• Clinical and Experimental Reproductive Medicine
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• 제40권4호
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• pp.143-147
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• 2013

Oocyte in vitro maturation (IVM) is an assisted reproductive technology in which oocytes are retrieved from the antral follicles of unstimulated or minimally stimulated ovaries. IVM of human oocytes has emerged as a promising procedure. This new technology has advantages over controlled ovarian stimulation such as reduction of costs, simplicity, and elimination of ovarian hyperstimulation syndrome. By elimination or reduction of gonadotropin stimulation, IVM offers eligible infertile couples a safe and convenient form of treatment, and IVM outcomes are currently comparable in safety and efficacy to those of conventional in vitro fertilization. IVM has been applied mainly in patients with polycystic ovary syndrome or ultrasound-only polycystic ovaries, but with time, the indications for IVM have expanded to other uncommon situations such as fertility preservation, as well as to normal responders. In this review, the current clinical experiences with IVM will be described.

• Clinical and Experimental Reproductive Medicine
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• 제38권2호
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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.

• 대한한방부인과학회지
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• 제31권1호
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• pp.122-137
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• 2018

Objectives: This study is to review the effect of Korean medicinal herbs on treatment of polycystic ovary induced rat models reported in domestic & foreign journals. Methods: 7 electronic databases (Pubmed, CNKI, EMBASE, Oasis, RISS, CENTRAL, Koreankt) were searched with term as polycystic ovary, and study reports on polycystic ovary impairment with Korean medicinal herbs. After selecting several studies, the analysis was focused on items reflected in the Rotterdam criteria for diagnosis of polycystic ovary syndrome such as hyperandrogenism (HA), ovarian weight, the number of follicle cysts, estrous cycles, and etc. Results: 15 studies were reviewed. As a polycystic ovary induction material, estradiol valerate (EV) was used in 9 studies, testosterone propionate (TP) in 2 studies and dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), Poretsky's method and letrozole (LE) was used in rest 4 studies, respectively. Tribulus terrestris (TT), Nardostachys jatamansi (NJ), Lycii cortex (LC), Cinnamomum cassia kees (CCK) and Atractylodis macrocephalae koidz (AMK) produced statistically significant results related to hyperandrogenism. In ovarian weight, Silybum marianum (SM), AMK and Alllium sativum (AS) were statistically significant. In the the number of follicle cysts, SM and TT were statistically significant. In estrous cycles, AMK, NJ, TT and Coix lacryma-jobi (CL) were statistically significant. Conclusions: Based on the diagnosis criteria of Rotterdam, TT, NJ, AMK, SM, AS, and CL produced statistically significant results in rat model.

• Clinical and Experimental Reproductive Medicine
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• 제46권2호
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• pp.50-59
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• 2019

Anti-$M{\ddot{u}}llerian$ hormone (AMH), a peptide growth factor of the transforming growth $factor-{\beta}$ family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a "fertility test."

• 대한한방부인과학회지
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• 제29권3호
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• pp.47-56
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• 2016

Objectives: We evaluated the effect of Korean medical treatment in case of irregular menstruation (amenorrhea, oligomenorrhea) due to Polycystic ovarian syndrome (PCOS).Methods: 20 Amenorrhea or oligomenorrhea Patients with PCOS were treated with Korean medical treatment at least 3 months. We analyzed clinical data of 20 patients and checked effectiveness of treatment through the change of menstrual pattern.Results: After Korean medical treatment, Patients who complained menstrual irregularity due to PCOS were improved in menstrual condition. Among 14 amenorrhea patients, 12 patients (85.7%) started menstruation within 3 months. Among 6 Oligomenorrhea patients, 4 patients (66.7%) got better menstruation pattern than before.Conclusions: PCOS Patients who got Korean medical treatment showed better condition in menstruation pattern. Amenorrhea patients started menstruation without contraceptive pill and oligomenorrhea patients got better menstruation cycle.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.73-76
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• 2012

More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-${\alpha}$, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

• 대한한방부인과학회지
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• 제31권4호
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• pp.39-53
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• 2018

Objectives: The purpose of this review was to overview and evaluate the efficacy of electroacupunture for women with polycystic ovarian syndrome (PCOS) Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in PubMED, EMBASE, OASIS, and Google scholar, up to May 2018. Data were extracted regarding hyperandrogenism, obesity and hyperinsulinemia indices. The risk of bias was assessed. Results: Five RCTs were included for analysis. In one RCT, electroacupuncture group had significantly lower free testosterone and testosterone, compared to no treatment group. However, The other RCTs showed no significant difference between two groups. For LH/FSH, Ferriman Gallway score, anti-mullerian hormone, body mass index, weight and waist, and insulin, electroacupuncture group showed no significant difference, compared to physical exercise, no treatment, and sham acupuncture group. Conclusions: Only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of electroacupuncture for treatment of PCOS.

• Clinical and Experimental Reproductive Medicine
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• 제44권3호
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• pp.146-151
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• 2017

Objective: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor $(PPAR)-{\gamma}$, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor $(TNF)-{\alpha}$ in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. Methods: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. Results: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. $PPAR-{\gamma}$ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p= 0.034 and p= 0.018, respectively), but the expression of IL-6 and $TNF-{\alpha}$ mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the $PPAR-{\gamma}$, COX-2, IL-6, and $TNF-{\alpha}$ mRNA levels. Conclusion: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of $PPAR-{\gamma}$ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.

• Clinical Nutrition Research
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• 제13권3호
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• pp.201-213
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• 2024

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to test our hypothesis that herbal tea may improve anthropometric parameters, metabolic factors, and hormone levels in women with polycystic ovarian syndrome (PCOS). A literature search was conducted on Information Sciences Institute, Medline (PubMed), Scopus, Embase, and Google Scholar, up to March 2023 without applying language or date restrictions. RCTs that assigned herbal tea vs. placebo on PCOS women and evaluated changes in anthropometric measurements, metabolic indices, or hormonal profiles were included. Six RCTs with 235 PCOS women (119 in the intervention and 116 in the control group) were included. Meta-analysis showed that herbal tea consumption led to significant decreases in weight (weighted mean difference [WMD], -2.02 kg; 95% confidence interval [CI], -3.25, -0.80), body mass index (BMI) (WMD, -0.88 kg/m²; 95% CI, -1.47, -0.28) and fasting blood glucose (FBG) (WMD, -6.47 mg/dL; 95% CI, -8.49, -4.45), compared to the control group. Herbal tea supplementation has also significantly increased follicle-stimulating hormone (FSH) concentration (WMD, 0.56 IU/L; 95% CI, 0.17, 0.95). Meanwhile, the effect of herbal tea on the waist/hip ratio, hip circumference, waist circumference, body fat, fasting insulin, FBG/insulin ratio, luteinizing hormone, total testosterone, and dehydroepiandrosterone sulfate was not significant. Herbal tea might be a potential supplemental therapy to manage weight, BMI, FBG, and FSH in PCOS women. Further large randomized clinical trials are recommended to affirm these findings.

• Clinical and Experimental Reproductive Medicine
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• 제51권3호
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• pp.181-191
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• 2024

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among reproductive-age women. As a leading cause of anovulatory infertility, it complicates fertility treatments, including in vitro fertilization. The widely accepted 2003 Rotterdam diagnostic criteria for PCOS include sub-phenotypes based on variations in androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. In this systematic review, we examined the impacts of inositol and vitamin D on fertility in PCOS. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we used relevant keywords to comprehensively search databases including PubMed, Google Scholar, and MDPI. From an initial pool of 345 articles, 10 met the inclusion criteria. The articles suggest that vitamin D and inositol, particularly myo-inositol and D-chiro-inositol, may represent therapeutic options for PCOS. Vitamin D influences ovarian follicular development, glucose regulation, and insulin sensitivity. When combined with metformin therapy, it is associated with improved menstrual regularity and ovulation. Inositol is crucial for cellular signaling, energy metabolism, glucose regulation, and fertility. This systematic review underscores the importance of investigating inositol and vitamin D within a PCOS management strategy, given the disorder's prevalence and impacts on fertility and metabolic health. Although these agents show promise, additional research could clarify their mechanisms of action and therapeutic benefits. This review emphasizes the need for exploration of effective treatments to improve the quality of life among individuals with PCOS. Inositol and vitamin D represent potential options, but more studies are required to elucidate their roles in the management of this condition.