• Title/Summary/Keyword: Infertility Patients

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Influence on the Pregnancy Rate of Motility of Fresh and Frozen Testicular Spermatozoa in Obstructive Azoospermic Patients (폐쇄성 무정자증 환자의 신선고환조직 정자와 동결고환조직 정자의 운동성이 임신율에 미치는 영향)

  • Park, Yong-Seog;Lee, Hyoung-Song;Byun, Hye-Kyung;Youm, Hye-Won;Song, Sang-Jin;Lim, Chun-Kyu;Lee, You-Sik;Yun, Jong-Min;Seo, Ju-Tae;Song, Ji-Hong;Kang, Inn-Soo;Koong, Mi-Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.28 no.2
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    • pp.155-160
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    • 2001
  • Objective: ICSI with testicular sperm could achieve optimal fertilization and pregnancy. This study was performed to observe the influence on fertilization and pregnancy of motility of fresh testicular sperm and sperm extracted from frozen-thawed seminiferous tubules in obstructive azoospermia. Materials and Methods: We analysed clinical outcome of ICSI using fresh testicular sperm and sperm extracted from thawed seminiferous tubules. The presence of motility were compared to determine the factor for optimal fertilization and pregnancy rates. Results: In 316 cases of TESE-ICSI in obstructive azoospermia, ICSI with fresh testicular sperm (fresh sperm group) were 163 cases and ICSI with sperm testicular sperm extracted from frozen-thawed seminiferous tubule (thawed sperm group) were 153 cases. The fertilization rates were 71.3% and pregnancy rates were 32.5% in fresh sperm group, in thawed sperm group, 65.1% and 33.3% respectively. The fertilization and pregnancy rates of motile and non-motile testicular sperm were 72.9% and 33.6%, 50.0% and 18.2%, respectively (p<0.05). The fertilization and pregnancy rates of motile and non-motile sperm extracted from the thawed seminiferous tubule were 67.8% and 34.7%, 55.1% and 28.1%, respectively (p<0.05). The comparative of the results of ICSI using motile fresh testicular sperm and motile sperm extracted from thawed seminiferous tubule, fertilization and pregnancy rates were not significantly different (72.9% and 33.6%, 67.8% and 34.7%, respectively). Conclusion: These results suggest that successful pregnancy in TESE-ICSI treatment is influenced by the motility of fresh testicular sperm and sperm extracted from thawed seminiferous tubule in obstructive azoospennic patients.

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The use of gonadotropin-releasing hormone antagonist post-ovulation trigger in ovarian hyperstimulation syndrome

  • Chappell, Neil;Gibbons, William E.
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.57-62
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    • 2017
  • The purpose of this paper is to assimilate all data pertaining to the use of gonadotropin-releasing hormone (GnRH) antagonists in in vitro fertilization cycles after ovulation trigger to reduce the symptoms of ovarian hyperstimulation syndrome (OHSS). A systematic review of the literature was performed to identify all studies performed on the use of a GnRH antagonist in IVF cycle post-ovulation trigger with patients at high risk for OHSS. Ten studies were identified and reviewed. Descriptions of the studies and their individual results are presented in the following manuscript. Due to significant heterogeneity among the studies, it was not possible to perform a group analysis. The use of GnRH antagonists post-ovulation trigger for treatment of OHSS has been considered for almost 20 years, though research into its use is sparse. Definitive conclusions and recommendations cannot be made at this time, though preliminary data from these trials demonstrate the potential for GnRH antagonists to play a role in the treatment of OHSS in certain patient populations.

Role of Acrosomal Matrix in Mammalin Fertilization (포유류 수정과정에서 정자 첨체기질의 기능)

  • Kim, Kye-Seong;George L. Gerton
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2001.05b
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    • pp.4-16
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    • 2001
  • Sperm competent for fertilization can become capacitated, bind to the zona pellucida (ZP)of an egg in a specific manner, and complete acrosomal exocytosis. Failure to carry out these functions results in infertility. Although the interactions between the ZP and the plasma membrane overlying the sperm acrosome have been considered important for sperm-egg recognition and signalling recent results have prompted a reassessment of current paradigms concerning these interactions. In this review, we're going to discuss about the roles of the acrosomal matrix, the particulate component of the acrosomal contents, in fertilization. The general hypothesis is that acrosomal exocytosis leads to the exposure of acrosomal matrix proteins that become de facto extracellula matrix(ECM) on the surface of the sperm head, and that the dynamic interactions of this newly-exposed sperm ECM with the egg ECM (the ZP) govern sperm-egg recognition and sperm penetration of the ZP. Informations from these experiments may provide new ways to address the poor ZP binding of sperm from some human infertility patients and may offer new avenues for contraception through the disruption of purposeful sperm-ZP binding.

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One Case Report of Infertile Woman Taking Whidam's Su-Gi therapy with Korean Medical Treatment (휘담식 수기요법을 중심으로 한 난임 치료 임상 1례 보고)

  • Jeong, Eun-Ji;Pi, Chien-Mei;Ahn, Hun-Mo;Jang, Sang-Chul;Bae, Jae-Ryong
    • Journal of Korean Medical Ki-Gong Academy
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    • v.17 no.1
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    • pp.64-82
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    • 2017
  • Objectives : This paper is to report a natural pregnancy of Whidam's Su-Gi therapy with korean medical treatment on a infertile patient who had a missed abortion and was repeatedly failed in IVF-ET. Methods : A patient who had infertility problem had a missed abortion, endometrial curettage and IVF-ET several times. In this study, the patient steadily took a Whidam's Su-Gi therapy with korean medical treatment such as herbal medication, acupuncture, and cupping therapy, and so forth. Results : Through taking Whidam's Su-Gi therapy without assisted reproduction techniques, the patient got pregnant naturally. Conclusions : This case suggest that Whidam's Su-Gi therapy with korean medical treatment is effective in treating infertile female after missed abortion and failure in IVF-ET and inducing natural pregnancy. Therefore, there needs to be more trial on infertile patients treated with Su-Gi therapy with korean medical treatment.

Clinical Consideration of Obese Infertile Women (비만 불임여성에 대한 임상적 고찰)

  • Nam, Yoon-Sung;Jeong, Chang-Jin;Kim, Nam-Keun;Yoon, Tae-Ki;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.3
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    • pp.209-214
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    • 2002
  • Objective : To analyze the clinical characteristics of obese infertile women. Material and Method: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose/insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. Results: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. Conclusions: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.

Effects of Irrational Parenthood Cognition, Post Traumatic Stress Disorder and Spousal Support on Quality of Life of Infertile Women (난임 여성의 비합리적 부모신념, 외상 후 스트레스 장애, 배우자 지지가 삶의 질에 미치는 영향)

  • Yang, So Ra;Yeo, Jung Hee
    • Women's Health Nursing
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    • v.23 no.2
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    • pp.145-153
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    • 2017
  • Purpose: This study examined degrees of irrational parenthood cognition, post traumatic stress disorder (PTSD), spousal support, and quality of life and investigated factors that influence the quality of life of infertile women. Methods: Research design was a cross sectional correlational survey with a total of 113 female patients receiving treatment for infertility. Data were collected from August 1 to November 30, 2015. The collected data were analyzed using t-test, ANOVA, Pearson's correlation, and multiple regression analysis. Results: The mean score of the quality of life was $59.0{\pm}14.8$. The quality of life was significantly associated with irrational parenthood cognition (r=-.70), post traumatic stress disorder (r=-.65), and spousal support (r=.56). The factors significantly affecting the quality of life in infertile women were irrational parenthood cognition (${\beta}=-.45$), post traumatic stress disorder (${\beta}=-.34$), and spousal support (${\beta}=-.32$). The explained variance by these factors was 70.4%, and the regression model was valid (F=89.81, p<.001). Conclusion: This study may contribute to the development of nursing intervention program to improve the quality of life of infertile women.

Clinical Experiences of Gamete Intrafallopian Transfer (GIFT) Procedure (Gamete Intrafallopian Transfer(GIFT)방법의 임상체험에 관한 고찰)

  • Song, J.S.;Park, Y.S.;Kye, Y.S.;Kim, E.I.;Hur, K.O.;Han, C.W.;Mok, Y.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.17 no.2
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    • pp.145-151
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    • 1990
  • This study was carried out to elevating the pregnancy rate in infertile patient by Gamete intrafallopian transfer (GIFT). The GIFT program was performed from July 1988 to June 1990. Of the 131 cycles, the mean age of patient was 31.6 years and the mean duration of infertility was 5.3 years. 41 patients became pregnant, for a pregnancy rate of 31.3%. 5 preclinical abortions and 6 clinincal abortion was occured. 2 ectopic pregnanices and 1 combined pregnancy were occured. 7 twin pregnancies and 1 triplet were occured (multiple pregnancy rate;22.2%). 11 pregnancies were term delivered, 17 are ongoing pregnancies. GIFT may be considered as an alternative to in vitro fertilazation in infertility cases in which at least one fallopian tube is patent.

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What should be done for men with sperm DNA fragmentation?

  • Kim, Gi Young
    • Clinical and Experimental Reproductive Medicine
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    • v.45 no.3
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    • pp.101-109
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    • 2018
  • In an age when a small quantity of sperm can lead to pregnancy through in vitro fertilization or intracytoplasmic sperm injection, selecting healthy sperm is important. Sperm DNA fragmentation (SDF) is known to be higher in infertile men. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and the alkaline comet test are SDF tests that directly measure DNA damage and have shown closer correlations with assisted reproduction results than indirect tools such as the sperm chromatin structure assay or the sperm chromatic dispersion test. It is difficult; however, to endorse a single test as the best test overall; instead, it is best to select a testing method based on each patient's clinical condition and goals. In a couple struggling with infertility, if the male partner has a high level of SDF, he should aim to decrease SDF through lifestyle modifications, antioxidant treatment, and ensuring an appropriate duration of abstinence, and physicians need to treat the underlying diseases of such patients. If sperm DNA damage continues despite the patient's and physician's efforts, other methods, such as micromanipulation-based sperm selection or testicular sperm extraction, should be used to select healthy sperm with nuclear DNA integrity.

Management of endometrial polyps in infertile women: A mini-review

  • Jee, Byung Chul;Jeong, Hye Gyeong
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.198-202
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    • 2021
  • Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

Klinefelter Syndrome: Review of the Literature

  • Jun, Kyung Ran
    • Journal of Interdisciplinary Genomics
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    • v.4 no.2
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    • pp.24-30
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    • 2022
  • Klinefelter's syndrome (KS) is a syndrome with extra X chromosome(s), in XY individuals, characterized by gynecomastia, small testes, and infertility. Additional X chromosomes can be present as variable karyotypic forms, including mosaicism (47,XXY/46,XY). The reported prevalence of KS ranges from one in 500 to one in 1,000 live males, but is probably underestimated. The classic phenotype is small, firm testes and infertility resulting from seminiferous tubule dysgenesis and androgen deficiency. The spectrum of KS includes tall stature with relatively long legs and arm span, decreased body hair, learning disabilities, behavioral problems, poor motor skills, and other important medical issues, such as metabolic syndrome, diabetes, autoimmune diseases, cardiovascular disease, certain neoplasia. The increased risk of certain medical problems in KS can be attributed to a direct effect of the extra X chromosome, the combined action of multiple genomic and epigenetic factors, or the hormonal imbalances. Typically, chromosome analysis is not ordered for adult patients with general medical conditions, except for suspected cases of hematologic and lymphoid disorders. Even though it was found during work-up for certain disorders in adult patient, most physicians do not suspect KS or consider its impact. Therefore, understanding the pathophysiology and variable manifestation in KS is necessary, and discussions with multidisciplinary teams will help to diagnose and treat males with KS.