• Clinical and Experimental Reproductive Medicine
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• v.37 no.3
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• pp.181-189
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• 2010

The placenta, which is a temporary organ derived from the fetus during pregnancy, is critical to support fetus development via optimal regulation between mother and fetus. Trophoblast as a major cell population of the placenta is one of the earliest to differentiate and shows an extensive proliferation or/and differentiation up to the formation of the placenta. The role of the trophoblast show dynamic changes from early embryo implantation to placentation during pregnancy. Implantation of the blastocyst into the endometrium of the maternal uterus is mediated by invasion of the differentiated trophoblast (e.g. syncytiotrophoblast) from the trophectoderm. During pregnancy, the unique role of the trophoblast is to invasion, eroding, and metastasizing in the placenta as well as to ensure appropriate bidirectional nutrient or waste flow required for growth and maturation of the embryo. The dysfunction of the trophoblast during pregnancy can result in several gynecological diseases including preeclampsia and congenital malformation in neonatal medicine. Therefore, trophoblasts act as a conclusive factor in placental and fetal development. This brief review outlines the classification of trophoblast and its function in the placenta during pregnancy. Also, we introduce the latest research in trophoblast for implantation and the placenta development, and the application potential of trophoblast for infertility and obstetrical diseases.

• Development and Reproduction
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• v.4 no.1
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• pp.7-12
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• 2000

At fertilization, sperm penetrates into oocyte, male and female pronuclei are fused together, and mitotic division follows. However, little information is available on the interactive roles and dynamic processes between cytoplasmic and nuclear components during the pronuclear formation, migration and cell division. The assisted reproductive technologies such as, intracytoplasmic sperm injection (ICSI) and round spermatid injection(ROSI) could provides new treatments for the male infertility as well as tools for the study of basic mechanism during fertilization. Nuclear transfer can also provide a mechanism on the interactive roles between nucleus and cytoplasm since the process includes nuclear reprogrammming of differentiated cells in the enucleated oocytes. Recently, I have investigated developmental processes in porcine oocytes following fertilization parthenogenesis, ICSI, ROSI and nuclear transfer using indirect immunocytochemical and electron microscopic studies. The results could provide an insight into biological questions related with epigenesis as well as strategies for the enhancement of embryology in general such as ICSI and nuclear transfer.

• Reproductive and Developmental Biology
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• v.29 no.3
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• pp.193-199
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• 2005

The cryopreservation of germ cells, sperm and embryos, has been largely used to increase the effect of artificial reproductive techniques for human infertility, but the efficiency of germ cell cryopreservation has been conkoversial till now. Thus, the effect of the cryopreservation of human sperm used for ICSI and the effect of the cryopreservation of embryos produced by ICSI on fertilizatiof development and pregnancy were investigated. Sperm freezing did not affect fertilizatiort development and pregnancy rates. Also, there was no significant difference between ejaculated and testicular sperm in ferclizatiort development and pregnancy. Embryo freezing methods, slow freezing and vitrificatior did not differ each other in viability and pregnncy rates. However, ICSI embryo freezing significantly decreased pregnancy rate compared to fresh embryos freezing (p<0.05). In conclusiof this result suggested that cryopreservation of sperm for ICSI did not affect on the resulted embryo development and pregnancy, but ICSI embryo cryopreservation would significantly inhibit pregnancy.

• Journal of Nutrition and Health
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• v.37 no.2
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• pp.115-122
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• 2004

Adequate vitamin B$_2$ vitamin B$_{6}$, folate and vitamin B$_{12}$ nutrition is known to be important for reproductive function in women of childbearing age. The purpose of this study was to evaluate serum vitamin B$_2$ vitamin B$_{6}$, folate and vitamin B$_{12}$ status and serum homocysteine levels in 115 women aged 33.2$\pm$4.0 years, who had been diagnosed with infertility, and 49 women aged 34.5$\pm$3.8 years having at least one born child. Total vitamin B$_2$ and vitamin B$_{6}$ intakes in infertile women were significantly lower than those in control. Serum vitamin B$_2$ vitamin B$_{6}$, folate and vitamin B$_{12}$ concentrations were significantly lower in infertile women than those in control and serum homocysteine levels were significantly higher in infertile women than those in control. Thirteen percent in infertile women and zero percent in control were assessed as hyperhomocysteinemic and there was a significant difference in the prevalence of hyperhomocysteinemia between infertile women and control. 41% infertile women were assessed as folate deficiency. Serum folate concentrations was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B$_2$ intakes was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B$_{6}$, folate intakes were negatively correlated with homocysteine of infertile women only. In conclusion, infertile women are needed to intake more B vitamins intakes. Furthermore researches are needed to estimate adequate B vitamin supplementation in infertile women. (Korean J Nutrition 37(2): 115-122, 2004): 115-122, 2004)

• The Journal of Korean Medicine
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• v.32 no.5
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• pp.25-40
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• 2011

Objectives: This study was performed to assess whether herbal medicine and acupuncture before in vitro fertilizationembryo transfer (IVF-ET) is effective on clinical pregnancy. Methods: From May 2010 to January 2011, a prospective analysis study was performed in 38 patients planning to undergo IVF-ET after taking herb medicine and acupuncture treatment. This study investigated the pregnancy rate and analyzed the change of dysmenorrhea by visual analog scale (VAS), body heat and condition of premenstrual syndrome (PMS), vaginal discharge and menstruation status. Results: 1. During herbal medicine and acupuncture treatment, five patients (13.16%) naturally became pregnant and six patients (15.79%) withdrew. After treatment, 15 patients (39.47%) received IVF-ET, 12 patients (31.58%) did not. 2. The biochemical pregnancy rate was 26.67%, the clinical pregnancy rate 26.67%, miscarriage rate 25% and ectopic pregnancy rate was 0%. 3. After treatment, PMS, dysmenorrhea and dysmenorrhea VAS was significantly decreased and the overall menstrual status improved. 4. After treatment, temperature difference of CV17-CV12 and CV4-CV12 increased, but it was not a statistically significant difference. 5. After treatment, decrease of hemoglobin and protein and increase of total bilirubin and creatinine were statistically significant. All the blood test results were within normal levels which proves safety of treatment. Conclusions: This study suggests that herbal medicine and acupuncture treatment before IVF-ET shows similar pregnancy rates with existing rates, but contributes to increasing the possibility of natural pregnancy.

• Clinical and Experimental Reproductive Medicine
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• v.13 no.1
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• pp.21-28
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• 1986

It is now apparent that many cases of amenorrhea. oligomenorrhea. corpus luteum deficiency, galactorrhea, and infertility are due to hyperprolactinemia. We investigated the relationships between serum prolactin values and factors such as menstrual pattern, frequency of galactorrhea etc, in 135 hyperproIactinemic patients at the Seoul National University Hospital during a period of 6 years, from January, 1979 to December, 1984. The results was as follows: 1. Menstrual pattern changed according to the serum prolactin level. The frequency of amenorrhea is 1.7 percent in patients with serum prolactin levels ranged from $25{\sim}40ng/ml$, whereas 72.4 percent in patients with serum prolactin levels above 100ng/ml. 2. The incidence of galactorrhea in hyperprolactinemic patients was 3.1 percent and the frequency of galactorrhea had direct relationship with the serum prolactin level and/or the frequency of abnormal menstrual pattern. 3. The incidence of pituitary tumor in hyperprolactinemic patients was 104 percent and sixty percent of patients with serum prolactin levels above 100ng/ml had a pituitary tumor . 4. There was an inverse correlation between serum prolactin and progesletone value. 5. The frequency of anovulatory menstrual cycle evidenced by basal body temperature is 23.9 percent in patients with serum prolactin levels ranged from $20{\sim}40ng/ml$, whereas 76.9 percent in patients with serum prolactin levels above 100ng/ml.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.3
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• pp.177-182
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• 2004

Purpose: To determine the efficacy of $Carnitil^{(R)}$ (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. Materials and Methods: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of $Carnitil^{(R)}$ daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. Results: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in volume ($2.64{\pm}1.65\;ml$ vs. $3.10{\pm}1.60\;ml$), motility ($35.1{\pm}17.7%$ vs. $45.9{\pm}20.4%$) and viability ($51.4{\pm}20.3%$ vs. $59.3{\pm}13.6%$) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in sperm count ($10.7{\pm}54.4\;million/ml$ vs. $38.4{\pm}32.5\;million/ml$) respectively. Conclusions: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.3
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• pp.191-200
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• 2004

Objective: To compare the clinical efficacy of double intrauterine insemination with single intrauterine insemination in GnRH antagonist combined ovarian hyperstimulation (Mild ovarian hyperstimulation) Materials and Methods: From Jan. 2001 to Jul. 2004, a retrospective clinical analysis was done of a total of 295 cycles in 170 patients who underwent ovarian hyperstimulation for ART (assisted reproductive technique). Subjects were divided into three groups; only clomiphene citrate ovarian hyperstimulation (n=55, 95cycles), GnRH antagonist combined ovarian hyperstimulation (soft ovarian hyperstimulation) (n=66 99cycles), and GnRH agonist combined ovarian hyperstimulation (short protocol) (n=49, 101cycles) Each group were randomly devided into two subgroups. One group underwent single IUI and the other group underwent double IUI. Results: GnRH antagonist group and GnRH agonist group had similar pregnancy rate. In GnRH antagonist Group, pregnancy rate was 36.1% in single IUI subgroup and was 36.6% in double IUI subgroup. These finding were not statistically significant. And Pregnancy rate was 20.8% in single IUI subgroup and was 19.3% in double IUI subgroup in single clomiphene citrate group, and 36.3% in single IUI subgroup and was 33.3% in double IUI subgroup in GnRH agonist group. These finding were not statistically significant, too. Conclusion: Pregnancy rate of GnRH antagonist was high and complication rate such as OHSS and multiple pregnancy was lower. In GnRH antagonist group, to compare with single IUI and double IUI, the result do not statistically differ. So GnRH antagonist single injection with single IUI was relatively comparable ART in infertiliry patient.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.337-343
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• 2014

Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.111-119
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• 2009

Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.