• Title/Summary/Keyword: Reproductive medicine

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The effects of blastocyst morphological score and blastocoele re-expansion speed after warming on pregnancy outcomes

  • Yin, Huiqun;Jiang, Hong;He, Ruibing;Wang, Cunli;Zhu, Jie;Li, Yang
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.31-37
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    • 2016
  • Objective: The aim of this study was to investigate associations between the morphology score of blastocysts and blastocoele re-expansion speed after warming with clinical outcomes, which could assist in making correct and cost-effective decisions regarding the appropriate time to vitrify blastocysts and to transfer vitrified-warmed blastocysts. Methods: A total of 327 vitrified-warmed two-blastocyst transfer cycles in women 38 years old and younger were included in this retrospective study. Results: The clinical pregnancy rate (CPR) and implantation rate (IR) of transfers of two good-morphology grade 4 blastocysts vitrified on day 5 (64.1% and 46.8%, respectively) were significantly higher than the CPR and IR associated with the transfers of two good-morphology grade 3 blastocysts vitrified on day 5 (46.7% and 32.2%, respectively). No significant differences were found in the CPR and IR among the transfers of two good-morphology grade 4 blastocysts regardless of the day of cryopreservation. Logistic regression analysis showed that blastocoele reexpansion speed after warming was associated with the CPR. Conclusion: The selection of a good-morphology grade 4 blastocyst to be vitrified could be superior to the choice of a grade 3 blastocyst. Extending the culture of grade 3 blastocysts and freezing grade 4 or higher blastocysts on day 6 could lead to a greater likelihood of pregnancy. Since re-expansion was shown to be a morphological marker of superior blastocyst viability, blastocysts that quickly re-expand after warming should be prioritized for transfer.

Anti-Müllerian hormone as a predictor of polycystic ovary syndrome treated with clomiphene citrate

  • Hestiantoro, Andon;Negoro, Yuwono Sri;Afrita, Yohana;Wiweko, Budi;Sumapradja, Kanadi;Natadisastra, Muharam
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.4
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    • pp.207-214
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    • 2016
  • Objective: This study aimed to determine the threshold of $anti-M{\ddot{u}}llerian$ hormone (AMH) as predictor of follicular growth failure in polycystic ovary syndrome (PCOS) patients treated with clomiphene citrate (CC). Methods: Fifty female subjects with PCOS were recruited and divided into two groups based on successful and unsuccessful follicular growth. Related variables such as age, infertility duration, cigarette smoking, use of Moslem hijab, sunlight exposure, fiber intake, body mass index, waist circumference, AMH level, 25-hydroxy vitamin D level, and growth of dominant follicles were obtained, assessed, and statistically analyzed. Results: The AMH levels of patients with successful follicular growth were significantly lower (p= 0.001) than those with unsuccessful follicular growth ($6.10{\pm}3.52$ vs. $10.43{\pm}4.78ng/mL$). A higher volume of fiber intake was also observed in the successful follicular growth group compared to unsuccessful follicular growth group (p= 0.001). Our study found the probability of successful follicle growth was a function of AMH level and the amount of fiber intake, expressed as Y =-2.35+($-0.312{\times}AMH\;level$)+($0.464{\times}fiber\;intake$) (area under the curve, 0.88; 95% confidence interval, 0.79-0.98; p< 0.001). Conclusion: The optimal threshold of AMH level in predicting the failure of follicle growth in patients with PCOS treated with CC was 8.58 ng/mL.

Causes of amenorrhea in Korea: Experience of a single large center

  • Kwon, Su-Kyoung;Chae, Hee-Dong;Lee, Kyung-Hee;Kim, Sung-Hoon;Kim, Chung-Hoon;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.29-32
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    • 2014
  • Objective: To investigate the causes of amenorrhea in Korean women. Methods: Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results: Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-K$\ddot{u}$ster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080). Conclusion: In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women.

Pioglitazone treatment decreases follicular fluid levels of tumor necrosis factor-${\alpha}$ and interleukin-6 in patients with polycystic ovary syndrome

  • Kim, Chung-Hoon;Ahn, Jun-Woo;You, Rae-Mi;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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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.

A Observation of IVF-ET Program in the Reproductive Center of the Ohio State University Hospital (체외수정 및 배아이식:Ohio State University의 시술과정을 중심으로)

  • Kang, Kil-Chun
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.2
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    • pp.187-204
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    • 1989
  • This is a report concerning IVF-ET program and its outcomes of the reproductive center of the Ohio State University(OSU). The pregnancy rate/laparascopy in the OSU reproductive center was average 12.2%. However, the fertilization rate was lower than other reporters. The other problem of the OSU reproductive center was that there was no success in the field of cryopreserved embryo and donor embryo. Therefore, many aspects such as hyperstimulation protocol, culture systems, and embryo transfer technique should have to be reevaluated in order to enhance the outcome of IVF-ET program in the OSU reproductive center.

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Nanotechnology in reproductive medicine: Opportunities for clinical translation

  • Shandilya, Ruchita;Pathak, Neelam;Lohiya, Nirmal Kumar;Sharma, Radhey Shyam;Mishra, Pradyumna Kumar
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.245-262
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    • 2020
  • In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an indepth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.