• Title/Summary/Keyword: Infertile

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The Effect of Oriental Medicine Therapy on Results of In Vitro Fertilization-Embryo Transfer (한방치료가 체외수정시술에 미치는 영향)

  • Lee, Yoon-Jae;Kim, Eun-Ki;Choi, Dong-Hee
    • The Journal of Korean Medicine
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    • v.31 no.2
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    • pp.71-77
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    • 2010
  • Objectives: We investigated whether oriental medical therapy influences the results of in vitro fertilization-embryo transfer. Methods: 19 women with infertility were treated by oriental treatment from August 1999 to June 2000 in the department of obstetrics and gynecology of an oriental medical center. The women were planning in vitro fertilization-embryo transfer after oriental medicine treatment. The data from the women was analyzed, we obtained the following results. Results: The average age of infertile women was $35.42{\pm}4.86$; infertility caused by male factor or tubal factor were the most frequent. The average number of previous failed IVF treatments was $2.21{\pm}1.81$. The number of aspirated oocytes was $9.00{\pm}6.09$ in IVF cycle before oriental therapy, increasing to $9.80{\pm}5.41$ after therapy, but it was not statistically significant. In IVF before oriental therapy, the average number of embryos transfer was $3.20{\pm}1.90$, and it significantly increased to $4.40{\pm}1.45$ after treatment. The quality points of embryos were $10.00{\pm}6.02$ before treatment, but statistically significantly improved to $14.07{\pm}4.98$ after. The characteristics of women being pregnant and non-successful women were compared with age, period of taking herbal medicine and the number of failed IVF treatments, but there was no significant difference. Conclusion: Oriental treatment before IVF could be expected to have good results in treatment of infertility.

Molecular Variants of the $LH{\beta}$-subunit in Infertile Patients with Polycystic Ovary Syndrome (PCOS) in Korean Women (한국인의 다낭성 난포증후군 불임환자에서 황체형성 호르몬 유전자의 분자변이 연구)

  • Kim, Nam-Keun;Chung, Hyung-Min;Lee, Eu-Gene;Nam, Yoon-Sung;Choi, Dong-Hee;Sohn, Tae-Jong;Lee, Sook-Hwan;Ko, Jung-Jae;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.2
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    • pp.173-177
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    • 2000
  • 연구목적: 한국여성의 다낭성 난포증후군 환자에서 황체형성 호르몬 exon 2 유전자의 변이를 탐색하여 이들 변이와 질환과의 관련성 여부를 밝히고자 하였다. 연구재료 및 방법: 21명의 다낭성 난포증후군 환자를 대상으로 황체형성 호르몬 exon 2(Trp8Arg;TGG to CGG and Ile15Thr; ATC to ACC)의 변이를 탐색하였다. 혈액에서 Genomic DNA를 추출하여 PCR로 증폭한 후 RFLP 방법으로 변이형을 구분하였다. 결과: 황체형성 호르몬 exon 2의 변이형이 다낭성 난포증후군 환자에서 28.6%로 이미 조사된 바 있는 대조군의 16.7% 보다 약간 높게 나타났으나 통계적으로 유의한 차이는 없었다(p>0.05). 결론: 황체형성 호르몬 exon 2의 변이가 한국인의 다낭성 난포증후군 발병과 관련이 있는지를 밝히기 위해 더 많은 개체에 대한 연구가 요구된다.

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Pregnancy Rate by Intrauterine Insemination (IUI) or Timed-Intercourse In Stimulated Cycles with Clomiphene Citrate and Gonadotropins (Clomiphene Citrate와 성선자극호르몬을 병합한 배란유도주기에서 성교와 인공수정에 의한 임신율의 비교)

  • Hong, Jeong-Eui;Lee, Ji-Sam
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.31-41
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    • 1999
  • To evaluate the effectiveness of intrauterine insemination (IUI) in the treatment of infertility, timed-intercourse and intrauterine insemination by husband in stimulated cycles with clomiphene citrate and gonadotropins were compared in a total of 105 cycles. Patients received 100mg of clomiphene citrate daily for 5 days starting on day 3 of the menstrual cycle followed by hMG or FSH. Doses of exogenous gonadotropins were adjusted by the follicular development and concentrations of serum estradiol $(E_2)$. More than 3 follicles reaching >16 mm were present in the ovary, 5,000 IU of hCG was administered intramusculary. Patients received a maximum of three intercourse or IUI cycles for the treatment. Severe male (<$10{\times}10^6$ motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. The overall clinical pregnancy rates were 17.1% per cycle (18/105) and 21.2% per patient (18/85). The pregnancy rates (per cycle) were 17.5% (11/63) in intercourse and 16.7% (7/42) in IUI groups, respectively. IUI had no significant improvement in pregnancy rate compared with timed-intercourse. The multiple pregnancy rates were 11.1% (1 twin and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rate was 28.6% (2/7) in IUI group only. The delivery and ongoing pregnancy rates were 15.2% per cycle (16/105) and 18.8% per patient (16/85). There were no differences in age, duration of infertility, follicle size and level of estradiol $(E_2)$ on the day of hCG injection in pregnant and non-pregnant groups. However, total doses of gonadotropins were higher in pregnant group than in non-pregnant group (p<0.01). Pregnancy rate was not affected by ovulatory status at the time of insemination. These results indicate that well timed-intercourse in stimulated cycles is as effective as IUI for infertile couples.

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ROLE OF REACTIVE OXYGEN SPECIES IN MALE INFERTILITY

  • Sharma, Rakesh K.;Agarwal, Ashok
    • 대한생식의학회:학술대회논문집
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    • 2000.06a
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    • pp.13-28
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    • 2000
  • Human spermatozoa exhibit a capacity to generate ROS and initiate peroxidation of the unsaturated fatty acids in the sperm plasma membrane, which plays a key role in the etiology of male infertility. The short half-life and limited diffusion of these molecules is consistent with their physiologic role in key biological events such as acrosome reaction and hyperactivation. The intrinsic reactivity of these metabolites in peroxidative damage induced by ROS, particularly $H_2O_2$ and the superoxide anion, has been proposed as a major cause of defective sperm function in cases of male infertility. The number of antioxidants known to attack different stages of peroxidative damage is growing, and it will be of interest to compare alpha-tocopherol and ascorbic acid with these for their therapeutic potential in vitro and in vivo. Both spermatozoa and leukocytes generate ROS, although leukocytes produce much higher levels. The clinical significance of leukocyte presence in semen is controversial. Seminal plasma confers some protection against ROS damage because it contains enzymes that scavenge ROS, such as catalase and superoxide dismutase. A variety of defense mechanisms comprising a number of antioxidants can be employed to reduce or overcome oxidative stress caused by excessive ROS. Determination of male infertility etiology is important, as it will help us develop effective therapies to overcome excessive ROS generation. ROS can have both beneficial and detrimental effects on the spermatozoa and the balancing between the amounts of ROS produced and the amounts scavenged at any moment will determine whether a given sperm function will be promoted or jeopardized. Accurate assessment of ROS levels and, subsequently, OS is Vital, as this will help clinicians both elucidate the fertility status and identify the subgroups of patients that respond or do not respond to these therapeutic strategies. The overt commercial claims of antioxidant benefits and supplements for fertility purposes must be cautiously looked into, until proper multicentered clinical trials are studied. From the current data it appears that no Single adjuvant will be able to enhance the fertilizing capacity of sperm in infertile men, and a combination of the possible strategies that are not toxic at the dosage used would be a feasible approach.

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Clinical Analysis and Investigation for the Infertile Women with Hyperprolactinemia (불임환자의 고 Prolactin 혈증에 관한 연구)

  • Kang, S.B.;Kang, B.M.;Kim, J.G.;Lee, J.Y.;Chang, Y.S.
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.1
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    • pp.21-28
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    • 1986
  • It is now apparent that many cases of amenorrhea. oligomenorrhea. corpus luteum deficiency, galactorrhea, and infertility are due to hyperprolactinemia. We investigated the relationships between serum prolactin values and factors such as menstrual pattern, frequency of galactorrhea etc, in 135 hyperproIactinemic patients at the Seoul National University Hospital during a period of 6 years, from January, 1979 to December, 1984. The results was as follows: 1. Menstrual pattern changed according to the serum prolactin level. The frequency of amenorrhea is 1.7 percent in patients with serum prolactin levels ranged from $25{\sim}40ng/ml$, whereas 72.4 percent in patients with serum prolactin levels above 100ng/ml. 2. The incidence of galactorrhea in hyperprolactinemic patients was 3.1 percent and the frequency of galactorrhea had direct relationship with the serum prolactin level and/or the frequency of abnormal menstrual pattern. 3. The incidence of pituitary tumor in hyperprolactinemic patients was 104 percent and sixty percent of patients with serum prolactin levels above 100ng/ml had a pituitary tumor . 4. There was an inverse correlation between serum prolactin and progesletone value. 5. The frequency of anovulatory menstrual cycle evidenced by basal body temperature is 23.9 percent in patients with serum prolactin levels ranged from $20{\sim}40ng/ml$, whereas 76.9 percent in patients with serum prolactin levels above 100ng/ml.

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A Study on the Methods to Evaluate Adequacy of Luteal Function (황체기능 평가에 관한 연구)

  • Bai, Kwang-Bum;Kim, Jung-Gu;Moon, Shin-Yong;Lee, Jin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.13 no.2
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    • pp.113-119
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    • 1986
  • The present study was designed to assess the relationships between the methods to evaluate adequacy of luteal function. We measured mid-luteal serum progesterone levels by radioimmune assay, luteal phase lengths and mean post-ovulatory basal body temperature rise rates by basal body temperature charts in 40 in-phase-cycle infertile patients and 38 out-of-phase-cycle patients who underwent late-luteal endometrial biopsies at the sterility clinic of Department of Obstetrics and Gynecology, Seoul National University Hospital from Jan. 1986 to Aug. 1986. The results were summarized as follows: 1. No significant differences were found in mean age, mean duration of infertility, mean mid-luteal serum progesterone levels, and mean post-ovulatory temperature rise rate between in-phase-cycle patients and out-of-phase-cycle patients, but significant difference in mean luteal phase length between 2 groups was identified. 2. 91% of total patients sho had luteal phase lengths of less than 11 days showed out-of-phase-cycles. 3. In out-of-phase-cycle group with luteal phase lengths of less than 11 days, 50% had an endometrial lag of at least 4 days, but 10.7% had an endometrial lag of 4 or more days in group with luteal phase lengths of more than 11 days. 4. There was no significant correlation between mid-luteal serum progesterone level and endometrial lag of late luteal phase endometrial biopsy.

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Successful Clinical Pregnancy and Livebirth was Achieved after Intracytoplasmic Sperm Injection in a Globozoospermic Patient: A Case Report (Globozoospermia를 가진 불임환자에서 미세정자주입술을 이용한 체외수정시술 후 임신과 분만 1례 보고)

  • Kim, Eun-Kyung;Kim, Eun-Ha;Kim, Eun-Ah;Kwon, Hwang;Hong, Jae-Yup;Choi, Dong-Hee
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.83-88
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    • 2010
  • Objective: Globozoospermia is observed in <0.1% of male infertile patients. The aim of this study is to report the successful clinical outcome in man with globozoospermia. Design: A case report. Method: A 36-year-old man and 32-year-old partner visited our fertility center with 6 years infertility duration. The semen analysis revealed globozoospermia combined with oligozoospermia which was stained with Diff-Quick method. ICSI (Intracytoplasmic sperm injection) was performed on 12 matured oocytes. Result: 5 injected oocytes were fertilized normally. 5 embryos were transferred on day 3 after oocyte retrieval. The patient became pregnant and delivered a healthy boy at 39 weeks of gestation. Conclusion: In case of globozoospermia, it has a low fertilization rate even though ICSI method is used. The favorable technique is still needed to increase the fertilization rate.

Analysis of $LH{\beta}$ Exon 3 (Gly102Ser) Gene Mutation in Infertile Patients with Endometriosis and Polycystic Ovary Syndrome (PCOS) (자궁내막증과 다낭성 난포증후군 불임환자에서 $LH{\beta}$ Exon 3 (Gly102Ser) 유전자의 돌연변이 분석)

  • Kim, Nam-Keun;Lee, Eu-Gene;Cho, Min-Soon;Nam, Yoon-Sung;Chung, Hyung-Min;Chung, Ki-Wha;Oh, Yu-Kyoung;Ko, Jung-Jae;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.3
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    • pp.291-294
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    • 2000
  • 연구목적: 본 연구는 자궁내막증과 다낭성 난포증후군 불임환자들을 대상으로 $LH{\beta}$ exon 3 (Gly102Ser) 유전자의 돌연변이를 탐색하고자 시도하였다. 연구재료 및 방법: 그 대상으로 26명의 자궁내막증 환자와 52명의 다낭성 난포증후군 환자 그리고, 50명의 출산 경험이 있는 건강한 여성을 대조군으로 사용하였다. 이들을 대상으로 한 돌연변이 탐색은 PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) 방법으로 수행되었다. 결과 : 그 결과 자궁내막증과 다낭성 난포증후군 환자 및 출산 경험이 있는 건강한 여성에서 그 변이형이 나타나지 않았다. 결론: 따라서, 자궁내막증과 다낭성 난포증후군 불임환자의 $LH{\beta}$ exon 3 돌연변이형은 중국인 집단에만 존재할 가능성이 높으며, 더 많은 불임환자들을 대상으로 한 연구가 요구된다.

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Radionuclide Tubal Function Test (방사핵을 이용한 난관기능검사)

  • Roh, T.S.;Kim, J.G.;Yoon, B.H.;Moon, S.Y.;Lee, J.Y.;Chang, Y.S.;Chung, J.K.
    • Clinical and Experimental Reproductive Medicine
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    • v.14 no.1
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    • pp.1-6
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    • 1987
  • The Radionuclide test (RN test) using radioactively labelled human albumin microspheres was developed recently to evaluate the patency and functional capacity of the fallopian tubes. 57 infertile women underwent this procedure as a part of their infertility work up. The results of the radionuclide evaluation were compared with those of the hysterosalpingography (HSG) and further the surgical findings of the laparoscopy and laparotomy. In 64.9%(37/57) of the cases, there was complete agreement between radionuclide test (RN test), hysterosalpingography(HSG) and surgical findings. In comparison with surgical findings, RN test showed a complete agreement rate of 89.4%(51/57), a partial agreement rate of 5.3%(3/57) and no agreement rate of 5.3%(3/57), respectively. Likewise, HSG revealed a complete agreement rate of 80.7%(46/57), a partial agreement rate of 10.5%(6/57) and no agreement 8.8%(5/57), respectively. It would appear that as opposed to the traditional HSG, RN test may give a better understanding of the functional capacity of the tube and may prove a useful method before and after tubal surgery.

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Complications and Difficulties in Alternative Methods of Conception (인공수태(人共受胎)의 합병증(合倂症)과 난점(難點)에 관(關)한 연구(硏究))

  • Ku, Pyong-Sahm
    • Clinical and Experimental Reproductive Medicine
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    • v.14 no.1
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    • pp.29-35
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    • 1987
  • Alternative methods were used in the field of infertility as the latest means for the treatment of misconception. Artificial insemination, which has been commonly used already, IVF-ET and GIFT are also used as artificicial method for conception presently. Appling such methods to the patient, following three categories should be considered; first, there should be an understanding and an agreement from the patient, second, if possible, reduce the cost of hospital expense and relieve physical and emotional problems of the patient, and third, increcrsing the pregnancy rate. Under these considerations, complication and pitfalls of artifical inseminations are a big burden to the physian and the patient. Though the conicicental complications are relatively very rare, detailed laboratoy tests, carefull examinations, and follow-up studies are necessary. In the distribution of the age groups, 40.3% was in the 25 to 29 years group, 30 to 34 years was 45%. 35 to 39 years was 8% and only 3.2% was above the 40 age groups. The range of infertile periods were from 1 to 17 years, and half of the patients were over 5 years, the other group 20% in 3 years and 2 to 4 years were 10%. Among 159 cycles of artificial insemination, there were complications such as infection(1.9%) and discomfort(5%) and abnormal bleeding (0.6%). During pregnancy, clinical abortion (1.9%) and toxemia (2.5%) were shown. Sex of new born infants were, male (68%) and female (31%). Fortunately, there were no cases of psychological complication and genetic abnormality. Indications of artificial insemination for male factors were aspermia (2.5%), azoospermia (28.8%), oligospermia (26.4%) and asthenozoospermia (1.8%), for female factors were irregular cycle (11.7%) and dysmucorrhea.

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