• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.123-130
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• 1995

Many types of medication regimens have been used for controlled ovarian hyperstimulation for assisted reproductive technique(ART). Questions are now being raised regarding how to lower the escalating costs of assisted reproduction and decrease the extent of patient discomfort and disruption of life style without sacrificing success rates. In this investigation, from January 1994 through August 1994 patients presenting to the Chung-Ang university hospital, infertility clinic were offered the option of the clomiphene citrate (CC)/single Human Menopausal Gonadotropin(HMG) combination and conventional GnRH-agonist combination method. 60 patients (78 cycles) were given CC/single HMG combination as a study group, and 78 patients (102 cycles) were given conventional GnRH-a combined ultrashort protocol as a control group for IVF-ET program and the resulting number of oocyte retrieved, embryo produced, and pregnancy initiated were compared. There were no differences between the two groups in mean age, serum $E_2$, LH and FSH level on menstrual cycle day 2. HMG requirement was 2 ampules in study group and $24.2{\pm}6.8$ ampules in control group. On the day of HCG injection, serum LH and FSH levels were not significantly different, but serum $E_2$, was significantly higher in control group(p<0.001). There was relatively well endometrial quality in control group but not significant compare to study group. In control group, numbers of retrieved oocyte and transferred embryo were significantly more than study group(p<0.001). Fertilization rate was not significantly different in the two groups and pregnancy rates were 20.2% in study group 28.4% in control group(p<0.001). CC/single HMG protocol for IVF-ET is less expensive than GnRH-a combined ultrashort protocol and minimizes patients discomfort. In addition, CC/single HMG protocol produces acceptable pregnancy rate and represents an attractive alternative to select patients undergoing IVF-ET.

• 대한한방부인과학회지
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• 제24권1호
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• pp.144-161
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• 2011

Objectives: Oriental Medicine has thousands years of history. But this era, every medical decision should be based on scientific evidence, that is evidence-based medicine (EBM). This study is to suggest quantitative case report form for dysmenorrhea that can be easily used in clinics. Methods: First, to search published papers in Korea and overseas, OASIS, KISS and NCBI(pubmed) database. Second, to search clinical trials in clinical trial register website, ISRCTN and clinicaltrials.gov. Result: Visual Analogue Scale(VAS) is the most commonly used scale. Conclusion: The main scales for dysmenorrhea are Visual Analogue Scale(VAS), Multidimensional verbal Rating scale(MVRS), pain-killer intake amount and restriction of daily life activities. To measure the effect of herbal medicine, more than 2 menstrual cycle is recommended.

• Journal of Chest Surgery
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• 제39권4호
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• pp.328-331
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• 2006

월경과 동반되는 재발성 자연 기흉은 1958년 Maurer 등에 의해 최초로 기술되었으며 후에 Lillington 등은 이 증후군을 월경성 기흉이라 명명하고 1972년 5명의 환자를 보고한 바 있다. 월경성 기흉은 가임기 여성에서 월경 시작 전후 72시간 내에 발생하는 질환으로 대부분의 경우 우측에서 재발성으로 발병하나 그 발생기전은 아직 명확하지 않은 드문 질환이다. 저자들은 최근 37세 여자 환자에 발생한 월경성 기흉에 대하여 흉강경 수술로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한한방부인과학회지
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• 제20권3호
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• pp.129-136
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• 2007

Purpose: We intended to observe the usefulness of far-infrared radiation functional under inner-wear for dysmenorrhea. Methods: We introduced far-infrared radiation functional under inner-wear to women in childbearing-age by internet portal site. Then, we preliminarily examined dysmenorrhea severity by VAS(visual analogue scale) questionnaire to women interested in far-infrared radiation functional under inner-wear. We selected women scored 5 and above of 10 measurement VAS score. Finally, 121 women were the subject of study and used far-infrared radiation functional under inner-wear for one menstrual cycle. Before and after use of far-infrared radiation functional under inner-wear, we conducted a questionnaire survey of dysmenorrhea severity by VAS. After that, we compared VAS score before and after use. Also, we studied correlation between frequency of far-infrared radiation functional under inner-wear use and ${\Delta}VAS$(VAS score before use minus VAS score after use). For statistics, we used Paired samples test and Spearman's rho correlations, SPSS 13.0 for windows. Results: Before and after use of far-infrared radiation functional under inner-wear, VAS score means were different. Frequency of far-infrared radiation functional under inner-wear use was correlated to ${\Delta}VAS$. Statistically they showed significant result (p<0.05>. Conclusion: The results showed that dysmenorrhea severity by VAS decreased after far-infrared radiation functional under inner-wear use. As frequency of use increased, ${\Delta}VAS$ increased. So we can consider far-infrared radiation functional under inner-wear effects dysmenorrhea severity.

• 대한한방부인과학회지
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• 제21권3호
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• pp.111-120
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• 2008

Purpose: Although premsnstrual syndromes(PMS) have long been recognized, there has been difficulty to evaluate the symtoms. Usually the questionnaire has been used to dignose the PMS. Objective is to investigate the relationship of body temperature between women with PMS and without PMS. Methods: We studied 23 patients visiting ㅇㅇ hospital from 26th December 2005 to 26th April 2006. The Questionnaire for PMS was used to evaluate physical, emotional, and behavioral symptoms accompanying the menstrual cycle of the subjects. The subjects were categorized in two groups, non-PMS(11) and PMS group(12). Body temperature was assessed by Dorex spectrum 9000MB (DOREX Inc.. USA). We measured CV4, CV3, CV12 and CV17 to evaluate the distribution of body temperature, compared the difference of temperature(${\Delta}T$) between CV17-CV4, CV17-CV3, CV17-CV12 and CV12-CV3. We investigated the of temperature and ${\Delta}T$ between two groups by Mann-Whitney U-test. Results: The temperature of CV3 and CV 4 of PMS located in low abdomen were lower than those of non-PMS located in chest. But there was no statistical significance of temperature between two groups. There was lower temperature of low abdomen in PMS group than non-PMS group without statistical significance. Conclusion: The results suggest that DITI could be useful to assess the PMS objectively. But more research should be needed.

• 대한한방부인과학회지
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• 제21권3호
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• pp.99-110
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• 2008

Purpose: Premenstrual syndrome(PMS) is a collection of physical, psychological and emotional symptoms related to a women's menstrual cycle. The symptoms are related with Autonomic Nervous system. The purpose of this study is to investigate the activity of Autonomic Nervous system in women with premenstrual syndrome(PMS) by using Heart Rate Variability(HRV). Methods: We studied 26 patients visiting ㅇㅇ hospital from 26th December 2005 to 26th April 2006. Activity of Autonomic Nervous system was assesed by means of Heart Rate Variability(HRV). The subjects were categorized in two groups, PMS group(10) and non-PMS group(16). We studied the difference of HRV between two groups by Mann-Whitney U-test using SPSS for windows (version 12.0). Results: SDNN of PMS group was non-significantly lower than non-PMS group. RMS-SD of PMS group was significantly lower than non-PMS group. Mean PR of PMS group was non-significantly higher than non-PMS group. TP, VLF, LF, HF norm of PMS group was non-significantly lower than non-PMS group. HF of PMS group was significantly lower than non-PMS group. LF norm, LF/HF ratio of PMS group was non-significantly higher than non-PMS group. Conclusion: The results suggest that PMS can be related to decreased activity of parasympathetic nervous system. HRV can be useful to diagnose PMS. The more studies to diagnose PMS would be needed.

• Clinical and Experimental Reproductive Medicine
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• 제48권4호
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• pp.368-373
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• 2021

Objective: In this study we aimed to assess anorexigenic peptide levels in patients with or without polycystic ovary syndrome (PCOS) and their effects on assisted reproductive treatment (ART) outcomes. Methods: A prospective case-control study was conducted in a tertiary care university-based ART clinic. Eighty-three patients were included in the study. The PCOS group included 41 patients, and the non-PCOS group included 42 controls. The 2003 Rotterdam criteria were used for PCOS patient selection. The ART indications in the non-PCOS group were tubal factor or unexplained infertility. Venous blood samples were taken on the third day of the menstrual cycle to determine the serum anorexigenic peptide levels. The enzyme-linked immunosorbent assay method was used for laboratory analyses. Results: In the PCOS group, serum obestatin levels were significantly lower than in the control group, but serum anorexigenic peptide levels were similar in PCOS patients with or without clinical pregnancy. Ovarian hyperstimulation syndrome (OHSS) was diagnosed only in PCOS patients, and the obestatin levels of OHSS patients were significantly lower than those of other PCOS patients. Conclusion: Baseline anorexigenic peptide levels did not affect the clinical pregnancy rate in ART cycles. Obestatin may play a role in the pathophysiology of OHSS. This possibility should be confirmed in further research.

• Clinical and Experimental Reproductive Medicine
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• 제48권2호
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• pp.163-173
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• 2021

Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-E_max, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

• 한국수정란이식학회:학술대회논문집
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• 한국수정란이식학회 2002년도 국제심포지엄
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• pp.112-112
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• 2002

Under normal conditions, women produce a single dominant follicle that participates in a single ovuation each menstrual cycle. But Polycystic ovary syndrome(PCOS) conditions, folliculogenesis does not proceed normally. This condition leads to the accumlation of large numbers of small graffian follicles in which the theca interstitial cells (TIC) produce abnormally large amounts of androgen. PCOS is probably the most common endocrine disorder, affecting women of reprodutive age with 5-10% prevalence estimate. Chronic anovulation, hyperandrogenism, hirsutism, obesity, infertility and polycystic ovaries are clinical hallmarks of women with PCOS. Its etiology remains unknown. To investigate the gene expression pattern of ovary in PCO-induced rat, we used cDNA expression analysis. Total RNA was extracted from the ovary of PCO-induced rat and reverse-transcribed in the presence of［$\alpha$$^{32}$P］-dATP Which were hybridized to Atlas$^{TM}$ Rat Toxicology 1.2 array (Clontech) representing approximately 1176 rat genes. We compared gene expression between ovary of pco-induced immature female rats and control. Differential gene expression profiles were revealed (LIFR-alpha, ADRA1A, Heat shock 90-kDa protein A, PDGFRA). Reverse transcription-polymerase chain reaction(RT-PCR) was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the altered expression of genes and PCO is a matter of further investigation. This study was supported by Korea Science and Engineering Foundation(KOSEF)

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.389-398
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• 1999

Objective: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days starting on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG $5,000{\sim}10,000$ IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol ($E_2$) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. Conclusion: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.