• Clinical and Experimental Reproductive Medicine
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• v.38 no.4
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• pp.228-233
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• 2011

Objective: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP). Methods: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP. Results: There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups. Conclusion: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.3
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• pp.153-158
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• 2011

Objective: The aim of this study was to investigate whether anti-M$\ddot{u}$llerian hormone (AMH) levels could be predict ovarian poor/hyper response and IVF cycle outcome. Methods: Between May 2010 and January 2011, serum AMH levels were evaluated with retrospective analysis. Three hundred seventy infertile women undergoing 461 IVF cycles between the ages of 20 and 42 were studied. We defined the poor response as the number of oocytes retrieved was equal or less than 3, and the hyper response as more than 25 oocytes retrieved. Serum AMH was measured by commercial enzymelinked immunoassay. Results: The number of oocytes retrieved was more correlated with the serum AMH level (r=0.781, $p$ <0.01) than serum FSH (r=-0.412, $p$ <0.01). The cut-off value of serum AMH levels for poor response was 1.05 ng/mL (receiver operating characteristic [ROC] curves/area under the curve [AUC], $ROC_{AUC}$=0.85, sensitivity 74%, specificity 87%). Hyper response cut-off value was 3.55 ng/mL $ROC_{AUC}$=0.91, sensitivity 94%, specificity 81%). When the study group was divided according to the serum AMH levels (low: <1.05 ng/mL, middle: 1.05 ng/mL - 3.55 ng/mL, high: >3.55 ng/mL), the groups showed no statistical differences in mature oocyte rates (71.6% vs. 76.5% vs. 74.8%) or fertilization rates (76.9% vs. 76.6% vs. 73.8%), but showed significant differences in clinical pregnancy rates (21.7% vs. 24.1% vs. 40.8%, $p$=0.017). Conclusion: The serum AMH level can be used to predict the number of oocytes retrieved in patients, distinguishing poor and high responders.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.33 no.5
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• pp.431-438
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• 2000

To clarify the annual reproductive cycle in a rockfish, Sebastes schlegeli, monthly changes in gonadosomatic index (GSI), hepatosomatic index (HSI) and histological feature of gonads and plasma levels of sex steroid hormones ($estradiol-l7{\beta},\;17{\alpha},\;20{\beta}-dihydroxy-4-pregnen-3-one,\;testosterone\;and\;11-ketotestosterone$) were investigated. The annual reproductive cycle in females could be divided into 5 periods as follows: 1) recovery period (June to September): serum level of $estradiol-l7{\beta}$ increased gradually; 2) vitellogenesis period (Septemer to february) : vitellogenic oocytes were obsewed, GSI sustained high value, and serum level of $estradiol-l7{\beta}$ increased; 3) gestation period (February-April): developing larva showed in the ovary, and serum levels of $17{\alpha},\;20{\beta}-dihydroxy-4-pregnen-3-one$ and testosterone increased; 4) partrition period (April to May) : larva were delivered, and value of GSI and serum levels of hormones decreased rapidly; 5) resting period (May to June) : value of GSI and serum levels of $estradiol-l7{\beta}$ and testosterone remained low. The annual reproductive cycle in males could be divided into 6 periods; 1) early maturation period (April to June): value of GSI and serum levels of hormones incresed gradually, cyst of spermatogonia incresed in number, and a small number of cyst of spermatocyte was observed; 2) mid-maturation perid (June to September); value of GSI and serum levels of hormones increased, and germ cells in many cysts were undergoing active sperrnatogenesis; 3) late maturation period (September to November) : value of GSI and serum levels of hormones remained high and spermatozoa were released into the lumina of the seminal lobules; 3) spermatozoa dischaging period (Nobember to December) : the lumina of the seminal lobules were enlarged and filled with mature spermatozoa; 4) degeneration period (December to Februauy)i value of GSI decresed and cyst of spermatocyte were decresed in number; 5) resting period (December to April) : no histological changes of testes were observed, and value of GSI and serum levels of hormones remained low. In November, the lumina of the seminal lobules were filled with mature spermatozoa and sperm masses were present in the ovarian cavity. Thus, copulation in this species occurred in November and December.

• Korean Journal of Ichthyology
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• v.18 no.3
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• pp.184-192
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• 2006

To investigate reproductive cycle of Tridentiger obscurus in Jeju, total 408 fish were collected in brackish area (May 2004 to August 2005) and total 271 fish were collected in tidal pool (July 2004 to August 2005), respectively. Water temperature ranged $11.0{\sim}21.6^{\circ}C$ in brackish area. Water temperature of tidal pool ($11.1{\sim}24.5^{\circ}C$) in 2005 was similar to that of brackish area although it were highest $30.1{\sim}29.2^{\circ}C$ from July to August in 2004. In brackish area, female gonadosomatic index (GSI) increased in April and maintained high values from May to August. The reproductive cycle can be grouped into the following successive stages in the ovary: immature (November to May), maturing (March to September), ripe and spawning (May to September), and degenerating (July to December). In the tidal pool, female GSI rapidly increased in April and maintained high values until July in 2005. However, it has been low in July 2004 when water temperature was highest. The reproductive cycle can be grouped into the following successive stages in the ovary: immature (August to April), maturing (March to August), ripe and spawning (March to July), and degenerating (July to August 2004 and August 2005). Fecundity of mature female ranged from 1,214 to 12,109 in brackish and ranged from 2,427 to 13,892 in tidal pool area. The fecundity of fish in the tidal pool was significantly higher than that of fish in brackish area. Fecundity was correlated positively with total length and body weigh. Although the large group (> 111 mm total length) in brackish area observed only in spawning season, one in the tidal pool observed from October 2004 until next spawning season. Frequency of the large group was 0 to 12% and 11.4 to 57.9% in brackish area and tidal pool, respectively. These results were indicated that gonadal development of T. obscurus was affected to water temperature and day length.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.32 no.5
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• pp.629-636
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• 1999

Gonadal development, gametogenesis, reproductive cycle, egg-diameter and composition, condition factor, and the first sexual maturity of the clam, Potamocorbula amurensis were investigated by histological observation. Samples were collected monthly from the tidal flat of Moonpo, Puan-gun, Chollabuk-do, west coast of Korea from November 1996 to October 1997. P. amurensis is dioecious and oviparous. The gonads were composed of a number of gametogenic follicles. The oogonia and fully ripe oocytes were $9\~12\mu$m and $50\~60\mu$m in diameter, respectively. Each of the spermatogenic follicle formed stratified layers composed of spermatogonia, spermatocytes spermatids, and spermatozoa in groups on the follicular wall. The reproductive cycle of P. amurensis could be classified into five successive stages: early active, late active, ripe, partially spawned, and recovery. Spawning occurred twice a year from May to July and from September to October, the main spawning seasons also appeared twice a year between May and June, and in October when the water temperatures reached above $18^{\circ}C$. The monthly changes in the condition factor were closely related with the reproductive cycle. Minimum size for the sexual maturation of female and male were 8.1 mm in shell length. There were two patterns for the gametogenesis: 1. After spawning, the undischarged ripe oocytes and spermatozoa in the follicles were degenerated and absorbed, but in part, the existing follicles were not contracted significantly and then they took part in new gametogenesis within one or two months (especially, in summer). 2. After spawning, each follicle was contracted, thereafter gametogenesis again occurred in newly formed follicles.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.73-81
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• 2010

Objective: To examine the efficacy of letrozole in infertile women showing a poor endometrial development at previous ovulation induction cycle by using clomiphene citrate. Methods: Eighteen infertile women were selected who showed a poor endometrial development (endometrial thickness$\leq$6.5 mm) after clomiphene treatment (50~100 mg) as ovulation induction for timed coitus. The mean age of the patients was $30.7{\pm}2.8$ years old and the mean duration of infertility was $33.1{\pm}26.6$ months. The infertility factors were identified as corrected endometriosis (n=1), polycystic ovary syndrome (n=5) and unexplained (n=12). Letrozole was given orally in a dose of 2.5 mg for 5 days starting 3~5 of menstrual cycle. Results: The number of follicles was significantly lower in the letrozole cycle when compared with previous clomiphene cycle ($1.1{\pm}0.3$ vs. $2.2{\pm}1.5$, p=0.011). The endometrial thickness (mm) at the time of triggering or LH surge was significantly greater in the letrozole cycle ($8.4{\pm}1.7$ vs. $5.8{\pm}0.5$, p<0.001). The endometrial pattern 'type C' was significantly higher in the letrozole cycle (94.4% vs. 50%, p=0.036). The pregnancy was achieved in 11.1% of the letrozole cycle. Conclusion: Use of letrozole was associated with more thick and improved endometrium than previous clomiphene cycles in which thin endometrium was identified. Use of letrozole appears to be an effective strategy for second-line treatment in women with inadequate endometrial response to clomiphene.

• The Journal of Korean Obstetrics and Gynecology
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• v.25 no.1
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• pp.56-69
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• 2012

Objectives: This study was conducted to investigate the relationship between menstrual conditions and items of health checkup examinations in female university students for prediction of reproductive health. Methods: Data from the 2011's medical examination participants(990 students among total 1,699 students) of ${\bigcirc}{\bigcirc}$ University University in Korea were analyzed for this study. Menstrual condition, Sa-sang constitution and other surveys were checked through self-administered questionnaire, health checkup were measured anthropometric variables, CBC, B/C and U/A. Results: In the 46.4% of total participants appeared menstrual disorder of menstrual cycle or menstrual amount, the irregular period of menstrual cycle have a influence on menstrual amount. stress was relatively heavy factor of causing irregularity of menstrual cycle and amount, RBC, cholesterol, ABO type and Sa-sang constitution had some connection with menstrual amount. Conclusions: Among the items of health checkup examinations, stress, RBC, cholesterol, ABO type and Sa-sang constitution were related with the change of menstrual cycle and amount.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.3
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• pp.207-215
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• 2003

Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

• Clinical and Experimental Reproductive Medicine
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• v.40 no.2
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• pp.90-94
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• 2013

Objective: To evaluate the efficacy of earlier oocyte retrieval in IVF patients with a premature LH surge on hCG day. Methods: One hundred forty IVF patients (164 cycles) with premature LH surge on hCG day were included, retrospectively. We divided them into 2 study groups: LH surge with timed ovum pick-up (OPU) 36 hours after hCG injection (group B, 129 premature cycles), and LH surge with earlier OPU within 36 hours after hCG injection (group C, 35 cycles). Control groups were tubal factor infertility without premature LH surge (group A, 143 cycles). Results: The mean age (year) was statistically higher in group C than in groups A or B ($38.2{\pm}5.4$ vs. $36.2{\pm}4.2$ vs. $36.8{\pm}4.9$, respectively; p=0.012). The serum LH levels (mIU/mL) on hCG day were significantly higher in group B and C than in group A ($22.7{\pm}14.9$ vs. $30.3{\pm}15.9$ vs. $3.2{\pm}2.9$, respectively; p>0.001). Among groups A, B, and C, 4.9%, 31.7%, and 51.4% of the cycles, respectively, had no oocytes, and the overall rates of cycle cancellation (OPU cancellation, no oocyte, or no embryos transferrable) were 15.4%, 65.9%, and 74.3%, respectively. The fertilization rate (%) was significantly higher in group B than in group C ($73.2{\pm}38.9$ vs. $47.8{\pm}42.9$, p=0.024). The clinical pregnancy rate was significantly higher in group C than in groups A and B (44.4% vs. 27.3% vs. 9.1%, respectively, p=0.021). However, the miscarriage rate was also higher in group C than in group B (22% vs. 0%, respectively, p=0.026). Conclusion: Earlier OPU may not be effective in reducing the risk of cycle cancellation in patients with premature LH surge on hCG day. A larger scale study will be required to reveal the effectiveness of earlier ovum retrieval with premature LH surge.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.1
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• pp.47-52
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• 2011

Objective: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. Methods: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. Results: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of ${\geq}111{\times}10^6/mL$, a motility of ${\geq}$ 51.4%, and RAPID ${\geq}$ 30.1% before preparation for IUI. Conclusion: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.