• Title/Summary/Keyword: Infertility Patients

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Effect of Pioglitazone on Production of Regulated upon Activation Normal T-cell Expressed and Secreted (RANTES) and IVF Outcomes in Infertile Women with Endometriosis

  • Kim, Chung-Hoon;Lee, You-Jeong;Kim, Jun-Bum;Lee, Kyung-Hee;Kwon, Su-Kyung;Ahn, Jun-Woo;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Development and Reproduction
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    • v.17 no.3
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    • pp.207-213
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    • 2013
  • This study was performed to investigate the effect of peroxisome proliferators activated receptor-${\gamma}$ (PPAR-${\gamma}$) ligand, pioglitazone, on production of regulated upon activation normal T-cell expressed and secreted (RANTES) and in vitro fertilization (IVF) outcome in infertile patients with endometriosis. Sixty-four infertile patients with stage III or IV endometriosis undergoing IVF were randomly allocated to the study or the control group. The long protocol of GnRH agonist (GnRH-a) was used for controlled ovarian stimulation (COS) in all patients. Patients in the study group were treated with pioglitazone at a dose of 15 mg/day orally from the starting day of GnRH-a treatment to the day of hCG injection. Blood samples were drawn for serologic assay of RANTES on the first day of GnRH-a treatment and the day of hCG injection. There were no differences between the study and control groups in patient characteristics. There were also no differences between the two groups in COS duration, and the numbers of retrieved oocytes, fertilized oocytes and embryos transferred. The clinical pregnancy rate per cycle was higher in the study group, but this difference was not statistically significant. However, embryo implantation rate was significantly higher in the study group of 12.5% compared with 8.6% in the control group (P<0.05). The serum RANTES levels after pioglitazone treatment were significantly lower than those before pioglitazone treatmen in the study group (P<0.05). Our data suggest that pioglitazone treatment can suppress RANTES production and improve the embryo implantation rate in patients with endometriosis undergoing IVF.

The Study of Infertility Stress of Female Participating in Korean Medicine Pilot Program for Subfertility (난임한방진료시범사업에 참가한 여성의 스트레스 양상에 대한 연구)

  • Ahn, In-Suk;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.1
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    • pp.56-67
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    • 2017
  • Objectives: The purpose of this study is to elucidate infertility women's experience in psychological stress and to suggest effective infertility stress management methods. Methods: Twenty five infertility women who participate in Korean Medicine Pilot Project for Infertility completed questionnaires and Infertility Stress Scale, also, we have interviewed. Results: The Mean degree of stress of the infertile women was 2.24 point with Infertility Stress Scale. In focused interview, the infertility stress was considered to be within the aspects of intra and interpersonal. In regards to intrapersonal aspect, infertility women described the grief with lowered self-esteem and anxiety with obsession for fertility. As for the interpersonal aspect, infertility women were distressed by the relationship with spouse and in-laws, as well as friend and the public. Conclusions: Doctors in infertility clinic need to consider infertility stress of their patients and conduct effective intervention.

A Study of Lupus Anticoagulants and Anticardiolipin Antibodies in Patients with Infertility and Recurrent Spontaneous Abortion (불임환자와 반복자연유산 환자에서 루프스 항응고인자와 항카디오리핀 항체에 대한 연구)

  • Nam, Yoon-Sung;Cha, Kwang-Yul;Baek, Jin-Young;Kim, Nam-Keun;Kang, Myung-Seo;Oh, Do-Yeon
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.1
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    • pp.29-35
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    • 2002
  • Objective : To report the prevalence of lupus anticoagulants and anticardiolipin antibodies in patients with recurrent spontaneous abortion and infertility. Material and Method: Lupus anticoagulants and anticardiolipin antibodies were analyzed by Diluted Russell's Viper Venom Test (DRVVT) and solid phase enzyme immunoassay, respectively. Results : In 200 patients with infertility, there were 6 cases (3%) with positive lupus anticoagulants or anticardiolipin antibodies. Of these, 3 patients (1.5%) showed positive lupus anticoagulants and anticardiolipin antibodies, respectively. In 120 patients with recurrent spontaneous abortion, there were 13 cases (10.8%) of positive lupus anticoagulants or anticardiolipin antibodies. Of these, one patient (1%) showed lupus anticoagulants and 12 patients (10%) showed anticardiolipin antibodies. But in two groups, there was no cases with positive lupus anticoagulants and anticardiolipin antibodies. Conclusion: Lupus anticoagulants and anticardiolipin antibodies are definite cause of recurrent spontaneous abortion. There has been a speculation that they might be associated with infertility and repeated IVF failures. But it was found that the role of lupus anticoagulants and anticardiolipin antibodies in these cases are not clear.

Chromosome Configurations of Human Oocytes Matured in vitro following Cryopreservation at the Germinal Vesicle Stage (인간 미성숙난자의 동결.융해후 체외 배양된 난자에 대한 염색체 분석)

  • Park, S.E.;Chung, C.J.;Son, W.Y.;Chung, H.M.;Lee, S.H.;Lee, W.S.;Ko, J.J.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.253-259
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    • 1997
  • Objective: To investigate effects of cryoprotectant and cryopreservation on the chromosome of the human immature oocytes. Design: Intact cumulus-enclosed immature oocytes were collected from unstimulated ovaries and divided into three groups, such as no treatment as control (group 1), only 1,2-propanediol (PROH)-treated (group 2), and cryopreserved oocytes (group 3). Oocytes in group 1, 2, and survived oocytes after cryopreservation in group 3 were cultured for 48 hours. Setting: Infertility Medical Center at the CHA General Hospital, Seoul, Korea. Patients: Oocytes were obtained from Patients undergoing gynecological surgery. Main Outcome Measures: Maturation rate, abnormality in chromosomes by fluorescence in situ hybridization (FISH). Results: There was no effect of PROH only treatment on the chromosomal abnormalities in group 2 compared to control oocytes (41.4% and 31.8%, respectively). Whereas significantly increased abnormalities in chromosome (77.8%) were found in group 3. Conclusions: Human oocytes matured in vitro after cryopreservation at the germinal vesicle (GV) stage showed increased incidence of chromosomal abnormalities. These abnormalities may impair the capacity for further development of the embryos derived from frozen-thawed oocytes.

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Pioglitazone treatment decreases follicular fluid levels of tumor necrosis factor-${\alpha}$ and interleukin-6 in patients with polycystic ovary syndrome

  • Kim, Chung-Hoon;Ahn, Jun-Woo;You, Rae-Mi;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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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.

The Usefulness of Pre-operative Infertility Work-up in Assessing the Reversal Feasibility (난관복원술전에 실시한 불임검사의 임신율 예측지표로서의 유용성에 관한 연구)

  • Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.1
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    • pp.71-78
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    • 1993
  • Since the successful advent of IVF-ET, reproductive surgeons have been forced to compare pregnancy outcomes of surgical procedures for tubal infertility with those of IVF-ET. The current study was designed in an effort to determine the usefulness of pre-operative infertility work-up, especially diagnostic laparoscopy, in predicting the pregnancy rate and in assessing the reversal feasibility. 109 patients who underwent a microsurgical tubal reversal were reviewed. The patients were followed over one year. The total intrauterine pregnancy, spontaneous abortion, and ectopic pregnancy rates were 66.4%, 3.7%, and 7.3%, respectively. The result showed that the use of loupe might increase the chance of the ectopic pregnancy. I found that the final tubal length, especially the longest tubal length, the site of reanastomosis, and the methods of sterilization affected the pregnancy rates. A 85% intrauterine pregnancy rate was achieved in the patients with good preoperative assessments(Group II-1). There was only 10% incidence of intrauterine pregnancy in the patients with bad assessments(Group II-2). It is concluded that the pre-operative infertility work-up, especially diagnostic laparoscopy, is a good diagnostic tool in assessing the reversal feasibility.

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