• 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.

• Clinical and Experimental Reproductive Medicine
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• 제44권1호
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• pp.1-7
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• 2017

The task force of the Korean Society for Reproductive Immunology recommends intravenous immunoglobulin G treatment in women with reproductive failure, including recurrent pregnancy loss and/or repeated implantation failure, who show cellular immune factors such as abnormal natural killer cell levels, natural killer cell cytotoxicity, and/or type 1 T helper immunity.

• Clinical and Experimental Reproductive Medicine
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• 제42권4호
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• pp.149-155
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• 2015

Objective: The goal of this study was to investigate the relationship between serum progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration and the pregnancy rate among women undergoing controlled ovarian stimulation for in vitro fertilization (IVF) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) using a flexible antagonist protocol. Methods: This prospective study included 200 IVF and ICSI-ET cycles in which a flexible antagonist protocol was used. The patients were divided into five distinct groups according to their serum P4 levels at the time of hCG administration (0.80, 0.85, 0.90, 0.95, and 1.00 ng/mL). The clinical pregnancy rate (CPR) was calculated for each P4 interval. Statistically significant differences were observed at a serum P4 level of 0.9 ng/mL. These data suggest that a serum P4 concentration of 0.9 ng/mL may represent the optimal threshold level for defining premature luteinization (PL) based on the presence of a significant negative impact on the CPR. Results: The CPR for each round of ET was significantly lower in the PL group defined using this threshold (25.8% vs. 41.8%; p=0.019), and the number of oocytes retrieved was significantly higher than in the non-PL group ($17.3{\pm}7.2$ vs. $11.0{\pm}7.2$; p=0.001). Elevated serum P4 levels on the day of hCG administration were associated with a reduced CPR, despite the retrieval of many oocytes. Conclusion: Measuring serum P4 values at the time of hCG administration is necessary in order to determine the optimal strategy for embryo transfer.

• 대한한방체열의학회지
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• 제8권1호
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• pp.26-32
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• 2010

Purpose : To quantitative analyse the hot flush and abdominal cold hypersensitivity relief efficacy of Cheonglijagamtang in climacteric women by DITI. Methods : The patients was a 59-year-old climacteric woman who was suffered by hot flush and abdominal cold hypersensitivity. The patient was treated by herb medicine, acupuncture treatment, moxa treatment and physical treatment. The progress of symptoms was evaluated by checking the change of VAS, and inspecting the DITI. Results : Visual analog scale of hot flush and abdominal cold hypersensitivity in this climacteric women have decreased after treatment. The temperature of two abdominal site(RN12.RN4) after treatment get higher than those before treatment. Difference of acupoint-Indang and other abdominal site(RN12.RN4)'s temperature have decreased after treatment. Conclusion : The result suggest that DITI can be used for the diagnosis of hot flush and coldness relief efficacy in climacteric women.

• Clinical and Experimental Reproductive Medicine
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• 제30권2호
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• pp.141-150
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• 2003

Objective: To evaluate whether diagnostic laparoscopy before transcervical fallopian tube catheterization (TFTC) would improve tubal recanalization rate and pregnancy rate in patients with bilateral proximal tubal blockage in hysterosalpingogram (HSG). Methods: The retrospective study was performed in those underwent TFTC from January 1998 to December 2001. A total of 50 patients with bilateral proximal tubal blockage in HSG were subjected to TFTC sequentially using repeated HSG (rHSG), selective salpingography (SS) followed by tubal catheterization (TFTC). Each procedure was terminated once patency had been achieved without proceding to the next technique. In Group A patients (n=35, 64 tubes), diagnostic laparoscopy was performed before TFTC was taken to exclude the tube combined with peritubal adhesion or distal tubal pathology. In Group B, patients (n=15, 26 tubes) were performed TFTC without diagnostic laparoscopy. Results: There were significant difference in clinical pregnancy rate (45.7% vs 15.4%, p=0.034) but no differences were found in recanalization rate (75.0% vs 73.1%) and complication rate (8.6% vs 13.3%). Although there is no signficant difference, more tubes were canalized by SS, which means tubal obstruction rather than occlusion, in Group A (25.0% vs 5.3%, p=0.069). Conclusion: Diagnostic laparoscopy would be effective in the selection of tube for the relatively inexpensive and less invasive TFTC or patients in need of assisted reproductive technologies. With the tubes without combined peritubal adhesion or distal tubal pathology, pregnancy rate was significantly increased.

• Journal of Genetic Medicine
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• 제6권2호
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• pp.175-178
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• 2009

22q11.2미세중복 증후군은 학습장애, 선천적 기형에서부터 정상에 이르기까지 다양한 표현형을 나타내는 증후군으로써, 22q11.2 미세결실 증후군인 DiGeorge 증후군과 동일한 위치에서 발생하는 질환이며, 이러한 원인은 유전적 불안정성이 높은 low-copy repeats (LCR) 부위에서 일어나는 유전체의 결손이나 중복에 의해 형성되는 것으로 보고되고 있다. 최근 array CGH가 임상분야에 적용됨에 따라 22q11.2 미세중복 증후군의 진단이 증가되고 있다. 이론적으로 22q11.2 부위의 미세중복이나 미세결실의 빈도는 동일하게 발생해야 하지만, 현재까지 미세결실에 비해 미세중복의 증례보고는 상대적으로 드물며 이는 증상이 없는 경우가 많기 때문인 것으로 알려져 있다. 특히 이전 보고에서 산전에 발견된 미세중복의 증례는 단1례 만이 보고된 바 있다. 저자들은 산전에 진단된 22q11.2 미세중복 증후군 1례의 보고를 통해 유전상담의 중요성과 array CGH의 임상 적용에 관하여 논하고자 한다.

• Journal of Genetic Medicine
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• 제6권1호
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• pp.95-99
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• 2009

산전에서 성염색체와 13번, 18번, 21번 염색체를 제외한상염색체의 모자이시즘은 발생빈도가 낮고 증례보고가 적어서 예후 예측이 어렵다. 저자들은 삼염색체성 5번, 16번, 20번의 산전진단 4례를 보고하고자 한다. 모자�� 삼염색체성 20번 2례 중 증례 1은 양수 염색체 검사에서 36.6%의 모자이시즘을 보였으나 재검한 양수 검사에서는 보다 높은 빈도 (62.1%)를 보였다. 증례2에서는 양수 염색체 검사에서 모자이시즘 삼염색체성 20번이 5.25% 였으나, 재검 양수천자결과는 정상 핵형을 보였다. 증례 3은 30개의 양수세포에서 삼염색체성 16번의 모자이시즘이 13.6% 관찰되었다. 임신 종결 후, 총60개의 태아 혈액 세포에서 모자이시즘 없는 정상 핵형이 관찰되었으나 태아의 피부 섬유아세포에서 얻은 40개의 중기상 세포에서는 22.5%의 삼염색체성 16번 모자이시즘을 보였다. 부검결과 심실중격결손(ventricular septal defect)이 관찰되었다. 증례 4는 76개의 중기상 세포에서 10.5%의 삼염색체성 5번 모자이시즘을 보였으나 태아의 초음파검사에서는 정상소견을 보였다. Level III 모자이시즘은진성 모자이시즘으로 간주되지만 발생빈도가 낮은 상염색체의 삼염색체성 모자이시즘은 태아의 예후를 예견하기 어려우므로 산전 진단시 여러 조직의 재검 및 태아 초음파 소견과 함께 다양한 임상적 접근 방법으로 그 해석에 신중을 기해야 할 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제40권3호
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• pp.135-140
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• 2013

Objective: To evaluate correlations between serum anti-M${\ddot{u}}$llerian hormone (AMH) levels, phenotypes of polycystic ovary syndrome (PCOS), obesity, and metabolic parameters in patients with PCOS. Methods: A total of 175 patients with PCOS were diagnosed according to the Rotterdam Consensus were included. Exclusion criteria were age over 40, FSH>25 mIU/mL, and 17a-OHP>1.5 ng/mL. The Phenotypes of PCOS were divided into a severe form (oligo-anovulation, ANOV/hyperandrogenism/polycystic ovary morphology [PCOM]; n=59) and a mild form without HA (ANOV/PCOM, n=105). The serum AMH levels were classified into 3 groups (<5 vs. 5-10 vs. >10 ng/mL). Obesity was defined as body mass index (BMI) ${\geq}25kg/m^2$ (n=34). Results: The mean age was $25.9{\pm}5.7$ year and mean AMH level was $10.1{\pm}5.4$ ng/mL. The BMI ($kg/m^2$) was higher in group 1 ($24.2{\pm}6.3$) than in group 2 ($21.9{\pm}4.3$, p=0.046) or group 3 ($21.6{\pm}3.3$, p=0.019). There was no difference among the three groups in age, menstrual interval, antral follicle counts, androgens, or other metabolic parameters. The obesity group showed significantly lower AMH ($7.7{\pm}3.9$ ng/mL vs. $10.7{\pm}5.6$ ng/mL), p=0.004) and low-density lipoprotein levels ($93.1{\pm}21.2$ mg/dL vs. $107.5{\pm}39.3$ mg/dL, p=0.031), and showed higher total T ($0.74{\pm}0.59$ L vs. $0.47{\pm}0.36$ ng/mL, p=0.001), free T ($2.01{\pm}1.9$ vs. $1.04{\pm}0.8$ pg/mL, p=0.0001), and free androgen index ($6.2{\pm}7.9$ vs. $3.5{\pm}3.0$, p=0.003). After controlling for age factors and BMI, the serum AMH levles did not show any significant correlations with other hormonal or metabolic parmeters. Conclusion: For PCOS patients under the age 40, serum AMH is not negatively correlated with age. High serum AMH levels can not predict the phenotype of PCOS and metabolic disturbances in PCOS patients in the non-obese group. Further study might be needed to define the relation more clearly.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.133-137
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• 2013

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

• Clinical and Experimental Reproductive Medicine
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• 제42권2호
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• pp.45-50
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• 2015

Objective: Artificial oocyte activation (AOA) is an effective method to avoid total fertilization failure in human in vitro fertilization-embryo transfer (IVF-ET) cycles. AOA performed using a calcium ionophore can induce calcium oscillation in oocytes and initiate the fertilization process. We evaluated the usefulness of AOA with a calcium ionophore in cases of total fertilization failure in previous cycles and in cases of severe male factor infertility patients with non-motile spermatozoa after pentoxifylline (PF) treatment. Methods: The present study describes 29 intracytoplasmic sperm injection (ICSI)-AOA cycles involving male factor infertility at Cheil General Hospital from January 2006 to June 2013. Patients were divided into two groups (control, n=480; AOA, n=29) depending on whether or not AOA using a calcium ionophore (A23187) was performed after testicular sperm extraction-ICSI (TESE-ICSI). The AOA group was further split into subgroups according to sperm motility after PF treatment: i.e., motile sperm-injected (n=12) and non-motile sperm-injected (n=17) groups (total n=29 cycles). Results: The good embryo rate (52.3% vs. 66.9%), pregnancy rate (20.7% vs. 52.1%), and delivery rate (10.3% vs. 40.8%) were lower in the PF/AOA group than in the control group. When evaluating the effects of restoration of sperm motility after PF treatment on clinical outcomes there was no difference in fertilization rate (66.6% vs. 64.7% in non-motile and motile sperm, respectively), pregnancy rate (17.6% vs. 33.3%), or delivery rate (5.9% vs. 16.7%) between the two groups. Conclusion: We suggest that oocyte activation is a useful method to ensure fertilization in TESE-ICSI cycles regardless of restoration of sperm motility after PF treatment. AOA may be useful in selected patients who have a low fertilization rate or total fertilization failure.