• Title/Summary/Keyword: miscarriage

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Intraovarian platelet-rich plasma administration could improve blastocyst euploidy rates in women undergoing in vitro fertilization

  • Merhi, Zaher;Seckin, Serin;Mouanness, Marco
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.3
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    • pp.210-214
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    • 2022
  • Objective: Platelet-rich plasma (PRP) therapy has received a considerable attention as an adjunct to fertility treatments, especially in women with very low ovarian reserve and premature ovarian insufficiency. Although recent studies have demonstrated that PRP led to improvements in folliculogenesis and biomarkers of ovarian reserve, the effect of intraovarian PRP administration on embryo genetics has not been studied. Methods: We report a pilot study of patients who had preimplantation genetic testing for aneuploidy (PGT-A) before and then within 3 months following PRP administration. Twelve infertile women with at least one prior failed in vitro fertilization (IVF) cycle underwent ovarian stimulation (cycle 1) with a gentle stimulation protocol and PGT-A performed at the blastocyst stage. Following cycle 1, autologous intraovarian PRP administration was performed. Within 3 months following PRP administration, the patients underwent cycle 2 and produced blastocysts for PGT-A. The percentage of euploid embryos between both cycles was compared. Results: The mean age of all participants was 40.08±1.46 years, and their mean body mass index was 26.18±1.18 kg/m2. The number of good-quality embryos formed at the blastocyst stage was similar between cycle 1 and cycle 2 (3.08±0.88 vs. 2.17±0.49, respectively; p=0.11). Among all patients in cycle 1, 3 of 37 embryos were euploid (8.11%) while in cycle 2, 11 out of 28 embryos were euploid (39.28%, p=0.002). Three clinical pregnancies were noted among this patient group. Conclusion: This novel study is the first to present an improvement in the embryo euploidy rate following intraovarian PRP application in infertile women with prior failed IVF cycles. The growth factors present in PRP may exhibit a local paracrine effect that could improve meiotic aberrations in human oocytes and thus improve euploidy rates. Whether PRP improves live birth rates and lowers miscarriage rates remains to be determined in large trials.

A Survey on Doctor of Korean Medicine's Recognition for Developing Korean Medicine Clinical Practice Guideline of Sanhupung (산후풍 한의표준임상진료지침 개발을 위한 한의사 인식 조사)

  • Kim, Yu-Been;Hwang, Su-In;Yoon, Young-Jin;Kim, Dong-Il;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.1-18
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    • 2022
  • Objectives: This survey was conducted to research Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung, and to use it as a basic data for the development of Korean Medicine Clinical Practice Guideline for Sanhupung. Methods: From October 1, 2021 to November 1, 2021, a self-administered questionnaire was conducted on an online survey platform targeting Korean Medicine doctors belonging to The Association of Korean Medicine, and the responses were analyzed. Results: Patients most commonly visited Korean Medical clinic within 22 to 42 days of miscarriage or childbirth, and the average treatment period was 1 to 3 months. To diagnose Sanhupung, Korean Medicine doctors most frequently identified the characteristic symptoms of Sanhupung, and the symptoms complained by Sanhupung patients were common in the order of arthralgia, coldness, feelings like wind coming in and muscle pain. For the treatment of Sanhupung, 94.8% of the respondents used herbal medicine, followed by acupuncture 78.1%, moxibustion 50.1%, cupping 29.5%, and Chuna 12.6%. For the prevention of Sanhupung, 81.8% of the respondents prescribed herbal medicine, and 66.4% of the respondents provided education to prevent Sanhupung. Conclusions: We researched the characteristics of Sanhupung patients visiting Korean medicine clinic and Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung and reflected them in the CPG for Sanhupung.

Identification of unbalanced complex chromosomal rearrangements in IVF-derived embryos during NGS analysis of preimplantation genetic testing: A case report

  • Yu, Eun Jeong;Kim, Min Jee;Park, Eun A;Hong, Ye Seul;Park, Sun Ok;Park, Sang-Hee;Lee, Yu Bin;Yoon, Tae Ki;Kang, Inn Soo
    • Journal of Genetic Medicine
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    • v.19 no.1
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    • pp.14-21
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    • 2022
  • Complex chromosome rearrangements (CCRs) are structural chromosomal rearrangements involving at least three chromosomes and more than two breakpoints. CCR carriers are generally phenotypically normal but related to higher risk of recurrent miscarriage and having abnormal offspring with congenital anomalies. However, most of CCR carriers are not aware of their condition until genetic analysis of either abortus or affected baby or parental karyotyping is performed. Herein, we present the case that CCR carrier patients can be identified by preimplantation genetic testing of preimplantation embryos. An infertile male patient with severe oligoasthenoteratozoospermia was diagnosed balanced reciprocal translocation, 46,XY,t(3;11) (p26;p14) at first. After attempting the first preimplantation genetic testing for structural rearrangement (PGT-SR) cycle, we found the recurrent segmental gain or loss on 21q21.3-q22.3 of five out of nine embryos. As a result of karyotype re-analysis, the patient's karyotype showed a balanced CCR involving chromosomes 3, 11, and 21 with three breakpoints 3p26, 11p14, and 21q21. The patient underwent two PGT-SR cycles, and a pregnancy was established after the transfer of an euploid embryo in the second cycle. Amniocentesis confirmed that the baby carried normal karyotype without mosaicism. At 37 weeks gestation, a healthy girl weighting 3,050 g was born.

Review of Indicators and Tools used to Assess Korean Medicine Infertility Treatment (한의 난임 치료에 활용되는 평가지표와 평가도구 사용 현황 조사 및 고찰)

  • Soo-Jin Lee;Dong-Il Kim;Su-Ji Choi
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.3
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    • pp.173-195
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    • 2023
  • Objectives: To investigate and analyze the assessment indicators and tools used in clinical practice to assess Korean medicine (KM) treatment for infertility, and to establish a basis for assessment tools to diagnose and assess infertility. Methods: Relevant studies published until March 2023 were extracted from Pubmed, Research Information Sharing Service, and National Digital Science Library databases. Results: Sixty-four studies comprising 4,105 patients were included. We investigated pregnancy outcomes, and assessed pregnancy- and childbirth-related factors, overall health, reproductive health, and mental health. Pregnancy result was most common primary outcome. Ongoing pregnancy, stillbirth, miscarriage, and ectopic pregnancy rates were suggested as indicators of pregnancy and childbirth-related assessment. Overall health was most commonly assessed with Likert and Visual analogue scale (VAS). Among reproductive health variables, menstrual history was most frequently assessed. Moreover, indicators such as reproductive function, sexual intercourse, and gynecological disease were assessed. The Infertility Stress Scale and the Fertility Quality of Life tool (FertiQoL) were used to assess mental health. Conclusions: Subjective scales and objective assessment tools, such as the Likert scale and blood tests/ultrasonography, respectively, are used to assess KM infertility treatment. Inconsistent assessment tools make quantitative analyses more challenging. The development of a standardized mental and physical function assessment questionnaire with confirmed reliability and validity ensure the effectiveness of KM infertility treatment, and promote future studies on infertility treatment.

A Survey on the Treatments used in Oriental Obsterics & Gynecology (한방부인과질환에 사용되는 치료방법에 대한 조사연구)

  • Lee, In-Seon;Bae, Kyung-Mi
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.1
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    • pp.203-230
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    • 2009
  • Purpose: In order to know therapies used in the field of Obsterics & Gynecology of Oriental medicine. Methods: This survey investigated papers about clinical study, literature investigation for therapeutic methods and treatment reports published from 1999. 2${\sim}$2008. 11. Results: In the clinical studies, acupuncture is more frequently used than herbal medicine. But in the treatment reports, herbal medicine is most frequently used except some cases. Besides acupuncture and moxibustion was used frequently. In the treatment reports various acupuncture methods were used except vaginal bleeding or abdominal pain cases. Whole body acupuncture was used mainly. Pharmacopuncture, Sa-am Acupuncture, auricular acupuncture was also used frequently. And Dong's acupuncture, Hwa acupuncture was used sometimes. Moxibustion was tend to be used for dysfunctional uterine bleeding, menopausal disorder, urinary incontinence, vaginal bleeding or abdominal pain during pregnancy period, hyperemesis, recurrent miscarriage, postpartum disease, lochiorrhea. Also other treatment methods was used such as external therapy, aromatherapy, herbal retention enema, fumigation, electric lipolysis acupuncture, Chuna manual medicine, obesity management, acupuncture at uterus cervix, magnetic innervation therapy, exercise, cupping and physical therapy. Conclusion: These results suggests that acupuncture, moxibustion and herbal medicine are most frequent therapy in the field of Obsterics & Gynecology of Oriental medicine. And other therapy are used such as external therapy, aromatherapy, herbal retention enema, fumigation and so on.

Effects of Scutellariae Radix on Gene Expression of Human Cervical Cancer Cells(SNU-703) (황금추출물이 인간 유래 자궁경부암세포의 유전자발현에 미치는 영향)

  • Jo, Hyun-Jung;Gu, Hee-Jun;Cho, Seong-Hee;Park, Kyung-Mi;Yang, Seung-Jeong
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.3
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    • pp.117-134
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    • 2009
  • Purpose: In the theory of traditional medicine, Scutellariae Radix (SR) can clear away heat and remove dampness, purge the sthenic fire and remove toxic materials, cool blood and stop bleeding to prevent miscarriage. Recently, SR is known to have anti-cancer activity. For this reason, the present author designed to investigate the effect of SR on proliferation rates of cervical cancer cell line, then effects on genetic profile by SR. Methods: The genetic profile for the effect of SR on human derived cervical cancer cell line, SNU-703, was measured using microarray technique, and the functional analysis on these genes was conducted. Results: Total 519 genes were up-regulated and 606 genes down-regulated in cells treated with SR. Genes induced or suppressed by SR were all mainly concerned with metabolic process, regulation of biological process and protein binding. The network of total protein interactions was measured using cytoscape program, and some key molecules, such as TNFRSF1A, AKT1, MAPK3, and STAT3 that can be used for elucidation of therapeutical mechanism of medicine in future were identified. Conclusion: These results suggest possibility of SR as anti-cancer drug and also suggest that related mechanisms are involved in TNFRSF1A, AKT1, MAPK3, and STAT3 related signalling pathways.

Factors associated with clinical nurses' preconception health behavior in Korea: a cross-sectional survey

  • Yoon-Jung Park;Sun-Hee Kim
    • Women's Health Nursing
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    • v.30 no.1
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    • pp.79-89
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    • 2024
  • Purpose: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. Methods: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Results: Age (p=.024), educational level (p=.010), marital status (p=.003), work experience (p=.003), satisfaction with the work department (p<.001), smoking status (p=. 039), and previous health problems related to pregnancy outcomes (p=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (p<.001), pregnancy anxiety (p=.011), nursing practice environment (p=.003), and social support (p<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, p=.001), satisfaction with the work department (β=.23, p=.032), marital status (β=.22, p=.002), and perceived health status (β=.23, p=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, p<.001). Conclusion: Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

Outcome of in vitro Fertilization in Women $\geq$40 Years of Age (40세 이상의 여성에서 연령에 따른 체외수정시술 결과 분석)

  • Kwon, Cheo-Jin;Lee, Sang-Hee;Kang, Eun-Hee;Kim, Jong-Sik;Jung, Byeong-Jun
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.4
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    • pp.285-291
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    • 2007
  • Objective: To evaluate the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in women over 40 years of age. Methods: A total of 170 patients (271 cycles) over 40 years of age who underwent IVF-ET at Seoul Women's Hospital (Incheon, Korea) were analyzed in this study retrospectively. The patients were grouped into the women <44 years old group and the women $\geq$44 years old group. Statistical analysis was performed using Student's t-test and Fisher's exact test as appropriate. Results: An overall clinical pregnancy rate per retrieval was 11% (30/271). Of these, clinical miscarriage rate were 33% (10/30) and the overall delivery rate was 7.4% (20/271) per retrieval, respectively. The women $\geq$44 years old group had significantly higher cancellation rate (13% vs. 25%), lower number of retrieved oocytes (6.17$\times$4.62 vs. 4.13$\times$4.07), decreased number of 2PN (4.83$\times$3.61 vs. 3.46$\times$3.12), and reduced embryos for transfer (3.52$\times$1.72 vs. 2.81$\times$1.83) than the women <44 years old group. We found significantly lower clinical pregnancy rate (13.0% vs. 2.1%) and live birth rate (9.0% vs. 0.0%) in the women $\geq$44 years old group than the women <44 years old group. Conclusion: The present study has shown that IVF outcome is seriously impaired in the women $\geq$44 years old.

A Study on Primigravida's Antenatal Self-Care Behavior and Maternal Knowledge (초임부의 산전 자가간호 행위와 모성관련 지식에 관한 연구)

  • Park, Mi-Sook;Kim, Hae-Won
    • Women's Health Nursing
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    • v.6 no.1
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    • pp.153-165
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    • 2000
  • The antenatal self-care, one of antenatal management, was almost done by a pregnant woman herself. But It's especially difficult for primigravidas to cope with the change of being pregnant, and they also had insufficient knowledge of pregnancy, The purpose of this study was to serve as a basis for antenatal management, by grasping how much primigravidas performed antenatal self-care, how much they had maternity-related knowledge, and what factors affected those two factors. The subjects of this study were the primigravidas, selected from among visitors to a general hospital and a hospital for obstetrics and gynecology located in the city of K. A questionnaire survey was carried out over them from July 16 to August 19, 1998, to collect data. The test instrument used in this study for antenatal self-care behavior was one that modified the measurement instrument employed in studies by Kim Hae Won(1996), Lee Mi La(1984), and Yoon Young Mi(1994). Another one for maternity-related knowledge was Kim, Hae Won(1996)'s instrument. The collected data were statistically analyzed by SAS PC+. Frequency and percentage were calculated to find out the primigravidas' general characteristics, and the mean and standard deviation, rank were estimated to determine the degrees of antenatal self-care behavior and maternity-related knowledge, t-test and ANOVA were carried out to identify the general characteristic that affected antenatal self-care and maternity-related knowledge. and the relationship of antenatal self-care behavior to maternity-related knowledge was tested by Pearson correlation coefficient. The findings of this study were as follows; First, the age of the subjects ranged from 18 to 37, and their mean age was 26.43. Their mean gestational period was 24.87 weeks. 45% of the subjects were in the third-term pregnancy. Second, their total mean score in antenatal self-care behavior ranged from 94, the highest, to 36, the lowest. Its average score was 63.81(SD 9.98). The total mean score in maternity-related knowledge ranged from 20, the highest, to 1, the lowest, and its average score was 10.91(SD 4.59, 54.55 percent). Third, the general characteristics that gave impact on the primigravidas' antenatal self-care behavior were age, educational background, gestational period, experience of natural miscarriage, and experience of infertility test. A higher score in antenatal self-care behavior was gained by the primigravida group who had better educational background(F=3.29, p=.02), who was in the late stage of pregnancy(F=4.31, p=.01), who experienced a natural miscarriage(t=2.06, p=.04), and who went through a infertility test(t=-2.19, p=.04). Fourth, the general characteristics that had an influence on maternity-related knowledge were identified as the religion, the term of marriage, and the gestational period. A higher score in maternity-related knowledge was got by the primigravida group who had a religion(t=-2.02, p=.04), and who was in the late stage of pregnancy(F=5.77, p=.003). The term of marriage also made a significant difference(F=3.46, p=.02). Fifth, the relationship of the total mean score between antenatal self-care behavior and maternity-related knowledge was found to be at r=.37(p=.0001). In this study, an attempt was made to affirm the subjects' characteristics, the degree of their antenatal self-care behavior, and the extent of their maternity-related knowledge, to confirm what characteristics affected significantly primigravida's antenatal self-care behavior and maternity-related knowledge, and to verify that there was a relationship between the two variables. The meaning of this study might be backed up by the fact that its findings would serve as a basis for primigravida's efficient antenatal management in the future.

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Clinical Outcomes of Frozen-thawed Embryo Transfer after Microsurgical Removal of Damaged Blastomere (동결-융해 배아 이식에서 손상된 할구의 미세 수술적 제거의 임상적 효과)

  • Choi, Won Yun;Sohn, Jie Ohn;Park, Eun A;Lee, Dong Ryul;Lee, Woo Sik;Han, Se Yul;Park, Lee Suk;Cho, Jung Hyun;Kim, Soo Hee;Cha, Kwang Yul;Yoon, Tae Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.1
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    • pp.55-64
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    • 2005
  • Objective: Human infertility clinics have been faced the demand for improving clinical results. The purpose of this study was to evaluate the effect of microsurgical removal of damaged blastomeres (DB) in frozen-thawed embryos on the clinical outcomes. Methods: From January 2003 to May 2004, out of 258 thawing ET cycles were divided into three groups: Group-1 (n=46): Intact cleavaged embryos after thawing. Remained cycles with embryos containing DB were randomly divided into two groups. Group-2 (n=102): Drilling zona pellucida (ZP) of frozen-thawed embryos by acidified Tyrode's solution. Group-3 (n=110): Drilling ZP and removal of DB. Embryos after microsurgical manipulation were transferred into the uterus of patients. Results: Clinical profiles and the mean number of transferred embryos among three groups were not different. Pregnancy and implantation rates were similar in three groups. It were 30.4% and 9.3% in Group-1, 29.4% and 7.8% in Group-2, and 26.4% and 7.6% in group-3, respectively. Miscarriage rate in Group-3 (37.9%) was slightly higher than those in Group-1 and Group-2 (14.3% and 23.3%), but it was not statistically significant. Conclusion: Intact cleaving embryos after DB removal showed higher potent of pregnancy and implantation. We could not find any improvement of clinical outcome by removal of DB in frozen-thawed embryos.