대한 예후가 불량한 소아에서 성선자극호르몬 방출호르몬 효능약제의 시도가 이루어졌다. 이에 저자들은 조기 사춘기로 예측 성인신장이 저하된 여아에서 이 약제의 신장 증가효과를 분석하고자 하였다. 방 법 : 소아과 외래에 조기 사춘기와 예측성인신장이 저신장으로 예측되는 36명의 여아를 대상으로 GnRHa를 6개월 이상 사용한 제 1군과 6개월 미만 사용한 제 2군으로 나누어 치료 시작시와 치료 후의 역연령, 골연령, 신장 및 표준편차치, 예측성 인신장 및 표준편차치, 표적키 및 표준편차치, 혈청 IGF-1, IGFBP-3 치를 비교하였다. 결 과 : 1군의 평균 치료기간은 $1.37{\pm}0.92$년, 2군은 $0.41{\pm}0.08$년이었고, 전체적으로는 $0.89{\pm}0.81$년이었다. 치료 시작시 두군 간에 역연령, 골연령, 신장, 표적키, 예측성인신장, 혈청 IGF-1 및 IGFBP-3 치의 차이는 없었고, 마지막 추적시 두 군간에 역연령, 골연령, 신장, 예측성인신장, 혈청 IGF-1 및 IGFBP-3치의 차이도 없었다. 두 군 사이에 성장속도와 치료기간에 따른 예측성인신장의 증가분은 2군이 의미 있게 높았다. 이는 2군이 치료기간이 짧아 사춘기의 성장속도가 충분히 억제되지 않은 결과로 보인다. 치료 시작시에 비하여 마지막 추적시의 예측성인신장은 의미 있게 증가하여 단기간의 치료에도 어느 정도의 효과($3.7{\pm}3.2cm$)는 있었다. 전체 대상아에서 표적키($157.3{\pm}3.1cm$)와 치료 시작시 예측성인신장($148.5{\pm}5.8cm$) 사이에는 의미있는 차이가 있었으며, 마지막 추적시의 예측성인신장($152.2{\pm}5.9cm$) 사이에도 의미 있는 차이가 있었다. 검사 소견에서 혈청 IGF-1과 IGFBP-3는 치료 시작시에 비하여 마지막 추적시에는 의미 있게 감소하여 GnRHa의 사용으로 성장호르몬-IGF 축이 다소간 억제되는 것으로 보인다. 결 론 : 사춘기가 조기에 시작하여 골연령이 역연령에 비하여 증가되어 예측성인신장이 표적키에 못 미치는 경우에 단기간의 GnRHa의 사용으로 예측성인신장은 다소 증가하였으나 표적키에는 미치지 못함을 알 수 있었으며, 성장호르몬-IGF 축의 억제가 동반되는 점에서 GnRHa 치료시 예측성인신장이 표적키에 이르기 위해서는 성장호르몬의 동시 사용이 필요하겠다.

• 대한한방부인과학회지
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• 제18권1호
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• pp.192-206
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• 2005

Objective : To know about ovarian hyperstimulation syndrome pathophysiology, risk factors and clinical features and to research the trend of the study related to OHSS. Methods : We referred a PubMed site by using searching word of "ovarian hyperstimulation syndrome"(Limits: 1 Year, only items with abstracts, Human). Results : 28 journals with 49 papers were searched. Conclusion 1. The study of OHSS subjects on pathophysiology, prevention and medical treatment. 2. As OHSS is an exaggerated response to ovulation induction therapy, it's emphasized that aspect of prevention OHSS. 3. Preventing OHSS are the following. The first is to give a GnRH agonist or antagonist in substitute for hCG. The second is to screen out prevalence of thrombophilia. The third is to monitor $E_2$ levels. The forth is to aspirate of Mediculous follicle. The fifth is cryopreservation of all embryos. The sixth is that administration of albumin for treatment of OHSS. But, it's not useful to administration of albumin for prevention of OHSS. 4. There's no therapy of OHSS. But, there's only symptomatic treatment of OHSS.

• Clinical and Experimental Reproductive Medicine
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• 제21권3호
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• pp.233-240
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• 1994

This study was conducted to compare the endocrine milieu, and pregnancy rates in In Vitro Fertilization and Embryo Transfer(IVF-ET) program employing combined with gonadotropin releasing hormone agonist(GnRH-a) and pergonal(LH 75lU+FSH 75lU) when either human chorionic gonadotropin(HCG) or progesterone were used for luteal phase support. A total number of 40 IVF-ET treatment cycles were prospectively studied. Ovarian hyperstimulation method was modified ultrashort protocol using GnRH-a. All patients started Decapeptyl at menstrual cycle day # 2, and HMG was started at # 3 days. When leading follicle was ${\geqq}$18mm or at least two follicles were ${\geqq}$14mm in diameter, HCG 10000lU intramuscularly was injected. After 36 hours HCG administration, oocytes were retrieved as usual guided by transvaginal ultrasound. Embryo were transfered 36-48 hours later. The patient's cycles were prospectively randomized to receive HCG(20cycles) or Progesterone (20cycles) for luteal support. The progesterone group received 25mg 1M starting from the day of ET. The HCG group received 1500IU 1M. on days 0, +2, +5 after ET. Estadiol($E_2$) and Progesterone($P_4$) were measured on the day of oocyte aspiration, ET day, and every 6 days thereafter. Results were follows as; 1. Estradiol, progesterone and LH levels on the day of HCG trigger, retrieved oocytes and number of transfered embryo were not significantly different in both groups. 2. On the day of aspiration and embryo transfered day, $E_2$, $P_4$ level were significantly higher in progesterone group than HCG group(p<0.01). 3. $E_2$, $P_4$ level on 6 days after ET were significantly higher in progesterone group than HCG group(p<0.01). But, $P_4/E_2$ ratio was not different in both groups. 4. $E_2$, $P_4$ level 12 days after ET were decreased abruptly in both groups and higher hormonal level appeared in HCG group(P<0.01). 5. The total pregnancy rate in the HCG group was 40% (8/20) and in the progesterone group 15%(3/20). 6. Comparing the pregnant and nonpregnant cases progesterone group was not different the hormonal status. In HCG group, pregnant cases appeared in higher $P_4$, $P_4/E_2$ ratio than nonpregnanct cases(P<0.01).

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.143-151
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• 1997

The present study was designed to investigate if antithyroid antibodies (ATA) could affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization and embryo transfer (IVF-ET). From October 1995 to September 1996, 28 euthyroid women with ATA who underwent IVF-ET were studied. Fifty-one euthyroid women without ATA who underwent IVF-ET served as control. Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were assayed using radio ligand assay kits as ATA. All patients included in study and control groups had only tubal factor in infertility. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. There were no significant differences between study and control groups in patient characteristics such as age, infertility duration and hormonal profile. There were also no significant differences between two groups with respect to the clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transfered. There were no correlations between ATA (TPOA and TGA) titers and fertilization rate. The clinical pregnancy rate per cycle seemed to be lower in the study group than in the control group (26.3% vs 39.3%), but the difference was not statistically significant. The biochemical pregnancy rate per cycle and miscarriage rate were significantly higher in the study group at 18.4% (7/38) and 40.0% (4/10) compared with 5.6% (5/89) and 11.4% (4/35) in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or non-pregnancy group. In 10 women with ATA who achieved pregnancy following IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing or delivery group. In conclusion, euthyroid women with ATA appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.979-983
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• 2012

Background : Previous studies have suggested a lack of complete cross-resistance between steroidal (exemestane) and non-steroidal aromatase inhibitors (nSAI). Methods : Eighty-eight metastatic breast cancer (MBC) patients who received 25 mg of exemestane orally once a day at the National Cancer Center, Korea, between 2003 and 2009, were reviewed retrospectively. All patients had received nSAI for metastatic disease prior to exemestane therapy. Results : The median age was 52 years (range, 33-79), and 13 (14.8%) patients were premenopausal who concomitantly received GnRH agonist. Exemestane was given as a second- (80.7%) or third-line (19.3%) hormone therapy. The clinical benefit (CB) rate (complete response + partial response + stable disease ${\geq}$ 24 weeks) was 30.7%, with a median CB duration of 10.0 months (range, 6.3-78.7). The median progression-free survival (PFS) was 3.0 months (95% confidence interval [CI], 1.99-4.01) and the overall survival (OS) 21.5 months (95% CI, 17.96-25.04), with a median followup of 50.3 months. Patients who achieved CB had longer OS than those patients who did not (29.6 vs 17.9 months; P=0.002). On univariate analysis of predictive factors, patients who had achieved CB from previous nSAI tended to show lower CB rate (24.6% vs 44.4%, respectively; P=0.063) and shorter PFS (2.8 vs 4.8 months, respectively; p=0.233) than patients who had not. Achieving CB from previous nSAI became independent predictive factor for CBR to exemestane on multivariable analysis (Odds ratio = 2.852, P = 0.040). Conclusions : Exemestane after nSAI failure was effective in prolonging CB duration. The drug's efficacy seemed to be inferior in patients who had benefit from previous nSAI use.