• Clinical and Experimental Reproductive Medicine
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• 제8권2호
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• pp.45-55
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• 1981

Clomiphene citrate. antiestrogen, was given to 39 infertile males whose spermatogenesis were disturbed and the efficacy of the drug was evaluated at the Department of Urology in 1980. (Table 1). Patients were divided into 3 clinical observation groups such as group I composed of 19 cases of idiopathic azoospermia, group II consisted of 15 cases of oligospermia following the vasovasostomy, and group III comprised 5 cases of testicular azoospermia. (Table 2). Clinical characteristics of these patients were as follows: Age of the patients ranged from 26 to 43 years old with mean of 34, and that of their wives ranged from 24 to 41 years old with mean of 31. Duration of marital life ranged from 1 to 21 years with mean of 5 years. Sizes of testis ranged from 6 to 25 ml with mean of 16 ml. Coital frequency ranged from 0.5 to 6 per week with mean of 2.4 per week. Levels of plasma FSH ranged from 3.15 to 23.06 lU/1 with mean of 8.15 lU/1, those of LH ranged from 2.98 to 19.89 lU/1 with mean of 8.18 lU/1 and those of testosterone ranged from 3.09 to 9.97 ng/ml with mean of 6.48 ng/ml. (Table 3). Clomiphene citrate was given in dosage of 50 mg per day (in d.) orally to 31 patients for 3 to 9 months and in dosage of 100 mg per day (b.i.d.) orally to 8 patients for 3 to 9 months. (Table 8). Semen samples were analysed monthly on each patient by routine analysis techniques. For the assessment of the efficacy of Clomiphene citrate on faulty spermatogenesis following empirical criteria were used: For semen quality: Improvement (I) represents that semen parameter increased more than 25% from basal level after the treatment, Unchange (U) expresses that semen parameter increased less than 25% of basal level or not changed after the treatment and Deterioration (D) means that semen parameter decreased from basal level after the treatment. For fertility unit (total counts ${\times}$ motility ${\times}$ morphology ${\div}10^6$): Improvement (I) represents that fertility unit increased more than 10 units after the treatment, Unchange (U) expresses that fertility unit increased less than 10 units or not changed after the treatment, and Deterioration (D) means that fertility unit decreased after the treatment. (Table 4). Results obtained from the Clomiphene therapy were as follows: Changes of spermiograme before and after the Oomiphene therapy shown in the Table 5. Sperm counts increased from 23 to 31 ${\times}10^6$/ml in group I, from 17 to 29 ${\times}10^6$/ml in group II. Other parameters of spermiogramme were not changed significantly after the treatment. Fertility units increased from 14 to 18 units after the treatment in group I, and from 16 to 18 units after the treatment in group II. Effectiveness of Clomiphene citrate on spermatogenesis was summarised in the Tables 6 and 7. After the treatment, sperm count increased in 11 patients, motility increased in 6 patients, morphology increased in 4 patients and fertility units increased in 9 patients. No sperm could be produced by Clomiphene citrate in group III of testicular azoospermia. Dosage of 50 mg of Clomiphene citrate per day for 3 to 6 months was proved to be the most effective in the present series. (Table 8). Pregnancy occurred in 2 patients after the treatment. No particular side effects were noted by the treatment. Pharmacologic compounds used for male infertility were shown in the Table 9. Reported results of Clomiphene citrate were shown in the Table 10.

• Clinical and Experimental Reproductive Medicine
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• 제19권1호
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• pp.65-69
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• 1992

The sucess of intrauterine inseminations with washed human spermatozoa was evaluated in 92 patients. In according to indication of insemination, intrauterine inseminations of women with hostile cervical mucus yield a 35.3% and 12.8% with male factors and 27.3% with unexplained infertility. In ovulation induction group with variable agents including clomiphen, human menopausal gonadotropin (HMG) and GnRH analog, the pregnancy rate was 27.8% (22/79) and in natural cycle group, 15.4% (2/13). The fetal loss rate in insemination group was 12.5% (3/24). Multiple pregnancies were 7 cases and ovulation induction were performed in 6 cases among them. Intrauterine insemination with washed human spermatozoa therefore represents an effective and safe procedure selected infertile couples.

• Clinical and Experimental Reproductive Medicine
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• 제17권1호
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• pp.57-63
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• 1990

The purpose of this study is to improve fertilization rate in IVF-ET program of patients with male infertility used micromanipulation technique, partial zona dissection (PZD) or micro-insemination by sperm transfer (MIST). The results were as follows 1. The fertilization rate of non-micromanipulated oocytes and micromanipulated (PZD) oocytes were 12.5% (n=2) and 42.2% (n=19), respectively, and showed significant differences between two groups (p<0.05). 2. The fertilization rate of micromanipulated (MIST) oocytes was 30% (n=27). 3. The damage rate of Group 1 (PZD) and Group 2 (MIST) were 15.7% (3/19) and 29.6% (8/27), respectively. 4. One pregnancy resulted following replacement of micromanipulated (MIST) embryos in 4 patients.

• Clinical and Experimental Reproductive Medicine
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• 제40권1호
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• pp.29-32
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• 2013

Objective: To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. Methods: We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. Results: The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. Conclusion: Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.

• 대한한방부인과학회지
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• 제28권2호
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• pp.174-182
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• 2015

Objectives : AMH (Anti-Müllerian Hormone) is considered a sensitive marker of ovarian reserve, and it tends to be included among basic fertility tests. This paper is to report four pregnancies which were achieved by subfertile women with low AMH level after Korean medical treatments. Methods : Four cases of pregnancy by subfertile women, aged 34 to 37, with low AMH level (0.04 to 0.76 ng/mL), after Korean medical treatments between July 2012 and May 2015, were analysed. The patients were diagnosed as Kidney deficiency (腎虛), Blood extravasation (瘀血) and/or Liver Qi stagnation (肝氣 鬱結). Herbal medicine, acupuncture, pharmacopuncture and moxibustion treatments were applied. Results : The four subfertile women with low AMH level achieved pregnancy after Korean medical treatments. Conclusions : The case report suggests that Korean medical treatment can be an effective option for subfertile women with low AMH level before Assisted Reproductive Technology.

• Journal of Acupuncture Research
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• 제35권4호
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• pp.200-206
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• 2018

Background: To evaluate whether ${\geq}3$ adjunct acupuncture sessions accompanying embryo transfer, increases the chance of pregnancy amongst post-myomectomy women aged ${\geq}35$ years. Methods: This was a prospective study carried out at Nordica Fertility Center. Following written informed consent, 75 patients undergoing assisted reproduction therapy and who had good quality embryos, were age-matched and grouped into post-myomectomy (n = 24) and normal women who had no evidence of fibroids or previous myomectomy (n = 51). Between 1 and 3 sessions of acupuncture were performed on 6 post-myomectomy and 19 infertile women who had not undergone myomectomy, while > 3 acupuncture sessions were performed on 18 post-myomectomy and on 32 normal patients, approximately 25 minutes before and after embryo transfer. Results: A positive pregnancy test was defined as ultrasonographic evidence indicating presence of a fetal sac 6 weeks after embryo transfer. Of the 5 post-myomectomy women who were pregnant, only 1 (20.0%) received 1-3 adjunct acupuncture sessions whilst the remaining 4 (80.0%) received > 3 acupuncture sessions. Of the 11 normal pregnant women, 5 (45.4%) received 1-3 adjunct acupuncture sessions while 6 (54.5%) received > 3 adjunct acupuncture sessions. Conclusion: Pregnancy rates in infertile post-myomectomy women may be improved by > 3 adjunct acupuncture sessions.

• Clinical and Experimental Reproductive Medicine
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• 제17권2호
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• pp.137-144
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• 1990

Seventy-two patients initiated intrauterine insemination between March 1989 and March 1990. Indication for the intrauterine insemination included abnormal semen, poor cervical mucus, presents of sperm antibody, unexplained, poor postcoital test and endometriosis. During this time period, 216 inseminations were performed and resulted in twenty four pregnancies in the 72 patients receiving artificial insemination by homologous donor for an overall pregnancy rate of 33.3%. Where pergonal treatment was followed by insemination, a significantly greater pregnancy per cycle was achieved. It is therefore suggested that a trial if induction of multiple follicular development be performed on coulpes with male-related or unexplained infertility before inclusion in protocols for invasive procedures, such as IVF or GIFT.

• 대한한방부인과학회지
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• 제24권2호
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• pp.79-96
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• 2011

Objectives: This study was to investigate clinical usage of Guibi-tang based on actual application in obstetrics and gynecology. Methods: This study investigated the number of patients who were prescribed Guibi-tang-gami-bang and what herbal medicines were adjusted according to their chief complaint from January 1st, 2007 to August 31th, 2008. Results: The number of patients who were prescribed Guibi-tang for obstetrics and gynecological diseases at the Department of Obstetrics and Gynecology was 721. Guibi-tang has been used to treat menstrual irregularity, postpartum general weakness, postpartum pantalgia, perimenopausal symptoms and postmenopausal syndrome most frequently. And Guibi-tang has been widely used in obstetric and gynecologic diseases such as general weakness after abortion or gynecological surgery, pelvic pain, dysmenorrhea, uterine myoma, endometriosis, infertility, premenstrual syndrome, urinary incontinence and breast disease. Conclusions: Guibi-tang can be used in obstetric and gynecologic diseases as described in classical oriental medicine literatures, and it is necessary to research clinical usage of Guibi-tang through randomized controlled trial.

• 대한한방부인과학회지
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• 제28권1호
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• pp.128-137
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• 2015

Objectives: Spontaneous pregnancy is a rare event after repeated failure of in vitro fertilization (IVF) or Intrauterine insemination (IUI) treatment. So this paper is to report the natural pregnancy of Gamiseogagjihwang-tang treatments on two infertile patients who were repeatedly failed in IVF or IUI. Methods: One patient was a 35-year-old patient diagnosed with the adenomyosis and contralateral tubal obstruction, treated with 90 cc Gamiseogagjihwang-tang two times per day for 6 weeks after second failure of IVF. The other patient was a 34-year-old patient undergone induced abortion by three times, treated with 90 cc Gamiseogagjihwang-tang two times per day for 4 weeks after second failure of IUI. Results: Through taking Gamiseogagjihwang-tang without assisted reproduction techniques, two cases got pregnant naturally. Conclusions: These cases suggest that Gamiseogagjihwang-tang is effective in treating infertile female after failure in IVF or IUI and inducing spontaneous pregnancy. Therefore, there needs to be more trial on infertile patients treated with Seogagjihwang-tang.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.