• Clinical and Experimental Reproductive Medicine
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• 제49권3호
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• pp.210-214
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• 2022

Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m². The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.

• 대한한방부인과학회지
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• 제36권3호
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• pp.114-128
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• 2023

Objectives: This study was conducted to reflect Korean Medicine doctors (KMD)' perception of lifestyle management in the process of developing a Korean Medicine (KM) Clinical Practice Guidelines (CPG) of female infertility. Methods: We sent four e-mails containing links to online questionnaires to 25,286 KMD belonging to the Association of Korean Medicine. The questionnaire consisted of sexual intercourse, weight, diet, exercise, drinking, smoking, caffeine intake, stress etc. KMD responded to self-administered questionnaires, and we analyzed 786 responds. Results: KMD put stress first among the infertile women's lifestyle management items, weight and sexual intercourse were next. Also KMD put stress first among the spouses' lifestyle management items, drinking and sexual intercourse were next. In relation to sexual intercourse, 'Recognizing the Fertile Window' was the most important. In relation to stress in the emotional domain, 'Depression' and 'Anxiety' were the most important, and in relation to stress in the relationship domain, 'Deteriorating of marital relationship' was the most important. Conclusions: We surveyed the status of KMD' awareness of infertility lifestyle management for patient education, and reflected it in the modification of the CPG for female infertility.

• Clinical and Experimental Reproductive Medicine
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• 제50권1호
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• pp.53-62
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• 2023

Objective: The aim of this study was to investigate the relationships of serum folate (vitamin B9), cobalamin (vitamin B12) levels and diet with semen parameters (semen standard parameters [SSP] and DNA fragmentation index [DFI]) in infertile men. Methods: Sperm samples were assessed for SSP and DFI (using the sperm chromatin dispersion test). Serum vitamin concentrations were measured with an immuno-electrochemiluminescence assay, and men completed a semi-quantitative food frequency questionnaire (FFQ). Results: Serum folate levels were positively correlated with sperm progressive motility and DFI. A comparison of SSP between two groups of patients according to serum folate concentration (B9 <4.840 ng/mL and B9 ≥4.840 ng/mL) showed significantly higher sperm concentration and sperm progressive motility in the latter group. However, there was no difference between these groups regarding DFI. Interestingly, serum folate levels were significantly higher in patients with a high DFI (using the cut-offs of 30% or 18%). FFQ data showed that the consumption of fruits and egg yolk correlated positively with sperm concentration and sperm motility, respectively. Conclusion: Serum folate levels showed significant associations with sperm concentration and sperm progressive motility. However, the positive association of serum folate with DFI raises the need for careful prescription of folate supplements.

• Journal of Medicine and Life Science
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• 제20권4호
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• pp.158-165
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• 2023

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

• Clinical and Experimental Reproductive Medicine
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• 제50권4호
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• pp.253-261
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• 2023

Objective: Azoospermia (the total absence of sperm in the ejaculate) affects approximately 10% of infertile males. Despite diagnostic advances, azoospermia remains the most challenging issue associated with infertility treatment. Our study evaluated transition nuclear protein 2 (TNP2) and synaptonemal complex protein 3 (SYCP3) polymorphisms, azoospermia factor a (AZFa) microdeletion, and gene expression levels in 100 patients with azoospermia. Methods: We investigated a TNP2 single-nucleotide polymorphism through polymerase chain reaction (PCR) restriction fragment length polymorphism analysis using a particular endonuclease. An allele-specific PCR assay for SYCP3 was performed utilizing two forward primers and a common reverse primer in two PCR reactions. Based on the European Academy of Andrology guidelines, AZFa microdeletions were evaluated by multiplex PCR. TNP2, SYCP3, and the AZFa region main gene (DEAD-box helicase 3 and Y-linked [DDX3Y]) expression levels were assessed via quantitative PCR, and receiver operating characteristic curve analysis was used to determine the diagnostic capability of these genes. Results: The TNP2 genotyping and allelic frequency in infertile males did not differ significantly from fertile volunteers. In participants with azoospermia, the allelic frequency of the SYCP3 mutant allele (C allele) was significantly altered. Deletion of sY84 and sY86 was discovered in patients with azoospermia and oligozoospermia. Moreover, SYCP3 and DDX3Y showed decreased expression levels in the azoospermia group, and they exhibited potential as biomarkers for diagnosing azoospermia (area under the curve, 0.722 and 0.720, respectively). Conclusion: These results suggest that reduced SYCP3 and DDX3Y mRNA expression profiles in testicular tissue are associated with a higher likelihood of retrieving spermatozoa in individuals with azoospermia. The homozygous genotype TT of the SYCP3 polymorphism was significantly associated with azoospermia.

• Clinical and Experimental Reproductive Medicine
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• 제50권4호
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• pp.262-269
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• 2023

Objective: The aim of this study was to compare semen parameters and sperm DNA fragmentation (SDF) and explore the relationship between semen parameters and SDF between 2 and 7 days of abstinence and a short abstinence period (within 4 hours) in oligozoospermic infertile patients. Methods: Two semen samples were collected from infertile oligozoospermic men (n=34) after an abstinence period of 2 to 7 days and within 4 hours, respectively. Sperm parameters were compared between the two abstinence duration groups, including semen volume, sperm concentration, total sperm count, sperm motility, total motile sperm count (TMSC), morphology, and SDF. Results: The semen volume, concentration, and total sperm count were significantly decreased after 4 hours of abstinence than after 2 to 7 days of abstinence, with median differences of 1.2 mL (p<0.001), 2×10⁶/mL (p=0.011), and 9.6×10⁶/ejaculation (p<0.001), respectively. TMSC was significantly lower after a short abstinence, with a median difference of 4.24×10⁶/ejaculate (p<0.001). However, there were no significance differences in the percentage of motility, the SDF, and the percentage of sperm with normal morphology. Interestingly, volume, concentration, total sperm count, sperm motility, and SDF, but not TMSC, exhibited significant linear correlations between the two abstinence groups in univariate regression analysis, except for TMSC. Conclusion: In oligozoospermic men, the volume, concentration, and total sperm count were significantly lower after a short abstinence period, but without adverse effects on sperm motility and SDF.

• 한국산림과학회지
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• 제54권1호
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• pp.25-35
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• 1981

본(本) 연구(硏究)는 한국삼림토양(韓國森林土壤)의 특성(特性)을 파악(把握)하여 그 합리적(合理的) 이용(利用) 및 관리방법(管理方法)을 제공(提供)하기 위하여 실시되었다. 1979년(年) 까지 조사발표(調査發表)된 375개(個) 토양통(土壤統) 중(中)에서 93개통(個統)에 달하는 삼림토양(森林土壤)에 대해서 각종토양특성(各種土壤特性)이 비교분석(比較分析)되었다. 첫째로 이상(以上)의 자료(資料)를 풍화모재별(風化母材別)로 구분(區分)해서 비교평가(比較評價)하였고, 둘째로 다시 모암별(母岩別)로 구분(區分)해서 비교분석(比較分析)하여 본 결과 다음과 같은 결론(結論)을 얻었다. 1) 풍화모재별(風化母材別) 토양특성(土壤特性)을 보면 화산회토(火山灰土)가 가장 비옥(肥沃)한 토양(土壤)으로 사료(思料)되며 충적토(沖積土)가 가장 척박(瘠薄)한 토양(土壤)으로 나타난다. 산악잔적토(山岳殘積土)는 전토심(全土深)만 매우 얕은것을 제외하면 대부분(大部分)이 평균수준(平均水準)에 있다. 2) 화성암(火成岩)(Igneous rock)에서 생산(生産)된 토양(土壤)은 토심(土深)이 깊고 유기물함량(有機物含量) 및 유효인산함량(有效燐酸含量)이 풍부하고 강산성(强酸性)으로 비옥도(肥沃度)는 낮은 편이다. 반면(反面) 퇴적암(堆積岩)(Sedimentary rock) 토양(土壤)은 토심(土深)이 얕고 유기물(有機物) 및 유효인산(有效燐酸) 함량(含量)은 낮으나 약산성(約酸性)으로 비교적(比較的) 비옥(肥沃)하다. 3) 화성암중(火成岩中) 현무암(玄武岩)(Basalt)과 조면암(粗面岩)(Trachyte)은 매우 비옥(肥沃)한 토양(土壤)을 생성(生成)하나 화강암(花崗岩)(Granite)과 안산암(安山岩)(Andesite)은 약간 척박(瘠薄)한 토양(土壤)을 생성(生成)한다. 4) 퇴적암중(堆積岩中) 석회암(石灰岩)(Limestone)은 중성(中性)의 비옥(肥沃)한 토양(土壤)을 생성(生成)하나 유효인산함량(有效燐酸含量)은 매우 적다. 사암(砂岩)(Sand-stone)류(類)는 토심(土深)이 얕으나 기타 성질들은 평균적(平均的)인 수준(水準)을 유지하는 토양(土壤)을 생성(生成)한다. 5) 화강편마암(花崗片麻岩)(Granite gneiss)류(類)는 유기물(有機物) 및 유효인산함량(有效燐酸含量)은 평균수준(平均水準)이나 비교적(比較的) 척박(瘠薄)한 토양(土壤)을 생성(生成)한다. 6) 충적사토(沖積砂土)(Alluvial sand)는 경작지(耕作地) 충적토(沖積土)와는 대조적으로 토심(土深)이 깊은것 외에는 일반적으로 척박(瘠薄)한 토양(土壤)을 생성(生成)한다.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.83-93
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• 1997

Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many infertile couples with normal semen parameters, and certain couples cannot be accepted for standard IVF-ET due to unfertilization or extremely low fertilization rate of oocytes. Recently, several procedures of microassisted fertilization (MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after partial zona dissection (PZD), subzonal insertion (SUZI), and intracytoplasmic sperm injection (ICSI). This clinical study was performed to develop and establish ICSI as an effective procedure of MAF in infertile couples who could not undergo standard IVF-ET repetitively because of failure in fertilization or extremely low fertilization rate of oocytes with the conventional fertilization technique in the previous IVF-ET cycles. From March, 1995 to May, 1996, 27 cycles of IVF-ET with ICSI in 19 infertile patients were included in study group, and the outcomes of ICSI were analyzed according to fertilization rate, cumulative embryo score (CES), and pregnancy rate. The number of oocytes retrieved after controlled ovarian hyperstimulation (COH) was $10.50{\pm}6.13$ in 30 previous cycles, and $10.57{\pm}5.53$ in 27 ICSI cycles. In ICSI cycles, the number of oocytes optimal for ICSI procedure was $7.89{\pm}4.30$, and the fertilization rate of $67.9{\pm}20.2%$ could be obtained after ICSI. The number of embryos transferred was $1.43{\pm}2.40$ in previous cycles, and $4.36{\pm}1.77$ with the mean CES of $41.8{\pm}27.4$ in ICSI cycles. In ICSI cycles, the overall pregnancy rate was 29.6% (8/27) per cycle and 42.1% (8/19) per patient with the clinical pregnancy rate of 22.2% (6/27) per cycle and 31.6% (6/19) per patient. In conclusion, MAF of human oocytes with ICSI is a promising fertilization method for IVF-ET patients, especially with the past history of failure in fertilization or low fertilization rate of oocytes in the previous IVF-ET cycles, and ICSI using micromanipulation procedures applied to human oocytes will provide a range of novel techniques which may dramatically improve the pregnancy rate in IVF-ET program and contribute much to effective management of infertile couples.

• Clinical and Experimental Reproductive Medicine
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• 제34권2호
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• pp.87-94
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• 2007

목 적: 경계성 난소 종양 환자에 있어서 보존적 수술 후 임신에 성공한 군과 비임신 군간 환자의 특성에 차이가 있는지 알아 보았으며, 경계성 난소 종양의 보존적 수술 후 체외수정시술의 유용성에 대해 알아 보았다. 연구방법: 1995년 1월부터 1999년 10월까지 경계성 난소 종양으로 보존적 술을 시행 받은 가임 여성 가운데 임신에 성공한 군 (14명)과 비임신 군 (30명)간 환자의 특성에 차이가 있는지 알아 보았으며, 비임신 군 가운데 불임을 주소로 내원하여 체외수정시술을 시행 받은 5명의 10주기를 대상으로 체외수정시술 결과 및 체외수정시술 후 난소 종양의 재발 유무를 추적 관찰하였다. 결 과: 경계성 난소 종양의 보존적 수술 후 임신에 성공한 군과 비임신 군간 환자의 평균 나이는 25.9세와 27.0세이었으며 혈청 CA-125 수치는 59.7 U/m와 72.0 IU/ml로 비임신 군에서 높은 경향을 보였으나 통계적 유의성은 없었다. 불임을 주소로 체외수정시술을 시행 받은 5명의 10주기 (attempt IVF cycle) 가운데 취소된 2주기를 제외하고 (attempt cycle cancellation rate, 20.0%) 채취된 난자 수는 평균 5.6개 (2$\sim$16개)이었으며 수정율은 14.5% (50.0$\sim$100.0%)이었다. 평균 2.4개 (1$\sim$4개)의 배아를 이식하였으며 배아이식 주기당 임신율과 착상율 및 출생율은 각각 50.0% (4/8 cycle), 31.6% 및 50.0% (4/8 cycle)이었다. 체외수정시술 후 평균 29.6개윌 (14$\sim$61개월)의 추적 관찰 기간 동안 난소 종양이 재발된 경우는 없었다. 결 론: 경계성 난소 종양의 보존적 수술 후 임신에 성공한 군과 비임신 군간 환자의 특성에 차이가 없으며, 보존적 수술 후 체외수정시술의 결과는 비교적 만족할 만한 수준으로 체외수정시술은 경계성 난소 종양의 보존적 수술후 고려될 수 있으나 향후 많은 환자를 대상으로 한 장기간의 추적 관찰을 필요로 한다.

• Clinical and Experimental Reproductive Medicine
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• 제16권2호
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• pp.173-177
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• 1989

Defective or inadequate semen quality, usually presenting as low sperm count or poor sperm motility , is recognizable by semen analysis. However, the ability of spermatozoa to fertilize an ovum is not determined used in various experiments. In this study, hamster oocyte sperm penetration assay was used to determine the fertilizing capacity of sperms in 20 subjects which divided into two groups, group A with 10 normal fertile men, and group B with 10 infertile men. The % penetration in group A and group B were 61% and 35% respectively, which showed statistically not significant but fertilization index was significantly different between group A(FI=2.24) and group B(FI=O.05). Additionally it seemed that the percentage of sperm penetraton was influenced more by the motility of spermatozoa than by the number.