• Clinical and Experimental Reproductive Medicine
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• 제24권3호
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• pp.293-300
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• 1997

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

• Clinical and Experimental Reproductive Medicine
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• 제38권2호
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• pp.98-102
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• 2011

Objective: To investigate the effects of pioglitazone on controlled ovarian stimulation (COS), IVF outcomes, and follicular fluid (FF) cytokine concentrations in patients with polycystic ovary syndrome (PCOS). Methods: Eighty-six infertile patients with PCOS resistant to clomiphene citrate were randomized to receive pioglitazone (30 mg/day) or placebo on the starting day of oral contraceptive (OC) pretreatment, followed by an IVF protocol using a GnRH antagonist. Pioglitazone or placebo was administered once daily from the starting day of OC to the day of hCG injection. Results: Total dose and days of recombinant follicle-stimulating hormone administered, and the numbers of retrieved and mature oocytes, were significantly lower in the pioglitazone group than in the control group. FF tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-6 (IL-6) concentrations at oocyte retrieval were also significantly lower in the pioglitazone group. The clinical pregnancy rate was higher and the incidence of severe ovarian hyperstimulation syndrome was lower in the pioglitazone group, but the differences were not statistically significant. Conclusion: Pioglitazone reduces FF TNF-${\alpha}$ and IL-6 levels, and may improve ovarian response to COS in patients with PCOS.

• 한국인구학
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• 제5권1호
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• pp.133-144
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• 1982

One of the primary objectives of Korean family planning program is to assist parents in having the number of children they want, both by providing fertility-en-hancing services to infecund and subfecund women and by providing fertility-limitation services to fecund women. As far as fertility-enhancing services to infecund and subfecund women is concerned, there has been little effort from the national family planning program, So far, there is no any basic data on infertility prevalence rate among the Korean women. Therefore, an attempt has been made to review data of 1976 and 1978 fertility and family planning surveys in order to estimate the level of infertility rate among the Korean women. In the 1978 survey 3. 7 percent of the current married women responded that they were physically infertile while in the 1976 survey physically infer-tile women was calculated as 3 percent of the total ever married women which is similar level of 1978 data of 3.7 percent. Mean age at first marriage of Korean women is 23 and most of the women are married in the high fecund age. Only 0.3 percent of the respondents married age 30. in addition, the rate of women with no children among the ever married women whose married duration is more than 5 year is very low;2. 5 percent among 5-9 years, 1. 4 percent among 10- 14 years; 1.8 precent among 15-19 years; 1.0 percent among 20-24 years; and 0. 7 percent among 25 or more years of marriage duration. If we consider those data shown above, it is manifest that infertility rate of Korean women is less than 5 percent level which is much lower than the 10 percent level of infertility rate in the United States of America. However, this kind of estimation is still not able to show definite data on fertility rate. Therefore, a nationwide planned survey should be carried out as early as possible to figure out the real situation of infertility rate in Korea.

• 대한예방한의학회지
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• 제18권3호
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• pp.1-10
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• 2014

Objective : The purpose of this study is to assess the communication and medical interview level of the students in the college of korean traditional medicine using Standardized Patients(SP). Method : 35 students of 5th grade in the college who are doing their clinical practice class participated and conducted medical interview on standardized infertile female patient. SP and professor who observed the interview evaluated the students' communication skill and medical interview level using the assessment sheet composed of 23 questions. Results : 1. Satisfaction of SP was 1.66 of 3. In the communication section, students conducted well in appropriate voice and no inappropriate interruption but they didn't show good practice in considerate physical examination, understandable explanation relatively. 2. The scores that were acquired by students in informing the time required, obtaining agreement at initiating and closing, family history taking, checking mental status and physical examination 2 were low in the medical interview section. 3. There were some differences in the communication and medical interview scores by the students' sex (p<.01), age(p<.05) and medical camp experience(p<.05). But we couldn't find any evidence about the relation between character type and the communication and medical interview scores(p>.62). Conclusion : On the whole, students who participated this study had difficulties in building relationship with patient and conducting medical interview. They need to improve their ability in those fields by appropriate education before their graduation.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.223-230
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• 2005

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

• Clinical and Experimental Reproductive Medicine
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• 제44권3호
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• pp.141-145
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• 2017

Objective: Delaying embryo transfer (ET) enables us to select among the embryos available for transfer and is associated with positive effects on implantation and pregnancy outcomes. However, the optimal day for ET of human cleavage-stage embryos remains controversial. Methods: A retrospective study of 3,124 in vitro fertilization/intracytoplasmic sperm injection cycles (2,440 patients) was conducted. We compared the effects of day 2 and 3 ET on rates of implantation and pregnancy outcomes between young maternal age (YMA; < 38 years old, n = 2,295) and old maternal age (OMA; ${\geq}38years\;old$, n = 829) patient groups. Results: The YMA and OMA groups did not differ in terms of patient characteristics except for the proportion of unexplained factor infertility, which was significantly greater in the OMA group, and the proportion of arrested embryos, which was significantly greater in the YMA group. However, the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion, and implantation rates per cycle were not significantly different between day 2 and 3 ET in the YMA group or the OMA group. Conclusion: We suggest that offering patients the opportunity to decide which day would be suitable for ET could be part of a patient-friendly protocol that takes into consideration an infertile woman's circumstances and work schedule by allowing ET to be performed on day 2 instead of the traditional transfer on day 3.

• 농업과학연구
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• 제46권2호
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• pp.361-368
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• 2019

The objective of the current study was to determine calcium (Ca) and phosphorus (P) utilization in 4 different hatchery by-products (HBPs) for broiler chickens. The four different HBPs included infertile eggs (IFE), unhatched eggs (UHE), low grade and dead chicks (LDC), and a mixture (MIX) of 55% IFE, 10% UHE, and 10% LDC with 25% hatched eggshells. A total of sixty four 50-day-old Ross 308 broiler chickens were randomly allotted to 1 of 4 dietary treatments with 8 replicates per treatment. Two birds were placed together in one metabolic cage. Additional 16 birds were used to measure the endogenous losses of Ca and P. A forcefeeding procedure (i.e., crop intubation) was used to measure the apparent and true total tract retention (ATTR and TTTR, respectively) of Ca and P in the 4 HBPs. The results showed that the TTTR of Ca in the UHE was less (p < 0.05) than that in the IFE, LDC, and MIX. The amounts of available Ca in the MIX were greater (p < 0.05) than those in the IFE and UHE, which were greater (p < 0.05) than those in the LDC. The TTTR of P was not different among the 4 HBPs. However, the amounts of available P in the LDC were greater (p < 0.05) than those in the IFE and UHE, which were greater (p < 0.05) than those in the MIX. In conclusion, HBPs contain high amounts of available Ca and P because of high concentrations of total Ca and P with a high utilization rate. Therefore, the use of HBPs in broiler diets can reduce costs on Ca and P supplements.

• 대한한방부인과학회지
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• 제35권2호
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• pp.1-15
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• 2022

Objectives: The purpose of this study is to report the results of Korean medicine treatment infertility support program in Gwang-ju Metropolitan City in 2021. Methods: Participants of Korean medicine treatment infertility support program were provided Herbal medicine, acupuncture, pharmacopuncture and Counseling for 3 months and followed up for 3 months after the treatments. The project was carried out for 100 infertile women under the age of 42 living in Gwang-ju Metropolitan City, of which 91 completed treatment until the end. Collected data of 91 women containing pregnancy rates, characteristics of subjects, treatments, and satisfaction of the program were analyzed. Results: After the treatment, 23 out of 91 subjects were pregnant, two of whom were miscarried, and 21 were maintained. The average age of pregnant women in 23 pregnant subjects was 33.8 years old, of which the average age of those who maintained pregnancy was 32.4 years old, and the age of one miscarried person was 39 years old. More than 85% of subjects answered that they were satisfied with the program in the satisfaction survey. Conclusions: Based on this report, the clinical data were obtained from the infertility treatment program. This study can be used as basic data to help establish infertility support programs and subsequent policies like support for men in the future Korean medicine infertility project and extension of the herbal medicine treatment period.

• Journal of Genetic Medicine
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• 제19권1호
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• pp.14-21
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• 2022

Complex chromosome rearrangements (CCRs) are structural chromosomal rearrangements involving at least three chromosomes and more than two breakpoints. CCR carriers are generally phenotypically normal but related to higher risk of recurrent miscarriage and having abnormal offspring with congenital anomalies. However, most of CCR carriers are not aware of their condition until genetic analysis of either abortus or affected baby or parental karyotyping is performed. Herein, we present the case that CCR carrier patients can be identified by preimplantation genetic testing of preimplantation embryos. An infertile male patient with severe oligoasthenoteratozoospermia was diagnosed balanced reciprocal translocation, 46,XY,t(3;11) (p26;p14) at first. After attempting the first preimplantation genetic testing for structural rearrangement (PGT-SR) cycle, we found the recurrent segmental gain or loss on 21q21.3-q22.3 of five out of nine embryos. As a result of karyotype re-analysis, the patient's karyotype showed a balanced CCR involving chromosomes 3, 11, and 21 with three breakpoints 3p26, 11p14, and 21q21. The patient underwent two PGT-SR cycles, and a pregnancy was established after the transfer of an euploid embryo in the second cycle. Amniocentesis confirmed that the baby carried normal karyotype without mosaicism. At 37 weeks gestation, a healthy girl weighting 3,050 g was born.

• Clinical and Experimental Reproductive Medicine
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• 제50권3호
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• pp.185-191
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• 2023

Objective: Although intracytoplasmic sperm injection (ICSI) is a way to deal with in vitro fertilization failure, 3% of couples still experience repeated fertilization failure after attempted ICSI, despite having sperm within normal parameters. These patients are a challenging group whose sperm cannot fertilize the egg during ICSI. Unfortunately, no test can predict the risk of fertilization failure. Phospholipase C zeta (PLCζ) and transition nuclear proteins (TNPs) are essential factors for chromatin packaging during sperm maturation. This study aimed to assess PLCζ1 and TNP1 expression in the sperm of patients with fertilization failure and the correlations among the DNA fragmentation index, PLCζ1 and TNP1 gene and protein expression, and the risk of fertilization failure. Methods: In this study, 12 infertile couples with low fertilization rates (<25%) and complete failure of fertilization in their prior ICSI cycles despite normal sperm parameters were chosen as the case group. Fifteen individuals who underwent ICSI for the first time served as the control group. After sperm analysis and DNA fragmentation assays, quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and Western blot analyses were performed to compare the gene and protein expression of PLCζ and TNP1 in both groups. Results: DNA fragmentation was significantly higher in the fertilization failure group. The qRT-PCR and Western blot results demonstrated significantly lower PLCζ and TNP1 gene and protein expression in these patients than in controls. Conclusion: The present study showed that fertilization failure in normozoospermic men was probably due to deficient DNA packaging and expression of TNP1.