• Title/Summary/Keyword: miscarriage

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In Pursuit of Genetic Factors for Recurrent Pregnancy Loss

  • Baek, Kwang-Hyun
    • 대한생식의학회:학술대회논문집
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    • 2002.11a
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    • pp.15-21
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    • 2002
  • In order to keep the normal pregnancy, a number of gene products are required at the feto-matemal interface. We have isolated approximately 30 genes, involved in keeping the normal pregnancy, via subtractive hybridization and RT-PCR analyses of cDNAs from the chorionic villi of normal and RPL patients. Characterizing their functions will help us to understand the process of establishing and maintaining pregnancy. In addition, more detailed studies of their expression in normal and RPL patients are required to evaluate their clinical relevance. Further identification of genes aberrantly expressed in RPL patients will help the prognosis of the pregnancy, identifying pregnancies with a high risk of miscarriage and enabling management of those pregnancies.

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A Review of Mechanisms of Implantation

  • Kim, Su-Mi;Kim, Jong-Soo
    • Development and Reproduction
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    • v.21 no.4
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    • pp.351-359
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    • 2017
  • Implantation is a highly organized process that involves an interaction between a receptive uterus and a competent blastocyst. In humans, natural fecundity suggests that the chance of conception per cycle is relatively low (~30%) and two-third of lost pregnancies occur because of implantation failure. Defective implantation leads to adverse pregnancy outcomes including infertility, spontaneous miscarriage, intrauterine fetal growth restriction and preeclampsia. With use of advanced scientific technologies, gene expression analysis and genetically-engineered animal models have revealed critical cellular networks and molecular pathways. But, because of ethical restrictions and the lack of a mechanistic experiment, comprehensive steps in human implantation have still not been completely understood. This review primarily focuses on the recent advances in mechanisms of implantation. Because infertility is an emerging issue these days, gaining an understanding the molecular and hormonal signaling pathway will improve the outcome of natural pregnancy and assisted reproductive technology.

A Case Report of 1 Patient Complaining of Hyperemesis Gravidarium (임신오조(姙娠惡阻) 1例에 대한 임상보고)

  • Park, Jun-Sik;Lim, Eun-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.18 no.1
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    • pp.234-241
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    • 2005
  • Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 8-12 weeks of pregnancy, and symptoms usually resolve by week 16. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. The cause of severe nausea and vomiting in pregnancy has not been identified. Extreme nausea and vomiting may be related to elevated levels of estrogens or human chorionic gonadotropin. Once the diagnosis is made, treatment consists of mainly supportive care. Until vomiting is controlled, these patients should be maintained as NPO. We treated 1 patient who had hyperemesis gravidarum and visited Kyung-Won Incheon Oriental Hospital by Herbal medication, acupuncture, moxa and nega therapy and got good result from them.

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A Case Report of Postpartum Disease Treated with Gyeji-tang Based on No.12 Shanghanlun Provision (『상한론(傷寒論)』 태양병(太陽病) 12조(條)에 근거하여 계지탕(桂枝湯) 투여 후 호전된 산후풍(産後風) 1례)

  • Jeong, Yeon-Il;Yun, Hyo-Joong
    • 대한상한금궤의학회지
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    • v.10 no.1
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    • pp.37-45
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    • 2018
  • Objective : The purpose of this paper is to report the improvement of a patient who had a postpartum disease treated with herb medication based on Shanghanlun provisions. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', the patient was diagnosed with TaeYang-byung, number 12 provision, and was administered herb medication for 4 months. Visual Analogue Scale(VAS) was used to estimate the patient's status. Results : The VAS changed 10 to 0. These results suggest that cold pain and weakness in the legs have improved. Conclusions : The patient had an experience of miscarriage 3 times and finally got a baby but with postpartum disease. She treated with the herb medication for 4 months and the outcome was found effective and economical due to the diagnostic system based on Shanghanlun provisions.

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Comparison of ICSI Outcomes between Fresh and Cryopreserved-Thawed Testicular Spermatozoa (신선 고환조직 정자와 냉동보존-융해 고환조직 정자를 이용한 난자세포질내 정자주입술 결과의 비교 연구)

  • Choi, Young-Sik;Choi, Young-Min;Kim, Soo-Woong;Paick, Jae-Seung;Jee, Byung-Chul;Ku, Seung-Yup;Suh, Chang-Suk;Kim, Seok-Hyun;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.131-141
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    • 2008
  • Objective: To compare the outcomes of intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved-thawed testicular spermatozoa in patients with azoospermia. Methods: One hundred and nine cycles (66 couples) where ICSI was planned with fresh or cryopreserved-thawed testicular spermatozoa were included in this study; Ninety two cycles (61 couples) with fresh testicular spermatozoa (fresh group) and seventeen cycles (13 couples) with cryopreserved-thawed testicular spermatozoa (cryopreserved-thawed group). We compared ICSI outcomes such as fertilization rate, implantation rate, pregnancy rate and miscarriage rate, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: In 9 out of the 92 cycles where ICSI was planned with fresh testicular spermatozoa, testicular spermatozoa could not be retrieved. Fertilization rate tended to be higher in the fresh group than in the cryopreserved-thawed group ($58.0{\pm}27.8%$ vs. $45.9{\pm}25.0%$, p=0.076). The number of high quality embryos was significantly higher in the fresh group ($0.9{\pm}1.2$ vs. $0.2{\pm}0.5$, p=0.002). However, there were no significant differences in clinical pregnancy rate, implantation rate and miscarriage rate between the two groups. Conclusion: The results of this study suggest that although the use of cryopreserved-thawed testicular sperm for ICSI in patients with azoospermia may reduce fertilization capacity and embryo quality, it may not affect pregnancy rate, implantation rate and miscarriage rate. If testicular sperm can be obtained before ICSI procedure, the use of cryopreserved-thawed testicular sperm may also avoid unnecessary controlled ovarian hyperstimulation and cancellation of oocyte retrieval when spermatozoa cannot be retrieved as well as damage on testicular function by repeated TESE.

Factors Affecting Selection of Delivery Facilities Pregnant Women (산모의 분만기관 선택관련 요인)

  • Lee, Choong-Wan;Yu, Seung-Hum;Oh, Hee-Choul
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.4 s.32
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    • pp.436-450
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    • 1990
  • This study was designed to investigate the mar factors affecting selection of delivery facilities by pregnant women. Five hundred women hospitalized at 23 Seoul-area delivery facilities, such as university hospitals, general hospitals, hospitals, and clinics were selected and given questionnaires from April 24 to May 7, 1990. A total of 350 questionnaires were collected and analysed for the study. The results are as follows ; 1. In general, variables which significantly affected the choice of delivery facilities included the age of women, their educational level, the educational level of their husbands, monthly average incomes and residential areas. 2. In analyzing the obstetrical characteristics of the women, those variables significantly affecting the choice of delivery facilities were the gestational period, the facilities for prenatal care, the frequency of prenatal care, the type of delivery, the frequency of miscarriage, previous delivery experiences and the awareness on prenatal care. 3. In comparing the motivation factors for selecting the delivery facilities, all the factors except convenience and need for hospitalization differed significantly among delivery facilities. 4. The factor analysis was assessed for twenty possible factors motivating the choice of delivery facilities. Six factors including personal service, scale of the facility, reputation, urgency, convenience, and experience were noted explaining by 57.7%. 5. In the discriminant analysis used to clarify the major factors affecting the selection of delivery facilities, the 16 significant variables were regarded as independent variables, and the type of delivery facilities was considered a dependent variable. The stepwise method was applied to the analysis. Detected discriminant variables were the facilities for prenatal care, scale factor, personal service factor, urgency factor, convenience factor, reputation factor, experience factor, gestational period, types of delivery, frequency of miscarriage, age and income. These 12 discriminant variables were tested, with reference to discriminant prediction, on their importance in the choice of the delivery facility, by the discriminant functional formula. The test showed a hit-rate of 67.7%. The results suggest that general characteristics, obstetrical characteristics, and motivations for selecting the delivery facilities differ significantly according to the types of the delivery facilities. This study implies that all types of delivery facilities should attempt to acommodate characteristics and motivations of pregnant women. The facilities should be prepared to increase their patients satisfaction with required medical conditions by improving service and responding to the pregnant women's preferences.

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Improved pregnancy rate and sex ratio in fresh/frozen in vivo derived embryo transfer of Hanwoo (Bos taurus coreanae) cows

  • Jihyun Park;Wonyou Lee;Islam M. Saadeldin;Seonggyu Bang;Sanghoon Lee;Junkoo Yi;Jongki Cho
    • Journal of Animal Science and Technology
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    • v.65 no.4
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    • pp.779-791
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    • 2023
  • This study aimed to assess the effects of embryonic developmental stage, quality grade, and fresh or frozen/thawed conditions on the pregnancy rate and sex ratio of live offspring in Hanwoo (Bos taurus coreanae) cows. The quality and developmental stage of in vivo-derived (IVD) transferred embryos were evaluated using the standard criteria of the International Embryo Technology Society. The recipient cows were synchronized using conventional (estradiol benzoate and progesterone) protocols before embryo transfer. Embryos were transferred to 297 cows, and pregnancy was monitored for 60-70 days after embryo transfer. The pregnancy rates of fresh and frozen/thawed embryos were 56.90% and 52.49%, respectively. Pregnancy rates varied according to embryo quality (56.18% for grade 1 vs. 36.67% for grade 2). Pregnancy rates also varied by developmental stage and cryopreservation (67.86% vs. 63.49% for stage 4-1, 64.00% vs. 54.72% for 5-1, and 50.00% vs. 47.83% for 6-1, in fresh embryos vs. frozen/thawed embryos, respectively). For stage 7-1, the pregnancy rates were 72.73% for fresh embryos and 20.00% for frozen/thawed embryos. In 66 fresh embryos, the sex ratio of live offspring was 5:5, whereas it was 4(female):6(male) for frozen/thawed embryos among the 95 frozen/thawed embryos. The miscarriage rate was approximately 3% higher for frozen/thawed embryos than for fresh embryos (18.1% for fresh vs. 21.1% for frozen). Seasonal fertility rates were 33.3% in spring, 55.67% in summer, 52.8% in autumn, 60.0% in winter. The following male-to-female ratios were observed in different seasons: 6.7:3.3 in spring, 4.0:6.0 in summer, 5.5:4.5 in autumn, and 3.3:6.7 in winter. The current data revealed no significant differences in pregnancy rates between fresh and frozen/thawed IVD embryos. However, there was a lower pregnancy rate with advanced-stage frozen/thawed embryos (stage 7-1). The current study provides comprehensive results for the better optimization of embryo transfer in Hanwoo cattle to obtain the desired fertility rate, pregnancy rate, and sex ratio of calves. These results provide important insights into the factors that influence the viability and success of IVD embryo transfer in Hanwoo cows and may have practical applications for improving breeding programs and reducing production costs.

Triploidy that escaped diagnosis using chromosomal microarray testing in early pregnancy loss: Two cases and a literature review

  • Park, Ji Eun;Park, Ji Kwon;Kang, Min Young;Jo, Hyen Chul;Cho, In Ae;Baek, Jong Chul
    • Journal of Genetic Medicine
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    • v.16 no.2
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    • pp.76-80
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    • 2019
  • About 15% to 20% of all clinically recognized pregnancies result in spontaneous abortion or miscarriage, and chromosomal anomalies can be identified in up to 50% of first trimester miscarriages. Chromosomal microarray analysis (CMA) is currently considered first-tier testing for detecting fetal chromosomal abnormalities and is supported by the absence of cell culture failure or erroneous results due to cell contamination in pregnancy loss. Triploidy is a lethal chromosome number abnormality characterized by an extra haploid set of chromosomes. Triploidy is one of the most common chromosomal aberrations in first trimester spontaneous abortions. Here, we report two cases of triploidy abortion that were not detected using array comparative genomic hybridization-based CMA. The aim of this report was to remind clinicians of the limitations of chromosomal testing and the misdiagnosis that can result from biased test selection.

Systemic Review : The Study on Missed Abortion (Pub Med 검색을 통한 계류유산의 최신 연구에 대한 고찰)

  • Park, Chan-Soo;Jung, Min-Yung;Sohn, Young-Joo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.4
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    • pp.160-174
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    • 2007
  • Purpose: The purpose of this study was to investigate about missed abortion pathophysiology, diagnosis, medical treatment and to research the trend of the study related to missed abortion. Methods: We referred a PubMed site by using search word of "missed abortion"(Limits: 3 Year, only items with abstracts, Human). Results: 37 journals with 49 papers were searched. Conclusion: 1. The study of missed abortion pathophysiology was the following. The first was that important pathologies such as molar pregnancy and placental trophoblastic disease can be diagnosed by routine histopathologic analysis of product of conception following first-trimester spontaneous miscarriages. The second was that coelomic fluid leptin concentration in missed abortion is higher than in normal. The third was that adenosine deaminae activity in serum and placenta of patients with anembryonic pregnancies and missed abortions was low. The forth was that Leptotrichia amnionii sp. nov. was the etiopathogenetic factor in missed abortion. 2. Transvaginal ultrasound assessment of irregular vaginal bleeding is effective in diagonosis of missed abortion. 3. There were medical therapy with misoprostol, mifepristone or anti progesterone for missed abortion. Misoprostol was administrated oral(sublingual) and vaginal.

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Stimulated intrauterine insemination in women with unilateral tubal occlusion

  • Yi, Gwang;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.2
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    • pp.68-72
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    • 2012
  • Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.