• Clinical and Experimental Reproductive Medicine
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• 제45권3호
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• pp.135-142
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• 2018

Objective: To prospectively evaluate the efficacy and safety of a fixed early gonadotropin-releasing hormone (GnRH) antagonist protocol compared to a conventional midfollicular GnRH antagonist protocol and a long GnRH agonist protocol for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). Methods: Randomized patients in all three groups (early antagonist, n = 14; conventional antagonist, n = 11; long agonist, n = 11) received 21 days of oral contraceptive pill treatment prior to stimulation. The GnRH antagonist was initiated on the 1st day of stimulation in the early antagonist group and on the 6th day in the conventional antagonist group. The GnRH agonist was initiated on the 18th day of the preceding cycle. The primary endpoint was the number of oocytes retrieved, and the secondary endpoints included the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and the clinical pregnancy rate. Results: The median total number of oocytes was similar among the three groups (early, 16; conventional, 12; agonist, 19; p= 0.111). The early GnRH antagonist protocol showed statistically non-significant associations with a higher clinical pregnancy rate (early, 50.0%; conventional, 11.1%; agonist, 22.2%; p= 0.180) and lower incidence of moderate-to-severe OHSS (early, 7.7%; conventional, 18.2%; agonist, 27.3%; p= 0.463), especially among subjects at high risk for OHSS (early, 12.5%; conventional, 40.0%; agonist, 50.0%; p= 0.324). Conclusion: In PCOS patients undergoing IVF, early administration of a GnRH antagonist may possibly lead to benefits due to a reduced incidence of moderate-to-severe OHSS in high-risk subjects with a better clinical pregnancy rate per embryo transfer. Further studies with more subjects are required.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2003년도 제45차 추계학술대회
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• pp.93.2-94
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• 2003

• 대한한방부인과학회지
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• 제35권2호
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• pp.87-105
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• 2022

Objectives: The purpose of this study is to analysis the Clinical Study Trends on Korean Medicine Treatment for Polycystic Ovary Syndrome. Methods: The key words such as 'polycystic ovary syndrome', 'polycystic ovarian syndrome', 'korean medicine', 'herbal medicine', 'acupuncture' are used for the research through 'OASIS', 'KCI', 'KISS', 'RISS'. Results: Ten clinical studies with 73 patients were selected. All studies were the noncomparative studies, and 8 case reports, 1 case series, 1 retrospective chart review. Symptoms accompanied by PCOS were oligomenorrhea, amenorrhea, irregular menstruation, hirsutism, acne, obesity etc. The most used treatment was herbal medicine in all studies with 72 patients (98.6%). The most frequently used acupuncture and moxibustion point was respectively 合谷 (LI4) and 關元 (CV4). The duration of treatment was between 3 months and 10 months, the average 159 days. Outcome measurements were Recovery of menstrual cycle (97.6%), Hormone test (23.8%), Sonogram (61.9%), Indexes of obesity (23.8%). In terms of menstrual recovery, 35 patients (85.4%) have recovered from menstruation in 8 studies with 41 patients. In hormone tests, all 10 patients have decrease of LH/FSH ratio and LH in 3 studies with 10 patients. Through sonogram, Ovulation menstruation was confirmed in all 6 patients. In all 10 patients of 3 studies evaluating weight before and after treatment, weight was reduced. Conclusions: The effect on Korean Medicine treatment for Polycystic Ovary Syndrome had mostly positive results. However, Further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Polycystic Ovary Syndrome.

• Applied Microscopy
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• 제41권2호
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• pp.109-116
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• 2011

다낭성 난소증후군(polycystic ovary syndrome, PCOS)은 내분비 및 대사장애로 호르몬 불균형 상태를 야기하여 가임기 여성의 불임 및 여러 합병증을 유발한다. 폐경기 여성의 호르몬대체 치료에 사용되는 estradiol valerate (EV)는 과다 투여 시 PCOS를 유발하는 것으로 알려졌다. 신경성장인자(nerve growth factor, NGF)는 발생 중인 신경세포의 생존과 성숙을 조절하는 인자로 난소에서도 합성되고, EV 처리에 의해 유도된 다낭성난소(polycystic ovary, PCO)에서 발현이 크게 증가하는 것으로 보고됐다. 따라서 본 연구에서는 난소유래 세포인 CHO 세포주와 다낭성 난소를 이용해 호르몬 불균형 상태인 PCOS 진단 시 NGF가 생물학적 표지인자로서 사용될 수 있는 가능성을 규명하고자 하였다. CHO 세포에 EV 2 mg과 3 mg 처리는 초기에 세포증식을 억제했으나 1 mg 처리는 영향을 미치지 않음으로써 실험 시 최적농도로 사용하였다. 하지만 농도별 EV 처리에 따른 CHO 세포의 형태학적 차이는 관찰되지 않았다. CHO 세포에 EV 처리 후 NGF mRNA 및 단백질 발현은 대조군에 비해 30분 후 크게 증가하였고, 다수의 난포낭이 관찰된 PCOS 조직에서도 정상군에 비해 크게 증가하였다. 따라서 이상의 결과들을 종합하면 EV 처리 후 난소에서 유도되는 NGF 과발현은 비정상적 난포발달을 유도하는 인자로 작용할 것으로 보이며, 다낭성난소 진단 시 표지인자로서 사용될 수 있을 것으로 생각된다.

• 대한한방부인과학회지
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• 제31권3호
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• pp.152-163
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• 2018

Objectives: In recent studies, increased AMH level has been suggested as objective surrogate marker for diagnosis PCOS, one of the major causes of oligomenorrhea. The purpose of this study is to report the clinical effect of Korean medicine treatment on oligomenorrhea patient with increased Anti-mullerian hormone level, who can be diagnosed who can be ruled out PCOS. Methods: A 27 year old woman with oligomenorrhea was enrolled in this study. We measured serum hormone levels and ruled out PCOS. The patient received Korean medicine treatment for 3 months, we assessed the result of treatment through observation of the menstrual cycle and follow-up measurements of serum hormone levels. Results: 1. The patient had menstrual cycle regularly. 2. Increased serum AMH level of the patient decreased from 12.16 ng/ml to 8.51 ng/ml. 3. The other serum hormone levels such as testosterone, LH/FSH ratio decreased Conclusion: This case shows that Korean medicine treatment could have a beneficial effect on menstrual cycle and decrease the increased serum hormone levels of ruled out PCOS patient.

• KSBB Journal
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• 제19권6호
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• pp.433-436
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• 2004

홍삼 사포닌이 estradiol valerate로 유발된 랫드의 다낭성난소에 미치는 영향을 관찰한 결과 다음과 같은 결론을 얻었다. 1. 홍삼 사포닌을 투여한 실험군의 난소형태는 퇴축난포, 정상발달을 보이는 이차난포 및 황체형성 등 비교적 정상화된 난소의 소견이 관찰되어 다낭성난소의 현저한 치료 효과를 보였다. 2. 홍삼 사포닌을 투여한 실험군의 신경성장인자 염색은 대조군에 비해 난소조직에서 내협막 세포들과 간질세포들이 현저하게 감소된 현상을 보였으나, 뇌하수체 및 해마체에서는 뚜렷한 차이가 없는 것으로 관찰되었다. 이상의 결과를 종합해보면 홍삼 사포닌은 다낭성난소 증후군의 예방 및 치료에 효과가 있을 것으로 사료된다.

• 대한한방부인과학회지
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• 제25권2호
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• pp.43-65
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• 2012

Objectives: This study was designed to investigate the effects of Hyeolbuchukeotang( HCT) on the Estradiol Valerate(EV) induced Polycystic Ovaries and the Implantation of rats. Methods: PCO was induced by single intramuscular(IM) injection with EV in female rats. Normal group(n=8) were injected with sesame oil and orally administrated distilled water for 60 days. Control group(n=8) were injected with EV and orally administrated distilled water for 60 days. HCT treated group(n=8) were injected with EV and orally administrated HCT for 60 days. At the end day of experiment, we measured weights of body, ovaries, adrenal glands, uterus and contents of serum LH, FSH, ADD. The histomorphometrical changes of ovaries were also evaluated. And we observed the NGF and CRF expression by immunohistochemistry. Also we observed the mating and count the number of implantation. Results: - The weights(mg) of ovaries in HCT treated group($58.9{\pm}6.5$) were significantly increased (p<0.01) compared with control group ($42.3{\pm}8.5$). - The number of mature follicles in HCT treated group($9.8{\pm}2.6$) was significantly increased (p<0.01) compared with control group($6.1{\pm}2.1$). - The number of cystic follicles in HCT treated group($1.6{\pm}1.2$) was significantly decreased (p<0.01) compared with control group($3.8{\pm}1.5$). - The value of serum FSH(mIU/ml) in HCT treated group($3.870{\pm}2.151$) was significantly decreased(p<0.05) compared with control group($10.476{\pm}6.294$). - The expression of NGF-immunoreactive cells in the ovarian cells in HCT treated group was lesser observed than control group. - The number of implantation in HCT treated group($7.4{\pm}1.8$) was significantly increased (p<0.05) compared with control group($3.1{\pm}4.4$). Conclusions: Hyeolbuchukeo-tang(HCT) is effect on polycystic ovaries and the implantation of rats by EV-induced.

• Clinical and Experimental Reproductive Medicine
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• 제32권1호
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• pp.65-70
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• 2005

본 연구는 이식 후 남은 잉여의 포배기 배아를 두 번의 냉동과 융해 과정을 반복적으로 실시한 후 이식한 결과에 관한 보고이다. 사람 포배기 배아의 동결보존에서 높은 생존율과 성공적인 임신율이 보고되고 있으나 미성숙 난자로부터 발달한 포배기 배아에 두 번의 초급속 냉동 방법을 실시한 후 이식한 보고는 되어 있지 않다. 이에 본 연구에서는 다낭성 난소 증후군 환자에게서 얻은 미성숙 난자로부터 발달한 포배기 배아를 artificial shrinkage 후 초급속 냉동함으로써 생존율을 높이는 방법을 이용하여 재냉동 이식하였을 때 임신에 성공한 증례를 보고하고자 한다. 29세의 환자로부터 채취한 55개의 미성숙 난자들(germinal vesicle stage oocytes)을 체외배양 하여 성숙한 37개의 난자들로부터 30개의 수정란을 얻을 수 있었다. 12개의 배아가 포배기 배아까지 발달하였으며 이 중 3개의 양질의 포배기 배아를 선별하여 이식하였고, 이식을 한 후에 남은 9개의 포배기 배아들은 artificial shrinkage의 과정을 마친 후에 초급속 냉동 방법을 이용하여 동결보존 하였다. 그 중, 4개의 포배기 배아들을 융해한 후 이식을 하지 않고 다시 재냉동을 하여 보관하였고 이 후 재냉동 되었던 4개의 포배기 배아들을 다시 융해 하여 이식을 한 결과 임신이 되어 건강한 남아를 분만하였다. 이로써 미성숙 난자로부터 얻은 포배기 배아가 두 번의 냉동과 융해의 과정을 통해 크게 손상을 입지 않고 생존할 수 있다는 것을 알 수 있었다. 그러므로 융해이식 후 남은 잉여의 포배기 배아를 다시 냉동 보관하여 다음 주기에 이용함으로써 축적된 임신율을 증가시킬 수 있을 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.261-268
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• 2005

Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.