• Clinical and Experimental Reproductive Medicine
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• 제16권2호
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• pp.211-220
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• 1989

The aim of this study was to compare the response and their outcome of superovulation induction protocol in IVF-ET program. One hundued seventy seven infertile women were stimulated by FSH/hMG(group I, N=128), clomiphene citrate/hMG(group II, N=51), and hMG(group III, N=18) for the purpose of ovulation induction. The results were as follows; 1. The mean ages of patients were $31.9{\pm}3.8$ in group I, $30.6{\pm}3.3$ in group II, and $29.3{\pm}2.5$ in group III. 2. The day of hCG administration was $11.1{\pm}1.8$ in group I, $12.1{\pm}2.0$ in group II, and $13.7{\pm}6.8$ in group III. The hCG administration day of group III was significantly delayed compared with that of group I (p<0.001). 3. The terminal E2 pattern in group II was different from those of group I and III, but there was no significant difference. 4. The mean numbers of mature eggs aspirated were $5.5{\pm}3.8$ in group I, $5.0{\pm}3.3$ in group II, and $5.6{\pm}5.4$ in group III. There was no significant differences in the mean numbers of mature eggs retrieved among the three groups. 5. The fertilization rate of eggs was significantly higher in group II (67.9%) than that of group I (52.2%)(p<0.001). 6. The cleavage rate of group I (67.0%) was significantly lower than those of group II (93.2%) and group III (95.8%) (p<0.0001). 7. The mean numbers of embryos transfered were $3.3{\pm}1.4$ in group I, $3.1{\pm}1.3$ in group II, and $3.2{\pm}1.6$ in group III and the ET rate was 69.0% in group I, 77.3% in group II, and 100% in group III. There was significant difference in ET rate between group I and group III (p<0.005). 8. The pregnancy rates per OPU cycle or ET cycle were not significantly different among the three groups, but delivered and ongoing pregnancy rates were significantly different between group I (36.8%) and group II (p<88.8%) (p<0.05).

• 한국수정란이식학회지
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• 제27권3호
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• pp.141-147
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• 2012

This study was operated to establish induction using ultrasonography by estimating the relation of follicle size and estrus manifestation. Clinical estrus symptoms were observed 97.4% in cows and 87.5% in heifers when overall 55 cows were induced to estrus in a single dose of $PGF_{2{\alpha}}$ after verifying CL through ultrasonography, which means estrus hours among those 52 cows showing the clinical estrus symptoms were estimated 2.39 days on cows and for 2.37 days on heifers which showed no differences (p>0.05). The estrus manifestation hours according to the follicle size in cows didn't have any significance each other (p>0.05), though estrus hours was 54 hours (the shortest) with follicle size bigger than 10 mm and were made up within 69 hours. The estrus manifestation hours according to the follicle size in heifers didn't have any significance each other (p>0.05) and took around 42 hours (the shortest) with follicle size of 5mm (the smallest) and were made up within 66 hours. Follicles after $PGF_{2{\alpha}}$ injection were ovulated and assigned to many phases as follows; Group 1 (growing phase) - continuously growing into ovulation, Group 2 (growing and static phase) - delaying in growth after the growth of follicles, Group 3 (static and growing phase) - growing after growth delay, Group 4 (regressing and new growing phase) - the follicle is closed and a new follicle grows. In addition, the process of follicle development and estrus hours had no significance each other (p>0.05), though estrus manifestation hours in Group 1 and 2 was relatively short, and in Group 3 and 4 for a relatively long time. In the result of all above, the estrus manifestation hours after $PGF_{2{\alpha}}$ injection has no differences accoring to the follicle size in cows and heifers. Therefore, High pregnancy rate is obtained when practicing artificial insemination within 3 days in estrus or TAI in 72 to 80 hours after adminitrating $PGF_{2{\alpha}}$.

• Clinical and Experimental Reproductive Medicine
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• 제27권4호
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• pp.345-351
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• 2000

Objective: Hatching of the blastocyst from the zona pellucida (ZP) is a key event in mammalian implantation. In vivo, two factors have been identified as possible mediators of hatching: lysis of the ZP by substances elaborated either from the embryo or female reproductive tract and pressure exerted on the zona by expansion of the blastocyst. Two methods of zona manipulation were already in use to enhance the ability of embryos to hatch: mechanical PZD and chemical ZD by acidic Tyrode's solution. But several controversies of each method have been reported. The purpose of this study was to investigate the effect of pronase for mouse embryo hatching. Methods: Mouse embryos were obtained following ovulation induction of $F_1$ animals. Fresh and cryo-thawed morula embryos were exposed to 0.5, 1.0, 2.0, 5.0 ${\mu}g/ml$ pronase in Ham's F10 for 72 hrs. Main outcome measures were the rates of partial hatching and completely hatched blastocysts, and cell number of it. Results: In fresh and cryo-thawed group, the rates of completely hatched blastocyst were significantly higher in 5 ${\mu}g/ml$ pronase treatment group than control group. There was no difference in completely hatched blastocyst total cell number between pronase treatment group and control group. This suggest that pronase treatment did not harmful in mouse embryo development. In pronase treatment group, zona pellucida were thinner than control group. Conclusion: The addition of pronase to culture media may accelerate the hatching of embryo. So, enzymatic treatment of the zona may provide a valuable and effective assisted hatching technique for human in-vitro fertilization-embryo transfer.

• Clinical and Experimental Reproductive Medicine
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• 제38권1호
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• pp.37-41
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• 2011

Objective: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin ${\beta}$ with a conventional syringe delivering follitropin ${\beta}$ solution in patients undergoing IVF-ET. Methods: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). Results: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin ${\beta}$. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. Conclusion: The pen device for self-administration of follitropin ${\beta}$ is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin ${\beta}$ when compared with the conventional syringe.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.141-151
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• 1998

Objectives: To determine whether the body weight, body mass index (BMI), and basal serum level of LH, FSH, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) are related to the ovarian response to clomiphene citrate (CC) in patients with polycystic ovarian syndrome (PCOS). Materials and Method: From January 1996 to June 1997, total 57 patients with PCOS were enrolled in the present study. Women who had other infertility factors were excluded from our study. The ovulation induction using CC was used in all patients. The patients were grouped into 50 mg group, 100 mg group, and 150 mg group according to their daily CC dose. The patients were also grouped to ovulatory and non-ovulatory group. The body weight, BMI, and basal serum level of LH, FSH, T, DHEA-S were measured in all patients on the 2nd or 3rd day of the menstrual cycle. Results were analysed with Student's t-test and Fisher's exact test. Results: The body weight and BMI of the nonovulating group were significantly higher than those of the ovulating group in all groups (50, 100, 150 mg of CC). However, there were no significant differences of the level of LH and FSH between ovulating and nonovulating groups in all CC groups (50, 100, 150 mg). The level of T of nonovulating group was significantly higher in 50 and 100 mg of CC groups, but not in 150 mg group. The level of DHEA-S of the non-ovulating group is significantly higher in 50 mg group, but not in 100 and 150 mg groups. Conclusion: The body weight and BMI could be useful predictors of ovarian response to CC in patients with PCOS, and basal T and DHEA-S also might be useful in cases of low-dose CC treatment.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.11-24
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• 1996

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

• 대한한방부인과학회지
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• 제18권1호
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• pp.218-233
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• 2005

Purpose : To investigate clinical-epidemologic aspect of infertility patients in Conmaul Oriental Hospital. Methods : From 2003, 5 to 2004, 4, a total 1223(female 943, male 280) patients was recruited, and their medical records were reviewed retrospectively. Results : The mean age of female was $31.83{\pm}3.63$ yesrs, and $34.08{\pm}3.66$ years in male. The mean BMI of female was $20.83{\pm}2.74$, and $24.36{\pm}3.03$ in male. The most common occupation of female was profession, administration, management.The primary infertility was 52.9% and the secondary infertility 47.1%. The most common past history in female was laparotomy. The mean duration of infertility was $3.32{\pm}2.5$ years and $3.9{\pm}2.63$ years in female and male. 83.6% of secondary infertility women experienced abortion. The incidence of patients with both combinded infertility factors of female and male was the most highest, and the most common single factor was ovulatory. 92.4% of female patients took sterility tests, 71.0% of male patients took semen analysis. 50.8% female took ovulation induction, IUI, IVF before coming. 8.91% of female and 72.14% of male were accompanied by their spouse. 61.2% of female took sterility test with their spouse. Female's duration of treatment was longer than man's. The most reliable source of choices was encouragement of family members, acquaintance. Conclusion : In this study, we presented staus concerend with infertility and the characteristics of patients went to oriental hospital. Furthermore, the study about oriental treatments and the results of that treatments is required.

• 한국수정란이식학회지
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• 제22권1호
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• pp.53-61
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• 2007

본 연구는 PI한 한국흑염소 수정란의 이식 결과를 통해 수란 흑염소의 수태율에 영향을 미칠 것으로 생각되는 여러 가지 요인을 분석함으로써, 높은 수태율을 얻을 수 있는 수란 흑염소의 최적 조건을 찾아낼 목적으로 수행하였다. 분석 결과, 수태율에 유의적인 영향을 주는 요인들은 발정형태, 수술 빈도, 이식 부위, 황체의 발육 단계, 수정란의 발육단계, 이식된 수정란의 수 등이었다. 자연 발정이 관찰되어 이식된 흑염소(59.1%, 13/22)들이 $CIDR^(R)$로 발정이 유도된 후 이식된 흑염소(36.8%, 118/321)에서보다 높은 수태율을 나타내었으며(P<0.05), 두 번째 수술 받은 흑염소의 수태율(56.5%, 13/23)이 처음 이식 받은 흑염소(36.5%, 116/318)에 비해 수태율이 높았다(P<0.05). 이식한 부위에 따른 수태율은 좌측 난관에 이식한 흑염소(49.0%, 50/102)가 오른쪽 난관에 이식한 흑염소(35.9%, 46/128)에 비해 수태율이 더 높게 나타났으며(P<0.05), 황체의 발육 단계에 따른 수태율에서는 $CH_1$단계(47.5%, 57/120) 출혈체를 가진 수란 흑염소에서 $CH_3(17.9%,\;7/39)$의 출혈체를 가진 수란 흑염소보다 높은 수태율을 얻었다(P<0.01). 수정란의 발육단계에 따른 차이는 난관 이식의 경우에 1세포기 배가 이식된 수란 흑염소의 수태율(51.6%, 49/95)이 4세포기배를 이식한 경우(24.5%, 12/49)보다 높았다(P<0.01). 수정란의 수는 2개를 이식했을 때(27.%, 37/137)보다 3개를 이식했을 때(47.6%, 50/105) 더 높은 수태율을 얻었다(P<0.01). 수태율에 유의적인 영향이 없는 요인들은 난관 유착이나 자궁 유착, 난소 유착, 자궁각의 크기, 황체의 수, 대형 난포의 존재 유무, 이식의 난이도 등이었다 그러나, 중간 크기의 자궁을 가진 수란 흑염소(38.9%, 122/314)에서 직경 5mm 이하의 작은 자궁을 가진 수란 흑염소(20%, 1/5)나 20mm 이상의 큰 자궁을 가진 수란 흑염소(18.2%, 2/11)보다 수태율이 높은 경향을 보였고, 배란 황체가 있는 같은 쪽 난소에 대형 난포가 존재할 경우(53.3%, 16/30)에 존재하지 않는 경우(37.1%, 104/280)보다 수태율이 높아지는 경향을 보였으며, 이식이 쉽게 이루어진 경우(39.2%, 125/319)에 이식이 어렵거나(27.8%, 5/18) 곤란한 경우(0%, 0/3)에서보다 높은 수태율을 얻을 수 있었다. 따라서, 자궁각의 크기나 대형 난포의 존재 유무, 이식의 난이도 등도 수정란 이식 후의 수태율에 영향을 줄 수 있을 것으로 생각된다. 이상의 결과로 볼 때 PI한 한국 흑염소 수정란의 이식 시 높은 수태율을 얻기 위해서는 수란 흑염소는 자연 발정 온 개체를 이용하고, 난관에 이식하고자하는 경우에는 난소에 $CH_1$ 단계의 출혈체가 존재하는 쪽 난관에 1세포기의 수정란을, 그리고 자궁에 이식하는 경우에는 난소에 발육 단계가 $CL_3$인 황체가 존재하는 쪽 자궁각에 중기 배반포나 후기 배반포를 이식하는 것이 가장 바람직하다는 결론을 얻었다.

• Clinical and Experimental Reproductive Medicine
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• 제31권2호
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• pp.133-139
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• 2004

Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.

• 한국수정란이식학회지
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• 제2권1호
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• pp.36-46
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• 1987

The present work was designed to understand the mechanism of superovuiation and the cause of early embryo loss and Implantation failure in the superovulating immature female rats which were elaborated by a pituitary gland transplantation. A pituitary gland obtained from the orchidectomized rats was transplanted under the right kidney capsule of 28 day old female rats (PGT group) on the starting day of experiment which was designated as Day 2. The grafted pituitary glands were removed at 6h (RPGT 6h group), 12h (RPGT 12hgroup) and 24h (RPGT 24h group) after the transplantation. Control rats were treated with 41U PMSG on Day 2 (PMSG group). The estrous cycle and the levels of plasma progesterone and estradiol-17$\beta$ were observed on Day 0, Day 5, respectively. The implantation sites, the weights of ovary and uterus, and the number of corpora lutea were examined in all group on Day 8. The resuft obtained were summarized as follows: 1. The percentages of the number of the rats in proestrus and estrus were 93.0%, 82.6%, 0%, 90.7% and 89.5% in PMSG, PGT, RPGT6h, RPGT12h and RPGT24h group, respectively. The synchronization of estrus cycle was dchieved in all groups. 2. The mating rates of each group were 80.2, 75.0, 0, 56.4, 57.8% in PMSG, PGT, RPGT6h, RPGT12h, RPGT24h group, respectively. 3. The numbers of copora lutea on Day 8 were 47.1 i 4.9, 18.1 $\pm$0.5, 14.1 i 0.3 and 8.9 $\pm$ 0.3 in PGT, RPGT24h, RPGTl2h and PMSG group, respectively. There were signIficantly difference between all groups (P<0.05). 4. The numbers of implantation sites (18.1 +- 4.0) in PGT group on Day 8 were higher than those of PMSG (8.5 $\pm$ 2.5), RPGT 12h (9.8 i 0.2) and RPGT 24h group (10.8 i 0.2) (P<0.05). 5. The ovarlan weights in PGT (95.2 $\pm$ 14.3mgIlOOg BW), RPGT 12h (51.7 $\pm$ 0.6mgIlOOg BW), and RPGT24h (57.9 $\pm$ 0.9mg/l00g 8W) groups were significantly higher than those of PMSG group (30.4 $\pm$7.4mg/l00g BW) (P<0.05). 6. The uterine weights in PMSG (672.4 $\pm$ 4.7mg/l00g 8W), and PGT (660.7 $\pm$7.8mg/l00g BW) groupswere greater than those of RPGT 12h (403.0 $\pm$ 1.lmg/lOOg BW) and RPGT 24h (490.1 $\pm$ 0.9mg/l00g BW) group (P<0.05). 7. The plasma progesterone levels in PGT groups (15 lng/ml) on Day 5 were higher than those of PMSG (83ng/ml), RPGT 12h (S7ng/ml), RPGT24h (8lng/ml) group (P<0.05). 8. The plasma estradiol-17$\beta$ levels in PMSG group (lBSpg/ml) on Day S were higher than those of RPGT 24h (l3pg/ml) group (P<0.05). But estradiol-17$\beta$ levels in PGT and RPGT 12h group were too low to discuss.