• Clinical and Experimental Reproductive Medicine
• /
• v.39 no.1
• /
• pp.28-32
• /
• 2012

Objective: This study was performed to assess the prognostic value of serum hCG, progesterone, and inhibin A levels measured at 11 days post-ET for predicting pregnancy outcome in women participating in IVF. Methods: Between May 2005 and April 2008, sera were obtained from 70 infertile women who underwent IVF-ET at 11 days post-ET and stored. HCG, progesterone, and inhibin A levels were measured by commercial enzyme-linked immunosorbent assay kits. The predictive accuracy of hCG, progesterone, and inhibin A levels for establishment of intrauterine pregnancy and ongoing pregnancy was calculated by receiver-operating characteristic curve analysis. Results: For the prediction of intrauterine and ongoing pregnancy, serum hCG was better than progesterone and inhibin A. The predictive performance of progesterone and inhibin A was similar. The serum progesterone and inhibin A levels were significantly correlated each other (r=0.915, p=0.010). Conclusion: A single measurement of the serum hCG level is sufficient to predict pregnancy outcome in IVF-ET patients.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.35 no.2
• /
• pp.1-15
• /
• 2022

Objectives: The purpose of this study is to report the results of Korean medicine treatment infertility support program in Gwang-ju Metropolitan City in 2021. Methods: Participants of Korean medicine treatment infertility support program were provided Herbal medicine, acupuncture, pharmacopuncture and Counseling for 3 months and followed up for 3 months after the treatments. The project was carried out for 100 infertile women under the age of 42 living in Gwang-ju Metropolitan City, of which 91 completed treatment until the end. Collected data of 91 women containing pregnancy rates, characteristics of subjects, treatments, and satisfaction of the program were analyzed. Results: After the treatment, 23 out of 91 subjects were pregnant, two of whom were miscarried, and 21 were maintained. The average age of pregnant women in 23 pregnant subjects was 33.8 years old, of which the average age of those who maintained pregnancy was 32.4 years old, and the age of one miscarried person was 39 years old. More than 85% of subjects answered that they were satisfied with the program in the satisfaction survey. Conclusions: Based on this report, the clinical data were obtained from the infertility treatment program. This study can be used as basic data to help establish infertility support programs and subsequent policies like support for men in the future Korean medicine infertility project and extension of the herbal medicine treatment period.

• Clinical and Experimental Reproductive Medicine
• /
• v.23 no.3
• /
• pp.367-377
• /
• 1996

Genes on the long arm of Y chromosome, particularly interval 6, are believed to playa critical role in human spermatogenesis. The objective of this study was to validate a sequenced-tagged site(STS)-mapping strategy for the detection of Yq microdeletion and to use this method to determine the proportion of men with Yq microdeletions in idiopathic, obstructive, nonobstructive azoospermia, severe OATS and in normal males. We analyzed three STS markers mapped to interval 6 within long arm of the Y chromosome from 106 nonobstructive, 30 obstructive azoospermia, 15 severe OATS patients, and normal 42 males in Korean men. By PCR, we tested leukocyte DNA, for the presences of STS markers(DAZ, sY129 and sY134) and SRY gene as internal control. And PCR results were confirmed by Southern hybridization, and were investigated by SSCP analysis for DAZ gene mutation. None of 42 normal males and 30 obstructive azoospermia had microdeletions, Of the 15 severe OATS typed with DAZ, sY129 and sY134, 3(20.0%) patients failed to amplify 1 or more STS markers, and of the 106 nonobstructive azoospermia typed with DAZ, sY129 and sY134, 12(11.3%) patients failed to amplify 1 or more STS markers. From these results, high prevalence(12.4%) of Yq deletion(DAZ, sY129, sY134) in men with nonobstructive idopathic azoospermia and severe OATS were observed in Korean infertility patients. To avoid the infertile offspring by assisted reproductive technique using ICSI or ROSI, genetic diagnosis will be needed in IVF-ET program.

• Clinical and Experimental Reproductive Medicine
• /
• v.41 no.4
• /
• pp.158-164
• /
• 2014

Objective: To assess whether an early GnRH antagonist start leads to better follicular synchronization and an improved clinical pregnancy rate (CPR). Methods: A retrospective cohort study. A total of 218 infertile women who underwent IVF between January 2011 and February 2013. The initial cohort (Cohort I) that underwent IVF between January 2011 and March 2012 included a total of 68 attempted IVF cycles. Thirty-four cycles were treated with the conventional GnRH antagonist protocol, and 34 cycles with an early GnRH antagonist start protocol. The second cohort (Cohort II) that underwent IVF between June 2012 and February 2013 included a total of 150 embryo-transfer (ET) cycles. Forty-three cycles were treated with the conventional GnRH antagonist protocol, 34 cycles with the modified early GnRH antagonist start protocol using highly purified human menopause gonadotropin and an addition of GnRH agonist to the luteal phase support, and 73 cycles with the GnRH agonist long protocol. Results: The analysis of Cohort I showed that the number of mature oocytes retrieved was significantly higher in the early GnRH antagonist start cycles than in the conventional antagonist cycles (11.9 vs. 8.2, p=0.04). The analysis of Cohort II revealed higher but non-significant CPR/ET in the modified early GnRH antagonist start cycles (41.2%) than in the conventional antagonist cycles (30.2%), which was comparable to that of the GnRH agonist long protocol cycles (39.7%). Conclusion: The modified early antagonist start protocol may improve the mature oocyte yield, possibly via enhanced follicular synchronization, while resulting in superior CPR as compared to the conventional antagonist protocol, which needs to be studied further in prospective randomized controlled trials.

• Clinical and Experimental Reproductive Medicine
• /
• v.35 no.2
• /
• pp.143-153
• /
• 2008

Objective: To investigate the effects of aromatase inhibitor on reproductive hormone profiles and evaluate it's ovulation inducing capability in anovulatory infertile women. Methods: We quantified the blood levels of reproductive hormones from 30 healthy normal cycling women in natural cycle (control) and letrozole medicated cycle (study). LH, FSH, estradiol, testosterone, DHEA-S were quantified on third, 11th, 21th day in both cycles, and on 21th day, progesterone was added. Sixth anovulatory infertile women received either letrozole or clomiphene citrate for ovulation induction (n=30 in each groups). We compared the clinical parameters such as ovulation rate, pregnancy rate, the day of LH surge, number of follicles and endometrial thickness, cervical mucus amount, spinnbarkeit, mean diameter of follicles on the day of LH surge. Results: Letrozole had no effect on the LH, FSH, estradiol, DHEA-S secretion but there were significant increase in testosterone level on day 11 and progesterone level on day 21 in letrozole medicated cycle compared than control cycle ($0.40{\pm}0.16$ vs $0.28{\pm}0.11\;ng/ml$, p=0.002, $18.18{\pm}13.07$ vs $8.38{\pm}7.64\;ng/ml$, p=0.001, respectively). In comparison between letrozole and clomiphene groups, there were no significant difference in ovulation rate, pregnancy rate, number of mature follicle, mean diameter of follicles, but showed earlier LH surge, thicker endometrium, more cervical mucus, and higher spinnbarkeit in letrozole group ($12.12{\pm}2.46$ vs $14.52{\pm}3.18$ days, p=0.006, $10.48{\pm}1.23$ vs $8.52{\pm}0.93\;mm$, p=0.000, $2.04{\pm}0.61$ vs $1.57{\pm}0.59$, p=0.012, $6.00{\pm}1.12$ vs $4.95{\pm}1.61\;cm$, p=0.003, respectively). Conclusion: Letrozole may augment folliculogenesis and improve the endometrial condition for implantation in normal cycling women. Ovulation efficacy of letrozole in anovulatory women was comparable to clomiphene citrate and letrozole may be more physiological in ovulation induction.

• Clinical and Experimental Reproductive Medicine
• /
• v.12 no.1
• /
• pp.41-46
• /
• 1985

Various immunoserologic and cellular immunity techniques have been used to explore the presence of antisperm antibodies in the serum and seminal plasma of male patients and in the blood and genital fluid of infertile women. Several recent comparative investigations using various assays to detect and quantitate levels of antibody to human spermatozoa have produced widely varying results. So the first WHO workshop on iso- and autonatibodies to human spermatozoa in 1974 tried to establish some unification in the techniques used. The purpose of this study is to compare the results of two methods-the Kibrick macro-agglutination test and the Isojima micro-immobilization test-using the same test materials based on recommandation from WHO workshop. The results are as follows: 1. Twenty normal controls showed negative reactions in all the 2 tests. Out of 25 patients, the positive sera were noted in 15 (60%) on the Kibrick test and 13 (51%) on the Isojima test. 2. Twelve (48%) out of 25 patients showed positive reactions in the two tests, and 16 (64%) out of 25 patients showed positive reaction in one or more tests. 3. The titers of the antisperm antibodies on the Kibrick test was higher than that on the Isojima test. Therefore, it seems to be possible to increase the chances of detection of the antisperm antibodies, if two tests are imployed.

• Clinical and Experimental Reproductive Medicine
• /
• v.39 no.4
• /
• pp.182-186
• /
• 2012

Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.26 no.3
• /
• pp.73-84
• /
• 2013

Objectives: This study aims to identify associated factors in female infertility treatment using herbal medicine, acupuncture and moxibustion. Methods: Acupuncture and moxibustion treatments were performed with intake of herbal medicines (Jokyungjongoktanggagam-bang, Sutaehwangagam-bang) for six menstrual cycles in 32 subfertile women. The variables selected for initial analysis were age, duration and type of infertility, frequency of previous In Vitro Fertilization (IVF) and live births, weekly frequency of sexual intercourse, number of treatment cycles, endometrial thickness on MCD15 and hormonal parameter (anti-mullerian hormone, follicle-stimulating hormone, luteinizing hormone, estrone). Results: Six patients became pregnant (18.75%) and seven patients withdrew. Factors influenced pregnancy were age (${\leq}35$ years), a shorter duration of infertility (<6 years), frequency of IVF (${\leq}3$), anti-mullerian hormone level (>1 ng/ml), and number of treatment cycles(${\leq}3$ cycles). Conclusions: Korean medicine is a useful and optimized treatment option for women with younger age, fewer previous IVF cycles, shorter infertile duration and normal anti-mullerian hormone level at first 3 cycles of treatment.

• Clinical and Experimental Reproductive Medicine
• /
• v.47 no.3
• /
• pp.221-226
• /
• 2020

Objective: We attempted to identify the optimal cutoff numbers of mature oocytes that would produce at least one or multiple top-quality (grade A) day-3 embryos in normal responders undergoing stimulated in vitro fertilization (IVF) cycles. Methods: We selected 210 fresh IVF cycles performed in 170 infertile women at a single center from January 2014 to November 2019. Four to 14 (total) oocytes were obtained in all cycles after conventional ovarian stimulation. A receiver operating characteristic curve analysis was performed to find the moderate and extreme cutoff numbers of mature oocytes that would produce ≥ 1, ≥ 2, ≥ 3, ≥ 4, and ≥ 5 top-quality embryos. Results: The cutoff number of mature oocytes was significantly correlated with the number of top-quality embryos (r = 0.467, p= 0.000). The moderate cutoff number of mature oocytes was ≥ 3, ≥ 5, ≥ 5, ≥ 6, and ≥ 6 for obtaining ≥ 1, ≥ 2, ≥ 3, ≥ 4, and ≥ 5 top-quality embryos, respectively. The extreme cutoff number of mature oocytes was ≥ 9, ≥ 9, ≥ 10, ≥ 10, and ≥ 11 for obtaining ≥ 1, ≥ 2, ≥ 3, ≥ 4, and ≥ 5 top-quality embryos, respectively. Conclusion: We present the optimal cutoff numbers of mature oocytes that would yield ≥ 1, ≥ 2, ≥ 3, ≥ 4, and ≥ 5 top-quality embryos with 95% specificity. Our findings could help infertility clinicians to set target mature oocyte numbers in women undergoing stimulated IVF cycles.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.31 no.4
• /
• pp.73-88
• /
• 2018

Objectives: This study aims to assess the subfertility support project of Korean medicine in Gyeonggi-do. Methods: A total of 231 women ($36.84{\pm}3.79yrs$) out of 361 applicants completed the treatment in this study. The copies of the medical records and study-related documents were provided by the association of Korean Medicine in Gyeonggi-do, in which the personal information was discarded. Descriptive analysis and inferential statistics (e.g., Mann-Whitney U test, Paired t-test, Wilcoxon signed rank test, & logistic regression) were applied to examine the statistical differences between groups and before/after treatments utilizing SPSS 23. All Type I errors (${\alpha}$) for the statistical significance were set at .05 Results: After the treatment, 11.3% of participants became pregnant spontaneously. There was no significant change in blood tests before and after the treatment and the observation period. Also there was no adverse event during the project. After the project, the satisfaction survey was conducted, and 87.5% of participants were satisfied with the project. Conclusions: The findings of this study proved the efficacy of Korean medical treatment for infertile women.