• Clinical and Experimental Reproductive Medicine
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• 제13권2호
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• pp.101-112
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• 1986

It is now common practice to attempt ovarian hyperstimulation in vitro fertilization and embryo transfer (IVF-ET) to promote the development of multiple preovulatory follicles and to maximize the number of mature egg available. There are several drugs for hyperstimulation such as clomiphene citrate only, clomiphene citrate and human menopausal gonadotropin (HMG) and HMG only. Accumlated experience has shown that the hyperstimulation of the ovary in IVF-ET results in high pregnancy rate. But the hyperstimulation of the ovary in IVF-ET may cause the hyperandrogenism, so we must consider the adverse effect on pregnancy rate of the hyperandrogenism. Little is known about the functional significance of androgen for the follicular growth, however, the hyperandrogenism might interfere with oocyte maturation. The aim of the present investigation was to determine the serum profiles of estradiol, androstenedione and testosterone during the hyperstimulated menstrual cycles in IVF. The results were summarized as follows: 1. There was a gradual increase in the mean levels of serum estradiol, androstenedione, and testosterone approaching follicular maturation. 2. The mean serum estradiol levels in the hyperstimulated groups were significantly higher than that in the control group in late follicular phase and ovum retrieval (ovulation) day (p<0.01). 3. The mean serum androstenedione levels in the clomiphene citrate groups were significantly higher than that in the control group in late follicular phase (p<0.01). There was no statistically significant different in the mean serum androstenedione levels between the control group and the HMG group (p>0.05). 4. There was no statistically significant difference in the mean levels of testosterone among each group (p>0.05). 5. There was no statistically significant different in the mean levels of estradiol, androstenedione and testosterone between the fertilized patients and non-fertilized patients in clomiphene citrate and HMG group (p>0.05).

• Clinical and Experimental Reproductive Medicine
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• 제17권2호
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• pp.115-121
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• 1990

Ultrasonically guided oocyte collection gradually replaces laparoscope in many IVF center. In present study, we compare the efficacy of both methods in our IVF program. Totally 377 cycles which were undertaken in vitro fertilization treatment were divided into 2 groups. Ultrasonically guided transvaginal follicular aspiration was performed in 188 cycles and laparoscopic follicular aspiration was performed in 189 cycles under local anesthesisa. The mean age for both groups was similar. Follicular recruitment was achieved with human menopausal gonadotropin (hMG) or a com bination of clomiphene citrate and hMG or a combination of FSH and hMG. In the ultrasonically guided aspiration group, 1821 follicles were aspirated with 61.8% of recovery rate (1125 oocytes), 81.5% of embryo transfer rate (145 cycles) and (17%), 26 cases intrauterine pregnancies were estabilished. In the laparoscopic group, 604 follicles were aspirated with 68.7% recovery rate (445 oocytes) and a 79.9% ET rate (127 cycles), 11 cases (8.7%) intrauterine pregnancies were estabilished. A valid comparison of these data is not possible because the 2 groups are dissimilar for factors known to influence oocyte development and recovery. No statistically significant differences could be demonstrated between 2 groups in all but the recovery rate and clinical pregnancy rate, In ultrasound group, the clinical pregnancy rate was significantly higher than that of laparoscope group. The potentially detrimental effect of CO2 pnemoperitonium present during laparoscope but not in ultrasound guided recovery on ova quality may underlie the observed difference in the clinical pregnancy rate between the 2 groups. Ultrasound guided aspiration seems to be as effective as laparoscopy in terms of oocyte retrieval and conception rate. Furthermore, the procedure is simple and inexpensive, it may replace laparoscopy as a method for oocyte collection in most patients who undergo IVF.

• 한국수정란이식학회지
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• 제9권1호
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• pp.95-102
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• 1994

본 연구는 종모우의 선발방법으로 난포란을 이용하여 실험실내 정자의 수정능력을 직접 검정하여 평가코자 시도되었다. 즉 본 실험은 후대검정중에 있는 한우 후보종모우 15두의 동결융해정자의 수정능력을 평가하기 위하여 정액을 고장액(HIS)에 처리한 후 DM에서 6시간 그리고 소 난포액이 20% 첨가된 DM에서 4시간 전배양하여 수정능을 획득시켜 정자의 활력과 첨체 반응율을 조사하였고 전배양된 정자의 체내(토끼 난관) 또는 체외수정능력을 조사하기 위하여 FCS 15%, 발정암소혈정(CSS) 10%가 첨가된 mKRB에서 체외성숙된 한우난포란과 수정시켜 수정능력을 평가하였으며 인공수정에 의한 개체별 수태율과도 비교 검토한 바 다음과 같은 결론을 얻었다. 1. 한우 난포란의 체외성숙율은 BSA 첨가구 에서 43.8%, FCS 15% 첨가구에서 67.4%, CSS10% 첨가구에서 69.9%이었다. 2. 토끼 난관에서 체외수정율은 BSA 참가구에서 43.8%, FCS 15% 참가구 41.2% 및 CSS 10% 참가구 35.0% 이었다. 3. 후보종무우 15두의 정액을 HIS-DM으로 처리후 6시간 전배양하였을 때 정자의 활력지수는 9-32%였고 첨체반응율은 19-44% 이었으며 20% 난포액을 첨가하여 4시간 전배양 하였을 때 정자의 활력지수는 9-13% 이었고 첨체반응율은 20-43%로 개체간에 차이가 있었다. 4. 체외수정율은 6.6-85.7%였으며, 발정암소혈청(CSS) 10%가 첨가된 mKRB에서 성숙시킨 난포란이 FCS 15% 첨가된 mKRB에서 성숙시킨 난포란보다 다소 높았으나, 정자수정능획득방법간에는 차이가 없었 다. 5. 체외수정율에 있어서 전배양후 정자활력지수와는 부의 상관이 었으며, 첨체반응율과는 낮은 정의 상 관을 나타냈다. 6. 종모우의 수태율은 체외수정율, 정자활력지수 및 첨체반응율과 낮은 정의 상관관계를 나타냈다. 7. 종모우의 개체간 수태율 우열순위에서는 수정율순위와의 사이에 더욱 낮은 부의 상관관계를 보였다. 8. 이상의 연구결과 비록 후대정검중의 제한된 자료로 인하여 종모우 수태율과 체외수정율간에 유의적 인 상관관계는 없었으나, 연결 한우 수정율 평가에 대한 실험실내의 검정가능성을 찾을 수 있었다.

• Clinical and Experimental Reproductive Medicine
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• 제13권1호
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• pp.67-75
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• 1986

Follicle monitoring in the normal and clomiphene·stimulated cycles were analyzed in the Seoul IVF and ET (In vitro fertilization and embryo transfer) program. Ovarian follicular diameters were measured by the real·time sector scanner and plasma estradiol levels were assayed by radioimmunoassay methods during periovulatory period. The maximum follicular sizes of the clomiphene-stimulated and normal cycles were 21.1+-3.4mm and 19.2+-0.8mm, respectively. The peak levels of plasma estradiol in the clomiphene-stimulated and normal cycles were 10538+-553.6ng/ml and 298.3+-39.6pg/ml, respectively. Daily growth rate of the follicular diameters of the clomiphene-stimulated and normal cycles were 2.1mm and 1.9mm, respectively. Mean follicular number of the clomiphene-simulated and normal cycles were 2.28+-1.12 and 1.12+-0.21, respectively. There was a good statistical correlation between the mean follicular diameters and the plasma estradiol levels in the normal ovulatory and c1omiphene-stimulated ovulatory menstrual cycles (p<0.05). Our data revealad that the mean follicular diameter and the plasma estradiol level prior to HCG administration in IVF and program should reach at the level of 17.8+-3.0mm and 949.4+-487.1 pg/ml, respectively.

• 대한한방부인과학회지
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• 제35권2호
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• pp.28-41
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• 2022

Objectives: The purpose of this study is to investigate the effectiveness of moxibustion in infertility with In Vitro Fertilization and Embryo Transfer (IVF-ET). Methods: We searched 8 databases (Embase, PubMed, CiNii, CNKI, OASIS, ScienceOn, KMBASE, KISS)to identify eligible studies published before 2021 Oct. We included randomized controlled clinical trials (RCTs) using moxibustion in infertility with IVF-ET. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results: Two RCT studies were eligible in our review. The overall risk of bias was evaluated as unclear. The meta-analysis of 2 trials indicated that favorable results for the use of moxibustion with IVF-ET. Conclusions: This systematic review and meta-analysis of clinical trials suggests that moxibustion with IVF-ET can effect on Infertility patients. However, because of studies included analysis was biased due to unclear risk of bias and unreliable study design, future RCT studies and additional Meta-Analysis are needed to judge the supplementary treatment role of moxibustion in infertility with IVF-ET.

• Clinical and Experimental Reproductive Medicine
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• 제30권3호
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• pp.207-215
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• 2003

Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

• Clinical and Experimental Reproductive Medicine
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• 제39권1호
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• pp.28-32
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• 2012

Objective: This study was performed to assess the prognostic value of serum hCG, progesterone, and inhibin A levels measured at 11 days post-ET for predicting pregnancy outcome in women participating in IVF. Methods: Between May 2005 and April 2008, sera were obtained from 70 infertile women who underwent IVF-ET at 11 days post-ET and stored. HCG, progesterone, and inhibin A levels were measured by commercial enzyme-linked immunosorbent assay kits. The predictive accuracy of hCG, progesterone, and inhibin A levels for establishment of intrauterine pregnancy and ongoing pregnancy was calculated by receiver-operating characteristic curve analysis. Results: For the prediction of intrauterine and ongoing pregnancy, serum hCG was better than progesterone and inhibin A. The predictive performance of progesterone and inhibin A was similar. The serum progesterone and inhibin A levels were significantly correlated each other (r=0.915, p=0.010). Conclusion: A single measurement of the serum hCG level is sufficient to predict pregnancy outcome in IVF-ET patients.

• 한국수정란이식학회지
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• 제7권1호
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• pp.1-12
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• 1992

본 연구는 소의 난포란의 체외성숙과 체외수정에 영향을 미치는 요인을 구명하기 위하여 미숙 난포란을 채취하여 형태적 분류를 통해 우수한 란을 공시한 후 난포의 크기, 정액의 형태, 수정능득법, 혈청, 호르몬, 난포액, 난구세포등을 첨가한 TCM-199 배양액에서 배양하면서 체외성숙 및 수정율을 조사하였는 바 그 결과는 다음과 같다. 1. 소 난포란을 채취하여 배양을 통해 형태적 분류를 했을때 A형란은 61.4%, B형란은 12.1%, C형란은 19.2%, D형란은 4.2%였으며 발생중지 또는 퇴화란은 3.0%였다. 또한 A, B, C형란을 배양액에 배양했을때 난포란의 체외성숙율은 각각 89.1%, 78.0%, 52.6%였으며, 수정율은 각각 78.1%, 66.1%, 33.3%였다. 2. 소 난포의 크기를 1-2mm, 3-5mm 및 5mm이상으로 분류하여 채취한 난포란의 수는 각각 67개, 98개, 63개 였으며, 이를 TCM-199 배양액에서 배양했을때의 체외성숙 및 수정율은 각각 56.7%와 44.8%, 82.5%, 72.4%와 46.0%와 28.6%였다. 3. 소 난포란의 체외수정에 있어서 정소상체 미부정자, 희택정액 및 동결정액을 이용하여 매정하였을때 체외수정율과 분할율은 각각 63.3%, 73.3%, 70.0%와 32.7%, 37.8%, 38.3%였다. 4. 소 난포란의 체외수정에 있어서 m-KRB 처리법, HIS처리법, Ca-IA처리법, BFF처리법 및 heparin처리법으로 각각 수정능획득을 유기하였을때 체외성숙 및 분할율은 각각 53.1%, 28.1%, 33.9%와 17.7%, 50.8%와 26.2%, 48.1%와 22.8% 및 58.8%와 32.8%로서 heparin 처리법이 가장 높았다. 5. 소 난포란의 체외성숙과 수정에 있어서 각 농도의 우태아혈청과 FSH, HCG, $\beta$-estradiol을 첨가한 TCM-199배양액에서 배양했을때의 체외성숙 및 수정율은 각각 76.0-82.3%와 26.2-70.0%로서 무첨가에 비해 첨가가 높았다. 6. 발정우혈청 및 우태아혈청 5-20%를 첨가한 배양액에서 배양했을때의 체외성숙율은 각각 71.7-76.9%, 74.0-80.6%였으며 체외수정율은 51.9-58%와 26.2-30.0%로서, 체외수정율의 경우 발정우혈청의 첨가가 우태아혈청의 첨가에 비해 높았다. 7. 난포액20-30%를 첨가한 배양액에서 배양했을때의 난포란의 체외성숙율은 각각 68.0%와 64.6%, 수정율은 각각59.6%와 60.4%로서 난포액10%, 50%를 첨가한 배양액에서 배양시의 체외성숙율과 수정율에 비해 높았다. 8. 1$\times$10 6 /ml의 난구세포를 첨가한 배양액에서 배양했을때의 난포란의 체외성숙율과 수정율은 각각 76.5%와 61.7%로서 FCS 10%와 1$\times$10 4 -10 5/ml 와 1 $\times$10 8/ml난구세포를 첨가한 배양액에서 배양시의 체외성숙율과 수정율에 비해 높았다.

• 대한한방부인과학회지
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• 제26권2호
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• pp.120-137
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• 2013

Purpose: This study was to investigate status survey and cost of infertility patients in ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital. Methods: From January 2012 to June 2012, 171 new patients were admitted to ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital for treatment of infertility. We reviewed their medical records retrospectively and had telephone consultations to find out whether they were pregnant or not. Results: The mean age of outpatients was $32.72{\pm}4.08$ years and mean BMI of outpatients was $20.26{\pm}2.68$. 55.0% of patients who did not have childbirth or miscarriage. 82.5% of patients had normal menstrual period. 93.5% of patients visited OB/GYN, 33.3% were treated with ovulation induction, 18.7% underwent intrauterine insemination, and 18.1% underwent in vitro fertilization and embryo transfer. 99.7% were treated with acupuncture and moxibustion, 100% had taken Herbal Medicine. The mean treatment duration of outpatients was $8.84{\pm}8.17$ weeks, and the mean medical expense was $761,994{\pm}586,502$ won. It was found that 32.4% of patients were pregnant after treatment. Conclusions: We investigated status survey and cost of infertility patients. Further study about Korean medical treatments on infertility is required.

• Clinical and Experimental Reproductive Medicine
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• 제31권4호
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• pp.273-277
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• 2004

Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.