• Clinical and Experimental Reproductive Medicine
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• v.14 no.2
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• pp.127-137
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• 1987

Steroid hormone profiles during luteal phases after in vitro fertilization(IVF) and embryo transfer(ET) have been evaluated in 83 cycles stimulated by pure follicle-stimulating hormone/human menopausal gonadotropin/human chorionic gonadotropin, in which 13 patients became pregnant. Serum estradiol($E_2$) and progesterone($P_4$) levels were determined on days 2, 5, 7 and 9 after laparoscopic follicle aspiration. The follicular $E_2$ peak was slightly higher in pregnancies than in failures. Positive correlations were observed between the follicular $E_2$ peaks and the $P_4$ levels on days 5 and 7 of the luteal phase in pregnancies, but no correlation was found in failures. The $E_2$ and $P_4$ levels on days 5 and 7 of the luteal phase were significantly higher in pregnancies than in failures, but not different on days 2 and 9. Values of the $P_4/E_2$ ratio were similar between the two groups. The luteal phase durations were 12 to 19 days and no correlation was observed between the lengths of luteal phase and the luteal $E_2$ or $P_4$ concentrations. These data suggest that high $P_4$ levels in the mid-luteal phase, which have positive correlations with the follicular $E_2$ peaks, might have a favorable influence on the pregnancy success in human IVF.

• Clinical and Experimental Reproductive Medicine
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• v.19 no.1
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• pp.65-69
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• 1992

The sucess of intrauterine inseminations with washed human spermatozoa was evaluated in 92 patients. In according to indication of insemination, intrauterine inseminations of women with hostile cervical mucus yield a 35.3% and 12.8% with male factors and 27.3% with unexplained infertility. In ovulation induction group with variable agents including clomiphen, human menopausal gonadotropin (HMG) and GnRH analog, the pregnancy rate was 27.8% (22/79) and in natural cycle group, 15.4% (2/13). The fetal loss rate in insemination group was 12.5% (3/24). Multiple pregnancies were 7 cases and ovulation induction were performed in 6 cases among them. Intrauterine insemination with washed human spermatozoa therefore represents an effective and safe procedure selected infertile couples.

• Clinical and Experimental Reproductive Medicine
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• v.14 no.2
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• pp.109-118
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• 1987

Ninety-one patients with irreparable tubal disease underwent in Vitro Fertilization-Embryo Transfer (IVF-ET) in Seoul National University Hospital. Ovulation was stimulated in 104 cycles by human menopausal gonadotropin (HMG) or follicular stimulating hormone (FSH)/human chorionic gonadotropin (HCG). The patients were classified as high (>900 pg/ml), intermediate (400-900 pg/ml), or low (<400pg/ml) responder according to preovulatory $E_2$ response and four $E_2$ patterns were found. The overall pregnancy rate per cycle in this consecutive series was 11.5% (n=12). The number of preovulatory oocytes per cycle was higher significantly in intermediate and high responder group than in low responder group (P<0.01), While the number of immature oocytes per cycle significantly higher in low responder group than high and intermediate responder group (P<0.01). The pregnancy rate in each responder group was not signigicant. According to the $E_2$ pattern of response, there was no significant difference in number of the immature and preovulatory oocytes recovery per cycle. There was a apparently direct relationship between the preovulatory $E_2$ pattern and pre gnancy rate was noted.

• Clinical and Experimental Reproductive Medicine
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• v.15 no.1
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• pp.25-34
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• 1988

The intrafo1licular echoes of cumulus oophoruses within ovarian follicles were assessed with the use of ultrasound in 86 women taking part in an in vitro fertilization(IVF) or gamete intrafallopian transfer(GIFT) program, stimulated with pure follicle-stimulating hormone(FSH)/human menopausal gonadotropin(hMG)/human chorionic gonadotropin (hCG). When intrafo1licular echoes were clearly separated from the follicular wall or relatively dispersed within the follicle, they were considered to be a dissociated cumulus, and when they were only slightly prominent from the follicular wall, they were suspected to be a nondissociated cumulus. A cumulus was seen in 62.1% of the follicles larger than 10 mm diameter and 75.1% of them were dissociated. The larger the follicles in size, the more the cumuluses in number and dissociation. The number of follicles and intrafollicular echoes per woman was not different whether or not she would be pregnant, but the number of dissociated cumuluses was significantly more in pregnant women. The number of observed dissociated cumuluses correlated significantly with the number of recovered mature oocytes. When an intrafollicular echo is seen, it can be taken as evidence of a sign of maturity of that particular follicle and oocyte. Ultrasonographic monitoring of intrafollicular echoes and follicular size is very helpful to predict follicular maturation in ovulation stimulation cycles.

• Clinical and Experimental Reproductive Medicine
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• v.34 no.1
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• pp.33-39
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• 2007

Objective: The objective of this study was to investigate whether serum levels of vascular endothelial growth factor (VEGF) measured at ovulation triggering day reflect ovarian response in intrauterine insemination (IUI) cycles. Methods: Forty-nine fertile women who undergoing superovulation and IUI were included. Superovulation was performed using clomiphene citrate (100 mg/d on day 3$\sim$7) in combination with human menopausal gonadotropin (150 IU every other day starting on day 5). Serum samples were obtained on the day of hCG administration and the levels of VEGF-A and estradiol were measured. The numbers of mature follicle $\geq$17 mm in diameter were also counted. Results: Serum VEGF-A levels did not correlate with the numbers of mature follicle count nor serum estradiol levels. Serum estradiol level was positively associated with mature follicle count. Serum VEGF-A levels tended to be lower in women with mature follicle count less than three or women with more than five. Conclusion: Our results indicate that serum VEGF-A levels do not have an association with superovulation outcome in IUI cycles. However, a tendency of lower VEGF-A level in poor and high responder suggests that those with extreme response to superovulation may be related with abnormal angiogenesis. Further studies should be warranted in larger populations.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.2
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• pp.15-23
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• 1985

Therapy for anovulation represents one of the more gratifying and successful type of infertility management. Despite the introduction of bromocriptine, human menopausal gonadotropin (HMG), and gonadotropin releasing hormone (GnRH), clomiphene citrate remains the mainstay of ovulation induction therapy. There is wide variability in reported rates of ovulation induction (57-91%) and conception (25-43%) following clomiphene therapy. Factors contributing to this variability among different reports are the differences in dosage and duration of therapy, different criteria utilized in selecting patients for clomiphene therapy and different luteal phase parameters of presumptive ovulation. A review of recent experience with clomiphene citrate in the Department of Obstetrics and Gynecology in Seoul National University from January, 1983 to May, 1985 yields the following conclusions: 1. Ovulation rate per total patients treated was, 69.0% 2. Pregnancy rate per total patients treated was 31.7%, and that per total patients ovulated was 45.9%. 3. Ovulation rate at the dosage level up to 150 mg/day (50.3-53.8%) was somewhat higher than that at 200 mg/day or more (33.3-34.6%), and pregnancy rate per total patients treated was comparable at each dosage level. 4. Ovulation rate per total patients ovulated at each dosage level, where ovulation and conception occurred, showed a decreasing tendency as the dosage increased, but pregnancy rate per total patients conceived was comparable except at 200 mg/day. 5. Cumulative pregnancy rate per total patients conceived in each ovulatory cycle was 68.9% in 3 cycles, 88.9% in 4 cycles, and 100% in 6 cycles.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.684-691
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• 1997

1be ovarian hyperstimulation syndrome is a rare but serious complication of ovulation induction therapy with gonadotropin. The clinical manifestations are generalized edema, ascites with pleural effusion and may become life-threatening in severe cases. The pathophysiology is still unknown, therefore, the treatment should be symptomatic and conservative. We report a case of severe OHSS with massive right pleural effusion in excess of ten liters after human menopausal gonadotropin therapy because of secondary infertility. Fluid and electrolyte imbalances were corrected and albumin was administered. A right chest tube was placed for a total of sixteen days, draining eleven liters of pleural effusion totally, resulting a dramatic decrease of pleural effusion and improvement of symptoms.

• Journal of Menopausal Medicine
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• v.24 no.3
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• pp.196-203
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• 2018

Objectives: This study was aimed to establish the most effective premature ovarian failure (POF) mouse model using Cyclophosphamide (CTX), busulfan (Bu), and cisplatin considering treatment duration of anticancer drugs and natural recovery time. Methods: POF was induced by intraperitoneally injecting CTX (120 mg/kg)/Bu (12 mg/kg) for 1 to 4 weeks or cisplatin (2 mg/kg) for 3 to 14 days to C57BL/6 female mice aged 6 to 8 weeks. Controls were injected with equal volume of saline for the same periods. Body weight was measured every week, and ovarian and uterine weights were measured after the last injection of anticancer drug. To assess ovarian function, POF-induced mice were superovulated with pregnant mare serum gonadotropin and human chorionic gonadotropin, and then mated with male. After 18 hours, zygotes were retrieved and cultured for 4 days. Finally, the mice were left untreated for a period of times after the final injection of anticancer drug, and the time for natural recovery of ovarian function was evaluated. Results: After 2 weeks of CTX/Bu injection, ovarian and uterine weights, and ovarian function were decreased sharply. Cisplatin treatment for 10 days resulted in a significant decrease in ovarian and uterine weight, and ovarian function. When POF was induced for at least 2 weeks for CTX/Bu and for at least 10 days for cisplatin, ovarian function did not recover naturally for 2 weeks and 1 week, respectively. Conclusions: These results suggest that CTX/Bu should be treated for at least 2 weeks and cisplatin for at least 10 days to establish the most effective primary ovarian insufficiency mouse model.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.3
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• pp.355-362
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• 1999

Objective: This study was performed to compare the clinical response to controlled ovarian hyperstimulation (COH) of in vitro fertilization and embryo transfer (IVF-ET) according to the size of baseline ovarian cyst. Method: From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1 (n=63) had cysts with mean diameters between 20.0 and 29.0 mm on their baseline ultrasound on cycle day 3, group 2 (n=57, $30.0{\sim}49.0mm$), group 3 (n=68, >50.0 mm) and control group (n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. Results: There were no statistically significant differences between cases with baseline ovarian cyst <50.0 mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0 mm in mean diameter needed more amount of human menopausal gonadotropin (hMG), showed significantly lower estradiol ($E_2$) level, the number of follicle >15.0 mm on the day of human chorionic gonadotropin (hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. Conclusion: This study suggests that cases with baseline ovarian cyst <50.0 mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0 mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.169-172
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• 2010

Retrograde ejaculation is a condition that causes male infertility. Infertiltiy treatment is usually based on assisted reproductive technology with the use of sperms recovered from the bladder after ejaculation. Many pregnancies have been tried by artificial intrauterine insemination with the husband's sperm recovered from voided urine. In this case, ovulation was induced by clomiphene citrate and human menopausal gonadotropin, pH and osmorality of urine was controlled by modified Ham's F-10 contained 10% serum substitute supplement and immediately semen collection, to improve sperm motility. We had experienced a successful pregnancy case by above method, and reported with brief review of literature as well.