• 제목/요약/키워드: combined pregnancy

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Pretreatment of normal responders in fresh in vitro fertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills

  • Pereira, Nigel;Petrini, Allison C.;Zhou, Zhen N.;Lekovich, Jovana P.;Kligman, Isaac;Rosenwaks, Zev
    • Clinical and Experimental Reproductive Medicine
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    • 제43권4호
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    • pp.228-232
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    • 2016
  • Objective: The aim of this study was to investigate the impact of pretreatment with transdermal estradiol ($E_2$) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles. Methods: A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal $E_2$ versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded. Results: A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal $E_2$ and OCP groups, respectively. Patients in the OCP group had a longer duration of COS ($10.7{\pm}1.63days$, p< 0.01) than the $E_2$ group ($9.92{\pm}1.94days$). Patients in the OCP group also required higher cumulative doses of gonadotropins ($2,657.3{\pm}1,187.9IU$) than those in the $E_2$ group ($2,550.1{\pm}1,270.2IU$, p= 0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups. Conclusion: Our findings suggest that compared to OCPs, pretreatment with transdermal $E_2$ is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.

여성 난임과 한의학 (다낭성난소증후군으로 인한 난임의 한양방 치료) (Korean Medicine for Women Infertility)

  • 황덕상
    • 동서간호학연구지
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    • 제28권2호
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    • pp.100-108
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    • 2022
  • Korean medicine has traditionally provided a lot of medical care for the treatment of infertility. The combination treatment of Korean medicine and Western medicine can be effective for infertility to improve the problems caused by the extremely low fertility rate and the aging of pregnant women. In relation to female infertility, we reviewed the evidence for Korean medicine treatment for polycystic ovary syndrome, which has recently been increasing interest in female infertility, and the evidence for the collaboration between Korean and Western medicine in the treatment of polycystic ovary syndrome and infertility. Because polycystic ovary syndrome is closely related to metabolic diseases related to endocrine abnormalities, hormone treatment alone has limited therapeutic effects and has side effects. In domestic and international research, herbal medicine and acupuncture in the treatment of infertility have shown good clinical effects based on the hypothesis of various mechanisms of effect, and many cases of successful pregnancy have been reported. Although continuous research through large-scale randomized clinical studies is needed to prove efficacy, the importance of combined treatment of Korean medicine and Western medicine in infertility treatment is increasing in order to solve the extremely low fertility rate. Combining artificial insemination or in vitro fertilization with Korean medicine treatment is highly likely to be effective in increasing pregnancy success and fertility rates. In women with polycystic ovary syndrome, which is recognized as a metabolic disease due to endocrine abnormalities among the causes of female infertility, Korean medicine treatment can increase the pregnancy rate with herbal medicines and acupuncture, etc. Although well-designed large-scale clinical studies are currently lacking and meta-analysis has not provided sufficient evidence, the combination treatment of Korean medicine and Western medicine is more active to increase the pregnancy rate for solving the problem of low fertility.

테이핑과 병행한 스위스볼 운동이 임신성 요통 환자의 통증과 기능장애 및 삶의 질에 미치는 효과 (Effect of Swiss Ball Exercise Combined with Taping on Pain, Disability, and Quality of Life in Women with Pregnancy-Related Low Back Pain)

  • 정경심;인태성
    • 한국엔터테인먼트산업학회논문지
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    • 제14권6호
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    • pp.301-309
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    • 2020
  • 본 연구는 4주간 테이핑을 병행한 스위스 볼 운동이 임신성 요통환자의 통증과 기능장애 및 삶의 질에 미치는 효과를 규명하기 위하여 실시되었다. 단일 맹검 및 사전 무작위 임상시험으로 진행되었으며, 16명의 임신성 요통 환자는 무작위로 테이핑과 스위스 볼 운동군(n=8)과 테이핑과 신장 운동군(n=8)으로 배정되었다. 모든 대상자는 허리에 테이핑을 적용하였다. 추가적으로 테이핑과 스위스 볼 운동군은 스위스 볼 운동을 하루 30분, 주 5회, 4주간 시행하였고 테이핑과 신장 운동군은 같은 시간동안 스트레칭 운동을 적용하였다. 통증은 시각사상척도(VAS)를 사용하여 측정하였고, 기능장애는 Roland Morris Disability Questionnaire (RMDQ), 삶의 질은 Short-Form 36 items (SF-36)을 사용하였다. 훈련 후 테이핑과 스위스 볼 운동군이 테이핑과 신장 운동군에 비해 통증과 기능장애, 삶의 질이 유의하게 개선되었다(p<.05). 본 연구는 테이핑을 병행한 스위스 볼운동이 임산부의 요통과 기능장애 및 삶의 질을 효과적으로 향상시킴을 증명하였다.

불임증(不姙症) 환자(患者)의 통계적(統計的) 고찰(考察);서울대학교병원(大學校病院) 불임상담실(不姙相談室) 1872 예(例)의 분석(分析) (An Analysis of Infertility Patients)

  • 장윤석;이진용;문신용;김정구;최승헌;임용택
    • Clinical and Experimental Reproductive Medicine
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    • 제12권1호
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    • pp.47-70
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    • 1985
  • This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

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First trimester screening for trisomy 18 by a combination of nuchal translucency thickness and epigenetic marker level

  • Lee, Da Eun;Kim, Shin Young;Kim, Hyun Jin;Park, So Yeon;Kim, Min Hyoung;Han, You Jung;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제14권1호
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    • pp.1-7
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    • 2017
  • Purpose: The aim of this study was to assess the diagnostic efficacy of noninvasive prenatal screening for trisomy 18 by assessing the levels of unmethylated-maspin (U-maspin) and fetal nuchal translucency (NT) thickness during the first trimester of pregnancy. Materials and Methods: A nested case-control study was conducted using maternal plasma samples collected from 65 pregnant women carrying 11 fetuses with trisomy 18 and 54 normal fetuses. We compared the U-maspin levels, NT thicknesses, or a combination of both in the first trimester between the case and control groups. Results: U-maspin levels and NT thickness were significantly elevated in the first trimester in pregnant women carrying fetuses with trisomy 18 when compared to those carrying normal fetuses (27.2 vs. 6.6 copies/mL, P<0.001 for U-maspin; 5.9 vs. 2.0 mm, P<0.001 for NT). The sensitivities of the U-maspin levels and NT thickness in prenatal screening for fetal trisomy 18 were 90.9% and 90.9%, respectively, with a specificity of 98.1%. The combined U-maspin levels and NT thickness had a sensitivity of 100% in prenatal screening for fetal trisomy 18, with a specificity of 98.1%. Conclusion: A combination of U-maspin levels and NT thickness is highly efficacious for noninvasive prenatal screening of fetal trisomy 18 in the first trimester of pregnancy.

수유복 겸용 임부복(授乳服 兼用 姙婦服) 디자인 개발(開發)에 관(關)한 연구(硏究) (A Study on the Design Development of a Maternity wear combined with Nursing)

  • 심은정;김소라
    • 패션비즈니스
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    • 제10권2호
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    • pp.147-165
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    • 2006
  • The purpose of this study was to develop design of maternity dress combined with nursing. Six maternity wears combined with nursing were developed through the literature, preceding studies, and web sites those were about pregnancy, breast feeding, a maternity wear, and a nursing wear. The results of this study were as follows: 1. In order to develop clothes of diverse styles and designs, an after five dress, a poncho style blouse, wrap culotte as well as a skirt suit, a pants suit, an one-piece dress were designed. 2. It was established to make more amounts of front ease than those of back ease and to supplement a frontal hanging portion in consideration of breast development and abdominal prominence. 3. In order to make use of a maternity wear after a birth, stretch fabric was used for an abdominal part or whole clothes. Also an empire line and pleats, a poncho style, a shirts blouse, and inserting a string were used for it. 4. the fabrics of cotton, mixed cotton, polyester were used because pregnant women and nursing mothers perspires more than others do. 5. The horizontal, vertical, diagonal slits for a breast feeding were made. The storm flap of a trench coat, a machine pleated fabric, a poncho, a bolero style were used for a nursing cover.

조경종옥탕가미방(調經種玉湯加味方)을 병용한 원발성 불임환자 치험 5례(例) (5 Cases of Primary Infertility treated by Jokyungjongok-tang gamibang)

  • 구진숙
    • 대한본초학회지
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    • 제35권5호
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    • pp.41-46
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    • 2020
  • Objectives : According to 2013 statistics, the primary infertility rate is 13.5%. The current situation is much worse than that reported, so it is even emerging as a social problem. The purpose of this study is to analyze the 5 cases of successful infertility treatment with herbal treatment and to give hope to the infertile couple to become pregnant and to suggest the possibility of herbal treatment in infertility treatment. Methods : We administered Jokyungjongok-tang gamibang as a herbal medicine and treated with acupuncture, moxibustion. Treatment was done once or twice a week. The herbal medicines were taken 30 minutes after meals and 3 times a day. While taking the herbal medicine, they were prohibited from eating flour, pork, liquor, tobacco and coffee. Patient status was assessed by consultation through pulse, tongue and abdominal diagnosis. The diagnosis of pregnancy was confirmed by ultrasonography at hospitals and the success of the treatment was judged based on healthy birth. Results : Patients had common features, such as lower abdominal pain, menstrual cramps, and blood clots during menstruation. Herbal medicine combined with acupuncture, moxibustion improved patients' overall fatigue and reduced the body's coldness. Since then, the dysmenorrhea and blood clots have decreased, and the digestion condition has improved. Therefore they became pregnant and gave birth to a healthy baby. Conclusion : Jokyungjongok-tang gamibang was effective in improving the body's coldness and uterine condition and was successful in pregnancy and helped to give birth to a healthy baby.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis

  • Yoo, Hyeji;Ahn, Sukhee
    • 여성건강간호학회지
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    • 제27권3호
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    • pp.180-195
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    • 2021
  • Purpose: This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor. Methods: The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality. Results: Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges' g=-0.67; 95% confidence interval [CI], -0.91 to -0.44), gestational diabetes (Hedges' g=-0.38; 95% CI, -0.54 to -0.12), and preterm labor (Hedges' g=-0.73; 95% CI, -1.00 to -0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias. Conclusion: Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

Comparison of embryonic competence and clinical outcomes between early and late cumulus cell removal for in vitro fertilization

  • Pongsuthirak, Pallop
    • Clinical and Experimental Reproductive Medicine
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    • 제48권4호
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    • pp.362-367
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    • 2021
  • Objective: The impact of early mechanical removal of cumulus cells on fertilization and embryonic development is not yet precisely known. This study aimed to investigate the effects of early and late cumulus cell removal on fertilization, polyspermy, embryonic development potential, blastocyst development, and clinical outcomes. Methods: A prospective study was conducted of patients who underwent in vitro fertilization between September 2019 and October 2020. Sibling oocytes were randomly allocated after insemination to early cumulus cell removal at 6 hours (group I) and late cumulus cell removal at 16-18 hours (group II). If total fertilization failure (TFF) was determined to have occurred at early cumulus cell removal, rescue intracytoplasmic sperm injection (ICSI) was performed. Fertilization, embryonic development, and pregnancy outcomes were compared. Results: A total of 912 oocytes were assigned to group I (458 oocytes) and group II (454 oocytes). Fertilization, polyspermy, embryo quality, and pregnancy outcomes were not significantly different between both groups. Rescue ICSI enabled fertilization of 79.2% of the TFF oocytes. Conclusion: Early cumulus cell removal at 6 hours had no significant difference in fertilization, polyspermy, embryo development, or obstetric and perinatal outcomes compared to late removal. Early cumulus cell removal combined with early rescue ICSI may have the potential to help couples with TFF.

폐쇄성 정로장애로 인한 무정자증 환자에서 미세수술적 부고환 정자흡입술과 세포질내 정자주입술을 이용한 수정율 및 임신율 증진에 관한 연구 (Efficacy of Microsurgical Epididymal Sperm Aspiration(MESA) and Intracytoplasmic Sperm Injection(ICSI) in Obstructive Azoospermia)

  • 손일표;홍재엽;이유식;전진현;박용석;이호준;강인수;전종영
    • Clinical and Experimental Reproductive Medicine
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    • 제21권3호
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    • pp.267-272
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    • 1994
  • We studied the role of assisted fertilization(subzonal insemination, intracytoplasmic sperm injection) in enhancing fertilization and pregnancy rate in obstructive azoospermia. MESA was performed in the patients with congenital absence of the vas deferens and unreconstructable obstructive azoospermia. Sperm were aspirated microsurgically from various sites along the epididymal stump. Sperm were then washed on a mini-PercoH gradient or swim-up method and treated by 2-deoxyadenosine and pentoxifylline. Conventional IVF(group I, 14 cycles), SUZI(group II, 13 cycles) and ICSI(gruop III, 28 cycles) were carried out in 55 treatment cycles. The clinical results are as follows: 1. Fertilization rates for group I, II and III were 16.1 %,31.4% and 48.6%, retrospectively (p<0.05). 2. Clinical pregnancy rates for group I, II and III were 7.1 %,7.7%, and 32.1 'Yo, retrospectively. 3. In 5 of MESA-ICSI cycles, epididymal sperm from alloplastic spermatocele were used and 2 clinical pregnancies (40%) were obtained. According to our results the combined MESA-ICSI procedure is highly effcient in improving fertilization and pregnancy rate in congenital absence of the vas deferens and unreconstructable obstructive azoospermia.

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