• Title/Summary/Keyword: Multiple pregnancy

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Hysterosalpingo-contrast sonography: is possible to quantify the therapeutic effect of a diagnostic test?

  • Giugliano, Emilio;Cagnazzo, Elisa;Bazzan, Elisa;Patella, Alfredo;Marci, Roberto
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.4
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    • pp.161-165
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    • 2012
  • Objective: To evaluate the effect of hysterosalpingo-contrast sonography (HyCoSy) on natural conception in the infertile patient. Methods: We conducted a prospective observational study recruiting 180 patients admitted to Infertility Center of Ferrara University from January 2010 to February 2012. The essential inclusion criteria was the couple's desire to perform only diagnostic evaluation on infertility causes and to wait for natural conception before proceeding with further management. Couples were investigated with hormonal profile, semen analysis and HyCoSy. Expected time for spontaneous pregnancy was 180 days from HyCoSy. First datation sonography of pregnancy was used calculating time elapsed from HyCoSy at conception. Results: Forty patients (22.2%) obtained spontaneous pregnancy within 6 months after HyCoSy. The mean of "conception time" was 75 days. The pregnancy rate was significantly higher in the first 30 days (45%) compared to other the months of observation (p<0.0005). Multiple linear regression analysis showed that maternal age and sterility duration proved independent variables in detecting the "conception time" after HyCoSy (t=3.742, p=0.001, t=2.371, p=0.02, respectively). Conclusion: A possible beneficial effect of HyCoSy is feasible especially in the days following its execution. This temporal correlation supports its therapeutic use.

A healthy delivery of twins by assisted reproduction followed by preimplantation genetic screening in a woman with X-linked dominant incontinentia pigmenti

  • Kim, Myung Joo;Lyu, Sang Woo;Seok, Hyun Ha;Park, Ji Eun;Shim, Sung Han;Yoon, Tae Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.4
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    • pp.168-173
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    • 2014
  • The purpose of this study is to report a successful twin pregnancy and delivery in a female patient with X-linked dominant incontinentia pigmenti (IP) who underwent assisted reproductive technology followed by preimplantation genetic screening (PGS). A 29-year-old female with IP had a previous history of recurrent spontaneous abortion. A molecular analysis revealed the patient had a de novo mutation, 1308_1309insCCCCTTG(p.Ala438ProfsTer26), in the inhibitor of the kappa B kinase gamma gene located in the Xq28 region. IVF/ICSI and PGS was performed, in which male embryos were sexed using array-based comparative genomic hybridization (aCGH). After IVF/ICSI and PGS using aCGH on seven embryos, two euploid male blastocysts were transferred with a 50% probability of a viable male pregnancy. The dizygotic twin pregnancy was confirmed and the amniocentesis results of each twin were normal with regard to the mutation found in the mother. The patient delivered healthy twin babies during the 37th week of gestation. This case shows the beneficial role of PGS in achieving a successful pregnancy through euploid male embryo gender selection in a woman with X-linked dominant IP with a history of multiple male miscarriages.

Embryo Production and Transfer for Dairy MOET Scheme Application (젖소 MOET Scheme의 추진을 위한 수정란 생산 및 이식)

  • 손동수;김일화;류일선;연성흡;서국현;이동원;최선호;박수봉;이충섭
    • Journal of Embryo Transfer
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    • v.15 no.1
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    • pp.57-65
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    • 2000
  • The objective of this study was to apply the multiple ovulation and embryo transfer (MOET) program practically in dairy herds. Forty five superior Holstein cows ranked in 5% according to Type-Production Index(TPI) in Korea were selected as donors. The donors were superovulated with pFSH and the embryos collected from donors were frozen and preserved. The preserved embryos and frozen Holstein embryo imported from foreign country were thawed and transferred to recipients. The results obtained were as follows; 1. The total number of ova and freezable embryos collected per donor was 6.5 and 2.8, respectively. 2. The freezable embryos were obtained more(p<0.05) when the body condition score (BCS) of donors was in range of 2.50∼3.25(4.1) than in range of 3.50∼4.00(1.9), while the total number of ova was not changed. 3. The season affected on the collected number of freezable embryos(6.1 in winter, 4.5 in fall, 1.1∼1.5 in spring and summer, P<0.05), and the total number of obtained ova were more in winter than in other seasons(P<0.05). 4. Embryos were transferred to 343 recipients and 152 cows were confirmed pregnant(44.3%). 5. The higher pregnancy was obtained (P<0.05) when embryos were transferred in summer(53.3%) than in fall(36.0%), while the pregnancy rate was not affected by the origin and developmental stage of embryos, and the parity, BCS and estrus induction of recipients. From these results, the pregnancy rate was considered to be acceptable for the embryo transfer with domestic or imported Holstein embryos, however embryo production from superior Holstein donors was unsatisfactory for application of MOET scheme.

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Current Management for Pregnancy-related Low Back Pain by Korean Physical Therapists: A National Cross-sectional Survey Using the Vignette Method (비네트를 활용한 한국 물리치료사의 임신 관련 허리통증 환자에 대한 치료실태 조사연구)

  • Han, Hee-ju;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.53-62
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    • 2020
  • Background: Pregnancy-related low back pain (PLBP) has fewer systematic guidelines than pregnancy-related pelvic girdle pain, previous studies have not evaluated physical therapy for this ailment in Korea. Objects: We aimed to provide a detailed account of clinical decision making by Korean physiotherapists while treating PLBP. Methods: In total, 955 questionnaires were distributed mainly in places of continuing education held by the Korean Physical Therapy Association from April to July 2019. The same questionnaire was posted on a website used by physiotherapists. We collected subject information, a specific Vignette typically represent symptoms of PLBP, and responses to multiple questions about decision making, subjective recognition and interest level in the field of women's health physiotherapy (WHPT). Results: The overall response rate was 56% (n = 537); of these, responses to 520 questionnaires were analyzed. Most respondents chose various combinations of physical therapy methods. There were significant differences in subjective recognition levels of WHPT according to gender (p < 0.05), age (p < 0.01), education level (p < 0.01), and clinical experience (p < 0.05). There were significant differences in interest according to gender (p < 0.01) and education level (p < 0.01). With respect to the types of treatment, significant differences were noted in selective rates for "manual therapy", "pain control", and "supportive devices" based on gender. Manual therapy tended to be chosen more with increasing age and clinical experience. With increased education level, there were fewer choices for the use of pain control. Conclusion: This is the first data on how Korean physiotherapists manage PLBP patients using the vignette method. We were able to recognize the Korean physical therapist's decision on PLBP patients, and observed statistically significant correlations. This may aid in developing future research and education plans in the WHPT field.

Factors associated with clinical nurses' preconception health behavior in Korea: a cross-sectional survey

  • Yoon-Jung Park;Sun-Hee Kim
    • Women's Health Nursing
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    • v.30 no.1
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    • pp.79-89
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    • 2024
  • Purpose: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. Methods: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Results: Age (p=.024), educational level (p=.010), marital status (p=.003), work experience (p=.003), satisfaction with the work department (p<.001), smoking status (p=. 039), and previous health problems related to pregnancy outcomes (p=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (p<.001), pregnancy anxiety (p=.011), nursing practice environment (p=.003), and social support (p<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, p=.001), satisfaction with the work department (β=.23, p=.032), marital status (β=.22, p=.002), and perceived health status (β=.23, p=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, p<.001). Conclusion: Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

The Effect of Superovulation of Javanese Thin-Tail Ewes Prior to Mating on Lamb Birth Weight and Preweaning Growth

  • Manalu, W.;Sumaryadil, M.Y.;Sudjatmogo, Sudjatmogo;Satyaningtijas, A.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.3
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    • pp.292-299
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    • 2000
  • Forty-four Javanese thin-tail ewes were used to study the effect of superovulation prior to mating and of ration quality on lamb birth weight at parturition. Twenty-two ewes weaning at least one lamb were used to measure lamb preweaning growth. Prior to mating, the experimental ewes were injected twice with prostaglandin, with an 11 d interval between injections to synchronize the estrous cycle. At the last prostaglandin injection, 24 ewes were also injected with 700 IU of pregnant mare serum gonadotropin (PMSG) to stimulate superovulation and the remainder were injected with saline as control. During pregnancy and lactation, the experimental ewes were fed either on a low (12% CP and 65% TDN) or a high (15% CP and 75% TDN) quality ration. During lactation, the milk was collected twice a day and was refed to the lambs by bottle feeding immediately after collection. Superovulation or ration quality as a main factor did not significantly affect lamb birth weight. Litter size significantly affected lamb birth weight (p<0.05), and there was an interaction of superovulation and litter size. Nonsuperovulated ewes giving birth to multiple lambs had significantly lower average lamb birth weight (1.34 kg) as compared to those giving birth to a single lamb (1.97 kg) (p<0.05). However, superovulated ewes giving birth to multiple lambs had no significant difference in average lamb birth weight (1.68 kg) as compared to those giving birth to a single lamb (1.91 kg) (p>0.05). Superovulation of ewes prior to mating resulted in a significant improvement in lamb birth weight in the multiple litter size, without significant effect on average preweaning daily gain (p=0.07). Superovulation had a promising use in improving animal production through improvement of prenatal growth during pregnancy and milk production during lactation.

The Optimal Time for Embryo Transfer in Fresh IVF: Comparison between Day 3 and Day 5 on Pregnancy Outcomes (체외수정술 후 난할단계 배아와 포배기단계 배아를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Kim, A-Ri;Seok, Hyun-Ha;Kim, You-Shin;Lee, Woo-Sik;Yoon, Tae-Ki;Won, Hyung-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.143-151
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    • 2010
  • Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

The Studies on the Development of Human Blastocyst Embryos in IVF -ET Program - II. The Development of Human Blastocyst Embryos by co-culture with Cumulus Cells (IVF-ET Program에서 Blastocyst 배아의 발생에 관한 연구 - II. 난구세포 공동배양에 의한 Blastocyst 배아의 발생)

  • Lee, Suk-Won;Yoon, San-Hyun;Yoon, Hye-Gyun;Cho, Hyon-Jin;Heo, Yong-Soo;Yoon, Hye-Jin;Park, Se-Pill;Lee, Won-Don;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.1
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    • pp.35-41
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    • 1998
  • This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more "good" embryos (regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more "good" embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/ 4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate' was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.

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Embryonic Developmental Capacity and Pregnancy Rates of Fertilized Oocytes in IVF, ICSI and TESE-ICSI Cycles (IVF, ICSI 또는 TESE-ICSI에서 수정을 유도한 난자의 배아 발생능력 및 임신율)

  • Park, Kee-Sang;Park, Yoon-Kyu;Song, Hai-Bum;Lee, Taek-Hoo;Chun, Sang-Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.3
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    • pp.169-176
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    • 2004
  • Objective: This study was performed to evaluate and compare the embryonic developmental capacity and pregnancy rates in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with ejaculated sperm or testicular sperm cycles. Materials and Methods: Fertilization was examined in the following morning after IVF (group I), ICSI (group II) or TESE-ICSI cycles (group III). Fertilized oocytes were co-cultured with Vero cells until embryo transfer (ET). On day 2 and $5{\sim}7$, grades of embryos (<4- or $\geq$4-cell) and blastocysts (BG1, 2, 3 or early) were evaluated. Clinical pregnancy rate was determined by detecting G-sac with transvaginal ultrasonogram. We analyzed the results by $X^2$ and Student's t-test and considered statistically significant when P value was less than 0.05. Results: Fertilization rate was significantly higher (p<0.05) in group I ($79.0{\pm}21.2%$) than in group II and III ($56.8{\pm}21.6%$ and $36.7{\pm}25.3%$). Cleavage and blastulation rate of group I ($95.8{\pm}13.8%$ and $59.5{\pm}25.3%$) were significantly higher (p<0.05) than those of group III ($83.4{\pm}18.6%$ and $40.4{\pm}36.5%$). Clinical pregnancy rate was significantly higher (p<0.05) in group I and II (40.7% and 41.7%) than that in group III (12.5%). No differences were found in the rates of multiple pregnancy and abortion among three groups. Embryonic implantation rate was higher in group I ($15.1{\pm}20.2%$, p<0.05) and II ($14.7{\pm}20.6%$, NS) than that in group III ($5.1{\pm}15.6%$). However, embryonic implantation rate was increased in ET with blastocyst(s) among three groups. Conclusions: Fertilized oocytes obtained from TESE-ICSI were harder to be successfully cultured to blastocyst stage for 5$\sim$7 days than that from IVF cycles. However, all blastocyst(s) ET increased the embryonic implantation rate equally in IVF, ICSI and TESE-ICSI cycles.

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial

  • Le, Minh Tam;Nguyen, Thi Tam An;Nguyen, Thi Thai Thanh;Nguyen, Van Trung;Le, Dinh Duong;Nguyen, Vu Quoc Huy;Cao, Ngoc Thanh;Aints, Alar;Salumets, Andres
    • Clinical and Experimental Reproductive Medicine
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    • v.45 no.3
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    • pp.129-134
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    • 2018
  • Objective: In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET). Methods: Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole $40{\mu}m$ in diameter was made in the drilling group. Results: A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar ${\beta}$-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than $17{\mu}m$) according to the LAH method. Conclusion: The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.