• Title/Summary/Keyword: infertile women

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Assisted Reproductive Technology in Infertile Patients with Endometriosis (자궁내막증과 동반된 불임환자의 보조생식술을 이용한 치료)

  • Moon, Shin-Yong;Lee, Kyung-Soon;Roh, Jae-Sook;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Shin, Chang-Jae;Kim, Jung-Gu;Lee, Jin-Young;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.22 no.2
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    • pp.211-220
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    • 1995
  • Though the endometriosis is not always related with infertility, endometriosis causes infertility in some patients. There are many treatment modalities of infertile patients who have endometriosis. In recent years, Assisted Reproductive Technology(ART) have been widely accepted as being a useful tool for the treatment of infertile endometriotic patients. The objective of this study was to evaluate the outcome of ART in infertile endometriotic patients who have been carried out IVF-ET from Jan, 1992 to Dec, 1994 and to compare the results between COH/IUI and IVF-ET in the patients with endometriosis stage I. Tubal disease only patients were grouped(308 patient, 956 cycles) as a control. Endometriosis group was subdivided into 4 groups according to American Fertility Society classification; endometriosis stage I (45 patients, 61 cycles), stage II (26 patients, 39 cycles), stage III (26 pateitns, 37 cycles), stage IV (33 patients, 50 cycles). The outcomes of IVF-ET in endometriosis patients were as follows; The oocyte recovery rates were significantly lower in stage III, IV endometriosis. In case of stage III endometriosis, the fertilization rate was significantly lower than other stages of endometriosis. Clinical pregnancy rates per cycle were not different between the tubal group(22%) and the endometriosis group(25%). According to endometriosis stage, the implantation rate and clinical pregnancy rate were significantly lower in stage IV (5.6%, 16%) compared with other stages (I; 10.0%, 26%, II;9.8%, 31%, III;12.6%, 32%). It suggests that some factor like autoantibodies may inhibit implantation of embryos in stage IV endometriosis. To evaluate the possibility that simply increasing the number of gametes at the site of fertilization might account for pregnancies attributed to IVF-ET, the authors retrospectively analyzed the outcome of couples undergoing IUI during hMG cycles and CC cycles between 1992 and 1994 in the women with endometriosis stage 1. In case of stage I endometriosis, though the COH/IUI group showed lower FSH level and lesser age profile than IVF-ET group, IUI group has resulted in lower pregnancy rates(19.2%) compared with the IVF-ET group(26.2%). In conclusion, endometriotic infertile patients can get comparable pregnancy rates with the tubal factor infertility patients during IVF-ET program. Moreover even in stage I endometriosis, IVF-ET may be an more effective treatment modality than COH/IUI.

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A Study on Pattern Identification of Patients Who Participated in Korean Medical Infertility Support Program of CheongJu-City (청주시 한방난임지원사업에 참여한 난임환자의 한의학적 변증 특성 연구)

  • Kwon, Na-Yoen;Park, Yong-Youn;Kim, Hyeong-Jun;Lee, Dong-Nyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.147-164
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    • 2018
  • Objectives: This study was performed to analyze the pattern identification in infertile women who participated in infertility support program of Cheongju-city. Methods: The project proceeded from October, 2016 to June 2017. Participants filled in the questionnaire which is composed of 33 symptoms before korean medical treatments. Data were collected from 17 participants. We classified symptoms into six pattern identifications based on previous research and rated each answer to score. Results: Throughout the study, the average age of 26 patients was $34.88{\pm}3.19$ years old, the average height was $162.51{\pm}4.99cm$, and average weight was $58.41{\pm}7.88kg$. The average duration of acupuncture treatment was $121.03{\pm}52.73$ days and the average times of acupuncture treatment was $27.42{\pm}10.77$ times. The average number of herbal medicine treatment was $2.65{\pm}0.69$, the majority of it was Chokyungjongok-tang. After the treatment, 3 patients of infertility became pregnant (11.54%) in twenty six patients. By analyzing pattern identification survey papers, We can classify infertile women into 6 pattern identification based on previous research. The majority of participants was identified as Blood deficiency and the other participants were identified as Kidney deficiency, Liver depression, Dampness-phlegm, Qi deficiency and Static blood in order of priority. Most of patients' pattern identification were combined with two kind of pattern identification. In terms of priority, Liver depression combined with Kidney deficiency, Blood deficiency combined with Kidney deficiency, Liver depression combined with Qi deficiency, Liver depression combined with Dampness-phlegm. Conclusions: After the study we confirmed that Korean traditional medicine is a safe treatment for infertile women. Further clinical study about herbal medicines of patients who have combined pattern identification is needed.

The prevalence of positive urinary cotinine tests in Korean infertile couples and the effect of smoking on assisted conception outcomes

  • Kim, Hoon;Kim, Seul Ki;Yu, Eun Jeong;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.4
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    • pp.136-142
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    • 2015
  • Objective: Smoking has been reported to harm nearly every organ of the body, but conflicting results have been reported regarding the effects of smoking on assisted conception. In this prospective cohort study, we aimed to investigate the prevalence of positive urinary cotinine tests in infertile couples and whether cotinine positivity was associated with infertility treatment outcomes. Methods: A qualitative urinary cotinine test was administered to 127 couples who underwent in vitro fertilization (IVF, n=92) or intrauterine insemination (IUI, n=35). Results: The overall prevalence of positive urinary cotinine test was 43.3% (55/127) in the male partners and 10.2% (13/127) in the female partners with similar prevalence rates in both genders in the IUI and IVF groups. Semen characteristics, serum markers of ovarian reserve, and number of retrieved oocytes were comparable among cotinine-positive and cotinine-negative men or women (with the exception of sperm count, which was higher among cotinine-positive men). The results of urinary cotinine tests in infertile couples were not associated with IVF and IUI outcomes. Conclusion: The presence of cotinine in the system, as indicated by a positive urinary cotinine test, was not associated with poorer outcomes of infertility treatment.

Factors Influencing the Depression Level of Couples Participating in the National Supporting Program for Infertile Couples (정부 난임부부 지원사업 참여 대상자의 우울에 영향을 미치는 요인)

  • Hwang, Nami;Jang, Insun
    • Research in Community and Public Health Nursing
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    • v.26 no.3
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    • pp.179-189
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    • 2015
  • Purpose: The purpose of this study was to identify factors influencing depression of participants in the National Supporting Program for Infertile Couples (NSPI) who received a treatment of IVF (in vitro fertilization) or IUI (intra-uterine insemination). Methods: Using the 2013 NSPI Satisfaction On-line Survey data, secondary data analyses were conducted on 830 cases of IVF and 706 cases of IUI. Descriptive statistics, independent t-test, ${\chi}^2$ test, and logistic regression were performed using SPSS/WIN 21.0. Results: Logistic regression analysis showed that non-pregnancy status (OR=3.05), unexplained infertility (OR=4.29), relationship trouble with spouse (OR=3.57), and relationship trouble with the in-law family (OR=2.78) were significant factors predicting the depression level in the IUI treatment group. Non-pregnancy status (OR=5.28), childlessness (OR=1.92), financial support helpful hardly or not at all (OR=2.63), relationship trouble with spouse (OR=3.28), relationship trouble with the in-law family (OR=2.83), and unemployment (OR=1.60) were significant factors in the IVF treatment group. Conclusion: To reduce infertile women's depression, adequate attention and care need to be paid to these psychological symptoms. It is suggested to develop counseling and couple-therapy along with methods to enhance social support (including that from the in-law's family).

Analysis of the Azoospermia Factor (AZF) Gene on Y Chromosome and Expression Pattern of DAZ Gene in Korean Infertile Men (한국 남성 불임환자에서 Y 염색체상의 AZF Gene에 대한 분석 및 DAZ Gene의 발현 양상)

  • Lee, Ho-Joon;Lee, Hyoung-Song;Song, Gyun-Jee;Byun, Hye-Kyung;Seo, Ju-Tae;Kim, Jong-Hyun;Lee, You-Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.1
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    • pp.57-65
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    • 1997
  • Cytogenetic observations of loss of the distal portion of the Y chromosome long arm were found to be associated with disrupted spermatogenesis. The existence of a gene involved in the regulation of spermatogenesis, the azoospermia factor (AZF), was postulated. In this study, we screened the AZF region including DAZ and DAZH genes and observed the expression pattern of DAZ and DAZH transcript in infertile men with azoospermia and oligospermia by using a sequence-tagged site (STS)-based PCR method. PCR primers were synthesized for 11 STSs that span Yq interval 6, SRY, DAZ, and DAZH, functional DAZ homologue on chromosome 3. Microdeletions were detected in 4/32 (12.5%) azoospermic men and 1/11 (9%) severe oligospermic men. Only 2 of 5 patients had microdeletions of Yq that contained the DAZ gene, whereas the other 3 patients had deletions extending from intervals 5L-6F proximal to the DAZ gene on Yq. Testis biopsies of the azoospermic patients revealed a variety from Sertoli cell-only syndrome to testicular maturation arrest. Of 4 men with clinical data available, average testis size was R: 13.8 cc, L: 13.8 cc, serum T was $4.0{\pm}1.25$ ng/ml, LH was $3.63{\pm}1.90$ mIU/ml, and FSH was $8.85{\pm}5.13$ mIU/ml. These values did not differ significantly from the remainder of the patients tested. We could not observed the DAZ transcript in 2 patients, who have no mature spermatozoa. In 11.6% of patients microdeletions of the AZF could be detected. These deletions in the AZF region seem to be involved causing spermatogenic failure. But the frequency of microdeletions proximal to DAZ suggests that DAZ is not the only gene associated with spermatogenic failure.

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Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization (지시적 심상요법이 체외 수정을 받는 여성의 스트레스와 불안에 미치는 효과)

  • Bae, Choon-Hee;Chang, Soon-Bok;Kim, Sue;Kang, Inn-Soo
    • Women's Health Nursing
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    • v.17 no.2
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    • pp.178-186
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    • 2011
  • Purpose: The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF). Methods: Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program. Results: After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment. Conclusion: The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.

Clinical Evaluation of Intrauterine Insemination with Washed Sperm in Infertile Patients (불임환자의 세척정자에 의한 자궁내 인공수정의 임상적 평가)

  • Lee, S.H.;Yoon, Y.W.;Lee, B.Y.;Lee, B.S.;Park, K.H.;Hwang, D.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.1
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    • pp.65-69
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    • 1992
  • The sucess of intrauterine inseminations with washed human spermatozoa was evaluated in 92 patients. In according to indication of insemination, intrauterine inseminations of women with hostile cervical mucus yield a 35.3% and 12.8% with male factors and 27.3% with unexplained infertility. In ovulation induction group with variable agents including clomiphen, human menopausal gonadotropin (HMG) and GnRH analog, the pregnancy rate was 27.8% (22/79) and in natural cycle group, 15.4% (2/13). The fetal loss rate in insemination group was 12.5% (3/24). Multiple pregnancies were 7 cases and ovulation induction were performed in 6 cases among them. Intrauterine insemination with washed human spermatozoa therefore represents an effective and safe procedure selected infertile couples.

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A Study of Altered IL-6 and TNF-α Expression in Peritoneal Fluid of Patients with Endometriosis (자궁내막증 환자의 복강 액내 IL-6와 TNF-α의 변화 양상에 관한 연구)

  • Kang, Jeong-Bae;Lee, Young-Kyeong
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.1
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    • pp.45-52
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    • 2006
  • Objective: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-${\alpha}$ in the peritoneal fluid of women with and without endometriosis and infertile women. Methods: This study is prospective and case-control study in University hospital, enrolled thirty-four women with laparoscopic findings of minimal to severe endometriosis, and thirty-seven women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. IL-6 and tumor necrosis factor-${\alpha}$ levels in peritoneal fluid were determined using commercial ELISA. IL-6 and tumor necrosis factor-${\alpha}$ concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. Results: IL-6 and tumor necrosis factor-${\alpha}$ concentrations were higher than in the peritoneal fluid of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in peritoneal fluid from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. The concentrations were higher than among of infertile women than in fertile women. A significant correlation between IL-6 and tumor necrosis factor-${\alpha}$ concentrations and endometriosis stage III and IV was noted. Conclusion: Increased levels of IL-6 and tumor necrosis factor-${\alpha}$ in patients with endometriosis in the peritoneal fluid may be relate to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.

The Study of Infertility Stress of Female Participating in Korean Medicine Pilot Program for Subfertility (난임한방진료시범사업에 참가한 여성의 스트레스 양상에 대한 연구)

  • Ahn, In-Suk;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.1
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    • pp.56-67
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    • 2017
  • Objectives: The purpose of this study is to elucidate infertility women's experience in psychological stress and to suggest effective infertility stress management methods. Methods: Twenty five infertility women who participate in Korean Medicine Pilot Project for Infertility completed questionnaires and Infertility Stress Scale, also, we have interviewed. Results: The Mean degree of stress of the infertile women was 2.24 point with Infertility Stress Scale. In focused interview, the infertility stress was considered to be within the aspects of intra and interpersonal. In regards to intrapersonal aspect, infertility women described the grief with lowered self-esteem and anxiety with obsession for fertility. As for the interpersonal aspect, infertility women were distressed by the relationship with spouse and in-laws, as well as friend and the public. Conclusions: Doctors in infertility clinic need to consider infertility stress of their patients and conduct effective intervention.