• Clinical and Experimental Reproductive Medicine
• /
• v.48 no.3
• /
• pp.194-197
• /
• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• Asian-Australasian Journal of Animal Sciences
• /
• v.26 no.10
• /
• pp.1406-1415
• /
• 2013

The study was conducted to correlate the periparturient immune status in terms of neutrophil functions and cytokine expression in peripheral blood mononuclear cell culture with impending postpartum reproductive disorders in buffaloes. Forty pregnant buffaloes were observed for occurrence of postpartum reproductive disorders (PRD), i.e., metritis, endometritis and delayed uterine involution etc., during one week prepartum to four weeks postpartum period. A representative number (n = 6) of buffaloes that did not develop any PRD were included in group I (healthy, control), while the animals which experienced PRD were assigned into group II (PRD, n = 8). The blood samples were collected at weekly interval from one week prepartum to four weeks postpartum period considering the day of calving as 'd 0'. Differential leucocytes counts, superoxide and hydrogen peroxide production activity in isolated neutrophils and the mRNA expression profile of cytokines i.e., IL-2, IL-4 and IFN-${\gamma}$ in PBMC culture were studied in all the samples. A higher total leucocytes, neutrophil and band cells count along with impaired neutrophil functions i.e., lowered level of production of superoxide and hydrogen peroxide before parturition and during early postpartum period were observed in buffaloes developing PRD. Further, a lower expression of IL-2, IFN-${\gamma}$ and IL-4 mRNA in PBMC culture was observed at calving in buffaloes that subsequently developed PRD at later postpartum. Thus, suppression in neutrophil function and cytokine expression at prepartum to early postpartum period predisposes the buffaloes to develop postpartum reproductive disorders. Hence, monitoring of neutrophils function and cytokine expression profile would be effective to predict certain reproductive disorders at late pregnancy or immediately after parturition in buffaloes. In future, this may be a novel approach for determining suitable management and therapeutic decisions for prevention of commonly occurring reproductive disorders in farm animals.

• Clinical and Experimental Reproductive Medicine
• /
• v.32 no.4
• /
• pp.325-330
• /
• 2005

Objective: To investigate the histologic features of the uterus and adnexae extirpated from gender identity disorder (GID) patients that received depot androgen injection. Methods: We reviewed the histologic findings of the uterus and adnexae removed from sixteen GID patients, who had taken depot androgen injection for 5~168 months. Results: Fourteen patients (87.5%) showed the atrophied epithelium of exocervix and all of 16 patients (100%) showed the atrophy of endometrium. Seven patients (43.7%) showed multiple cystic follicles in the ovarian cortex and 6 patients (37.5%), 3 patients (18.7%) showed corpus albicans and corpus luteum, respectively. Conclusions: Exogenous androgen induced atrophy of cervix and endometrium. This effect was more prominent in the endometrium. In addition, PCO-like histologic features were observed in the ovary.

• Clinical and Experimental Pediatrics
• /
• v.63 no.9
• /
• pp.368-372
• /
• 2020

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication. Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2-10 years without ASD, while the cases were women with a child aged 2-10 years with ASD. We used a researcher-made questionnaire. Data were analyzed using Stata ver. 14 at the 0.05 significance level. Results: In the univariate analysis, there was significant association between child sex, delivery mode, history of preterm delivery, history of using ART, and maternal age at child's birth and the risk of ASD. After the adjustment for other variables, this association was significant for male sex (2.66; 95% confidence interval [CI], 1.11-4.31; P=0.001) and history of using ART (4.03; 95% CI, 1.76-9.21; P=0.001). Therefore, after the adjustment for confounder variables, there was no significant association between ART and the risk of ASD among children (4.98; 95% CI, 0.91-27.30; P=0.065). Conclusion: After the adjustment for other variables, risk factors for ASD were male sex and history preterm delivery. Thus, there was no significant association between ART and the risk of ASD among children.

• Journal of Embryo Transfer
• /
• v.21 no.4
• /
• pp.331-338
• /
• 2006

This survey was carried out to investigate the occurrence of reproductive disorders in Korean native cattle (Hanwoo). The general management status such as barn type, feed intake, parity and type of reproductive disorders were examined in the Hanwoo farms. In this survey, the total incidence of reproductive disorders that was assessed from 54 Hanwoo farms was 11.6% (73/ 631). We first examined the incidence of reproductive disorders following herd size per farm. The rates of reproductive disorders in under 10 heads, 10 to 20 heads and over 20 heads were 25.2%, 9.4% and 8.3%, respectively (P<0.05). The rate of reproductive disorders in tie stall barn was significantly (P<0.05) higher than that in free stall barn (14.9% vs. 8.1%). The major types of reproductive disorders were follicular cysts (21.8%), fat necrosis (21.8%), and repeat breeding (17.8%). The rate of reproductive disorders assessed by the parity tended to decrease as the parity increased. The relationship between incidence of reproductive disorders and body condition score (BCS) was investigated in 203 Hanwoo. The incidence of reproductive disorder was 80.0%, 8.8%, 9.4%, 10.0%, 33.3% and 57.1% at 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0 of BCS, respectively. These data show that the increase of herd size, barn type and BCS affect the incidence of reproductive disorders such as follicular cysts, fat necrosis and repeat breeding in Hanwoo.

• Journal of Embryo Transfer
• /
• v.23 no.1
• /
• pp.59-64
• /
• 2008

The objective of this study is to investigate the changes in concentrations of blood urea nitrogen (BUN) and sex steroid hormones, such as estrogen, progesterone, and testosterone in Korean cattle (Hanwoo) with reproductive disorders and to examine the relationship between BUN and body condition score (BCS) in Hanwoo. The concentration of BUN was 16.2 mg/dl, 17.8 mg/dl, 15.1 mg/dl, 17.9 mg/dl, and 28.3mg/dl in pregnancy, repeat breeding, follicular cyst, luteal cyst, and ovarian atrophy, respectively. In Hanwoo with BCS $2.0{\sim}2.9$, $3.0{\sim}3.5$ and $3.6{\sim}4.0$, the concentration of BUN was 15.8 mg/dl, 17.0 mg/dl, and 17.6 mg/dl, respectively. Fluoroimmunoassay showed that serum estrogen and progesterone levels were decreased in reproductive disorders Hanwoo, such as ovarian atrophy, endometritis, and weak estrus. The testosterone level was significantly decreased in Hanwoo with reproductive disorders compared to that in pregnant Hanwoo ($0.02{\sim}0.03\;ng/ml$ vs 0.13 ng/ml, p<0.05). The progesterone and estrogen concentrations in follicular fluid obtained from ovary with follicular cyst were significantly higher (p<0.05) than those in normal follicle fluid. These results show that there is no relationship between BUN and BCS in Hanwoo, and the concentration of sex steroid hormone in serum and follicular fluid are changed in reproductive disorders Hanwoo.

• Journal of Embryo Transfer
• /
• v.16 no.1
• /
• pp.7-14
• /
• 2001

The aims of these study were to diagnose early pregnancy and reproductive disorders by using progesterone concentration and ultrasonography. The measurement of blood progesterone (P$_4$) concentration was conducted to diagnose pregnancy and to detect corpus luteum (CL) or evaluate disorder of CLs. As a result, the incidence rates of reproductive disorders were as follows : SH and EED (41.9%), inacitve ovaries (32.6%), follicullar cyst (9.3%), PCL (7.0%), endometritis (4.7%), pyometra (2.3%) and luteal cyst (2.3%). 61 Cows having P$_4$concentration 1.0 ng/ml(at the insemination) were increased to 1.0 ng/ml $\geq$ 6day after insemination. 50 cows among 61 cows were diagnosed pregnant. 8 cows among 13 HanWoos having P$_4$concentration 1.0 ng/ml at the insemination and 1.0 ng/mnl 6 day after insemination had non-ovulatory estrus and the others had P$_4$concentration 1.0 ng/ml at the insemination and 1.0 ng/ml $\geq$ 6 day after insemination, which was the error of estrus detection. All 13 cows were diagnosed non-pregnant. 47 cows diagnosed pregnant after insemination of P$_4$concentration 3.0 ng/ml were examined by ultrasonography at 30 day post-insemination. As a result, 41 cows were diagnosed pregnant (87.2%) but 14 cows having P$_4$concentration 3.0 ng/ml at 21 day after insemination was diagnosed to non-pregnancy. Calving intervals by surveying 100 cows were as follows 11~12 months (20%), 12~13 months (36%), 13~14 months (19%), 14 months $\geq$ (25%), respectively. In conclusion, hormone and ultrasonography help to detect reproductive disorders exactly and diagnose early pregnancy. This study suggest that diagnosis of early pregnancy and reproductive disorder by blood P$_4$concentration and ultrasonography improve reproduction management of HanWoo.

• Clinical and Experimental Reproductive Medicine
• /
• v.48 no.1
• /
• pp.91-94
• /
• 2021

A 28-year-old woman presented with a 1-year history of severe progressive dysmenorrhea following suction evacuation and tubal ligation. Sonography showed a bicornuate uterus with hematometra in the left horn. Hysteroscopy ruled out a diagnosis of a congenital Müllerian anomaly, as both ostia appeared normal. Under laparoscopy, a mass was seen on the left fundal region near the insertion of the round ligament, and needle aspiration of a chocolate-colored fluid confirmed the diagnosis of an adenomyotic cyst. The cyst was excised. The patient recovered well and has been symptom-free since surgery. Adenomyotic cyst is a rare entity in young women and must be differentiated from obstructive Müllerian anomaly. Laparoscopy is the preferred minimally invasive modality for managing this rare disorder.

• Journal of Interdisciplinary Genomics
• /
• v.3 no.2
• /
• pp.30-34
• /
• 2021

Campomelic dysplasia (CD) is a rare genetic disorder characterized by multiple skeletal anomalies and the abnormal development of male reproductive organs. To date, the SOX9 gene is the only known causal gene for CD, and approximately 90 causative mutations in SOX9 have been identified worldwide. CD is diagnosed based on clinical characteristics of skeletal dysplasia (e.g., short bowed long bones, kyphoscoliosis, bell-shaped thoracic cage with 11 pairs of ribs, and hypoplastic scapulars), typical facial features of Pierre Robin sequence with cleft palate, and gonadal dysgenesis in 46,XY individuals. Most patients with CD exhibit life-threatening respiratory failure owing to laryngotracheomalacia and hypoplastic thorax during the neonatal period. Although fatal complications decrease after infancy, several medical conditions continue to require proper management. A better understanding of this rare but lethal condition may lead to more appropriate treatments for patients.

• Annals of Clinical Neurophysiology
• /
• v.4 no.1
• /
• pp.51-55
• /
• 2002

Background : An increased frequency of reproductive endocrine disorders and polycystic ovary(PCO) has been reported in women with epilepsy. A possible role of the seizure disorder or, of the use of antiepileptic drugs(AEDs) has been suggested as the pathogenic mechanism. The objective of the present study was to assess the prevalence of reproductive endocrine disorders, such as PCO or menstrual abnormalities, in a series of women with epilepsy, examining the possible relationships of these disturbances with different epilepsy syndromes and AED treatment. Methods : Thirty epileptic women, all of reproductive age and none pubertal, pregnant, or lactating, were evaluated by clinical endocrinological assessment, and pelvic ultrasonography. Seven patients were on valproic acid(VPA), nineteen on carbamazepine(CBZ), and four on diphenylhydantoin(DPH) treatment, respectively. Results : Menstrual irregularity was observed in 8 women(26.7%), dysmenorrhea in 7(23.3%), and premenstrual syndrome in 1(3.3%). Ultrasonographic examination revealed that one women(3.3%) showed polycystic ovary, 4(13.3%) had ovarian cyst(s), and 2(6.7%) had uterine myoma, respectively. There was no difference in the prevalence of menstrual abnormalities or polycystic ovary according to the different preparations of AEDs. Conclusions : Data from this investigation suggest that, in Korean reproductive age women, the treatment of AEDs and the kind of medication may not have a significant effect on the prevalence of menstrual abnormalities or ultrasonographic polycystic ovary.