• 제목/요약/키워드: ovarian failure

검색결과 79건 처리시간 0.031초

저반응군의 체외수정에서 한 개의 배아 이식 시 임신에 영향을 주는 요인 (Predictor of IVF Outcomes Following Single Embryo Transfer in Poor Responder Patients)

  • 김혜옥;김민지;연명진;차선화;궁미경;송인옥
    • Clinical and Experimental Reproductive Medicine
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    • 제35권3호
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    • pp.213-221
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    • 2008
  • 목 적: 난소기능이 저하된 저반응군 불임 여성에서 한 개의 배아를 이식할 때 임신율에 영향을 주는 요인에 대해 알아보고자 한다. 연구방법: 본원에서 1996년 6월부터 2006년 4월까지 시험관 시술을 받은 환자 중, basal FSH가 12 mIU/mL 이상, 획득된 난자가 4개 이하, hCG 투여일에 혈청 $E_2$가 500 pg/ml 미만인 저반응군 총 919주기에서 한 개의 배아만을 이식한 235주기를 대상으로 하였다. 여성의 연령, hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법, 이식 횟수에 따른 임신율과 생존아 출생률을 비교하였으며, 통계학적인 방법은 Chi-square를 이용하여 p-value 0.05 이하인 경우를 유의하게 평가하였다. 결 과: 총 919주기 중 난자채취 취소율은 25.6% (235주기), 난자채취 실패율은 18.5% (170주기), 배아 이식 취소율은 14.0% (129주기)였다. 한 개의 배아를 이식한 군의 전체 임신율은 8.1% (19주기), 생존아 출생률은 4.7% (11주기)였고, 35세 미만의 여성에서 35세 이상의 여성보다 임신율과 생존아 출생률이 통계적으로 유의하게 높았다 (20% vs. 3.5% p<0.0001, 12.3% vs. 1.8%, p=0.002). hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법에 따른 임신율과 생존아 출생률은 차이가 없었다. 이식 횟수에 따른 누적 임신율은 1회에 8.1%, 2회에 9.2%, 3회에 9.7%, 4회에 9.0%, 5회에 9.5%였다. 결 론: 저반응군의 체외수정에서 한 개의 배아를 이식할 때, 불임 여성의 연령이 35세 미만에서 임신율과 생존아출생률이 유의하게 증가함을 확인하였고, 이식 횟수에 따른 누적 임신율은 차이가 없었다. 이는 체외수정을 시도하려고 하는 난소기능 저하의 불임 여성에서 구체적인 상담 자료로 사용할 수 있겠다.

폐경전 무월경 여성에 있어서 골밀도 측정에 관한 연구 (Bone Mineral Density in Premenopausal Amenorrheic Women with Hypogonadism)

  • 박기현;이병석;이보연;조동제;송찬호
    • Clinical and Experimental Reproductive Medicine
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    • 제19권1호
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    • pp.49-56
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    • 1992
  • Bone mineral density was measured to assess whether the patients with premonopausal hypogonadism, comprised of 19 patients with hypogonadotropic hypogonadism(HH), 55 with premature ovarian failure(POF), 23 with hyperprolactinemia(HPLN), and 8 with Sheehan's syndrome. All aged from 20 to 39, were associated with some decrease in regional bone mass compared with that of 63 normal-associated with some decrease in regional bone mass compared with that of 63 normal-cycling control women matched with age and sex. Measurement of bone mineral density was carried out using Dual photon absorptiometry at four sites; femur neck, ward's triangle, trochanter and spine(L2-L4). Bone mineral density at all four sites were significantly decreased in patients with HH(p<0.01), POF(p<0.01). In hyperprolactinemic patients, the decrease in bone mass was significant at femur neck and Ward's triangle(p<0.05). The patients with POF were noted to be associated with significant bone loss when their duration of amenorrhea exceeded one year. In this study, the degree of loss of bone mass and the affected sites seemed to be different depending on the various types of hypogonadism and POF was noted have caused the appearance of loss of bone mass earlier than other thpes of hypogondism we experienced.

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난관불임술에 관한 임상적 고찰 (Clinical Study on Tubal Sterilizations)

  • 이선경;진영길;서병희;이재현
    • Clinical and Experimental Reproductive Medicine
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    • 제12권1호
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    • pp.71-81
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    • 1985
  • A clinical analysis has been made on 717 cases of tubal sterilization which had been performed at the Dept. of Obstet. & Gynecol., Kyung Hee University Hospital from Jan. 1, 1976 to Dec. 31, 1980. The results are as follows: 1) Prominant age group consisted of those 26-30 years old with frequency of 43.9%, the average being 30.6 years old. 2) Women having 2 living children represented 52.4% of the total and the average No. of living children was 2.5. 3) According to the sex of their children, 29.7% of all cases had one son and one daughter. 12.1% of cases had no son, while 25.7% of cases had no daughter, which showed a trend of male preference. 4) 47.7% of total cases had not experienced artificial abortion before sterilization and the mean No. of artificial abortion was 1.8. 5) With respect to interval between last delivery and tubal sterilization, 76.1% of cases was sterilized within postpartum period (including-c-section) and 12.4% of cases was sterilized within 3 years. 6) The contraceptive methods prior to sterilization were 42.8% with no method used, 17.7% by condom, 16.6% by oral pills, 14.9% by IUD method. 7) 84.5% of puerperal sterilization operation was performed within 48 hours after bearing. 8) Sterilization procedures were coincidentally performed with appendectomy (36.7%), D&E (15.8%), perineorrhaphy (5.0%), salpingectomy (1.8%), and ovarian cystectomy (1.5%). 9) General anesthesia was performed in the majority cases (88.4%). 10) Complications after the procedure were encountered in 7.8% (56 cases), but no intensive medical care was required for these complications. 11) The failure (0.3%) resulting in intrauterine pregnancies occured after the laparoscopic sterilization.

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A Case of Porcine Infertility Associated with Oviductal Obstruction

  • Koo, Ok-Jae;Kang, Jung-Taek;Kwon, Dae-Kee;Park, Hee-Jung;Park, Sol-Ji;Kim, Su-Jin;Moon, Joon-Ho;Kim, Hyun-Il;Jang, Goo;Lee, Byeong-Chun
    • 한국수정란이식학회지
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    • 제26권1호
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    • pp.53-56
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    • 2011
  • Infertility of the pig is directly affects on economic loss and failure of the embryo transfer. In the present case report, we show one rare case of porcine infertility resulted from oviductal obstruction. A gilt showing normal heat behaviors was selected as a recipient of embryo transfer. During the laparotomy surgery, abnormality of the reproductive tract was founded. Several large sized cyst-like structures were founded on infundibulum and body of uterus. Severe enlargement of oviduct represents that obstruction of the oviduct. Sign of fibrosis on the surface of uterus and other internal organs revealed that the obstruction was come arise from prior peritonitis. Mild neutropenia and elevated number of monocytes, eosinophils and platelets in blood smear represent that the peritonitis might be due to chronic parasitic infection. Ovarian function was seems to be normal due to blood progesterone concentration was higher than basal level. The pig was culled because she cannot be recovered by surgical or hormonal treatment.

여성의 요실금 빈도와 관련 요인에 대한 조사 연구 (Incidence and Correlates of Urinary Incontinence in Women)

  • 윤혜상;노유자
    • 대한간호학회지
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    • 제27권3호
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    • pp.683-693
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    • 1997
  • Urinary incontinence is defined as the involuntary and inappropriate loss of urine to failure to emit normal responses as the bladder fills, or inability to reach the bathroom in sufficient time. This study was undertaken to estimate the incidence of urinary incontinence and to determine the correlates of urinary incontinence among women. Subjects of this survey consisted of 408 women, 26 to 83 years old in Incheon. The results of this study are as follows. 1. Of the subjects 50.7% reported urine loss once or twice per year and 28.5% reported incontinence on a regular basis at least once per month. 2. 40.5% of women reported small volume accidents of only 1 to 2 drops, 31.4% ; 1 t-spoon, 16.9% : 1 T-spoon, while 10.1% of women couldn't estimate the volume of urine loss. 3. The volume of urine loss was great enough to require a change of garment (undergarments or outer garments) in 73%. But only 3.8% of those used some type of pads. 4. 56.5% of incontinent women didn't talk about their urinary incontinence with other persons because they felt that urinary incontinence was shameful(38.4%), was not a disease(31.6%), was incurable in spite of treatment(27.4%) and was fearful of being uncured (2.6%). 5. Only 15.5% of urinary incontinent women had sought treatment. 6. The incidence of urinary incontinence was significantly higher in women who had more pariety and uterine-ovarian disease, older age, worrying about where toilets were when they visited new places or voiding anxiety, nocturia and frequency, but was significantly lower in women who had coffee intake. The incidence of urinary incontinence was not related to smoking and enuresis. The results indicate that urinary incontinence is common among young and middle-aged women. That few seek treatment for urinary incontinence suggests a need for more information about women's attitudes toward urinary incontinence and more attention to this problem by health care providers.

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Clinical Outcomes of Gamma Knife Radiosurgery for Metastatic Brain Tumors from Gynecologic Cancer : Prognostic Factors in Local Treatment Failure and Survival

  • Shin, Hong Kyung;Kim, Jeong Hoon;Lee, Do Heui;Cho, Young Hyun;Kwon, Do Hoon;Roh, Sung Woo
    • Journal of Korean Neurosurgical Society
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    • 제59권4호
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    • pp.392-399
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    • 2016
  • Objective : Brain metastases in gynecologic cancer (ovarian, endometrial, and cervical cancer) patients are rare, and the efficacy of Gamma Knife Radiosurgery (GKRS) to treat these had not been evaluated. We assessed the efficacy of GKRS and prognostic factors for tumor control and survival in brain metastasis from gynecologic cancers. Methods : This retrospective study was approved by the institutional review board. From May 1995 to October 2012, 26 women (mean age 51.3 years, range 27-70 years) with metastatic brain tumors from gynecologic cancer were treated with GKRS. We reviewed their outcomes, radiological responses, and clinical status. Results : In total 24 patients (59 lesions) were available for follow-up imaging. The median follow-up time was 9 months. The mean treated tumor volume at the time of GKRS was $8185mm^3$ (range $10-19500mm^3$), and the median dose delivered to the tumor margin was 25 Gy (range, 10-30 Gy). A local tumor control rate was 89.8% (53 of 59 tumors). The median overall survival was 9.5 months after GKRS (range, 1-102 months). Age-associated multivariate analysis indicated that the Karnofsky performance status (KPS), the recursive partitioning analysis (RPA) classification, and the number of treated lesions were significant prognostic factors for overall survival (HR=0.162, p=0.008, HR=0.107, p=0.038, and HR=2.897, p=0.045, respectively). Conclusion : GKRS is safe and effective for the management of brain metastasis from gynecologic cancers. The clinical status of the patient is important in determining the overall survival time.

Identification of Differentially Expressed Genes in Bovine Follicular Cystic Ovaries

  • Choe, Chang-Yong;Cho, Young-Woo;Kim, Chang-Woon;Son, Dong-Soo;Han, Jae-Hee;Kang, Da-Won
    • The Korean Journal of Physiology and Pharmacology
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    • 제14권5호
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    • pp.265-272
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    • 2010
  • Follicular cystic ovary (FCO) is one of the most frequently diagnosed ovarian diseases and is a major cause of reproductive failure in mammalian species. However, the mechanism by which FCO is induced remains unclear. Genetic alterations which affect the functioning of many kinds of cells and/or tissues could be present in cystic ovaries. In this study, we performed a comparison analysis of gene expression in order to identify new molecules useful in discrimination of bovine FCO with follicular cystic follicles (FCFs). Normal follicles and FCFs were classified based on their sizes (5 to 10 mm and $\geq25mm$). These follicles had granulosa cell layer and theca interna and the hormone $17{\beta}$-estradiol ($E_2$)/ progesterone ($P_4$) ratio in follicles was greater than one. Perifollicular regions including follicles were used for the preparation of RNA or protein. Differentially expressed genes (DEG) that showed greater than a 2-fold change in expression were screened by the annealing control primer (ACP)-based PCR method using $GeneFishing^{TM}$ DEG kits in bovine normal follicles and FCFs. We identified two DEGs in the FCFs: ribosomal protein L15 (RPL15) and microtubule-associated protein 1B (MAP1B) based on BLAST searches of the NCBI GenBank. Consistent with the ACP analysis, semi-quantitative PCR data and Western blot analyses revealed an up-regulation of RPL15 and a down-regulation of MAP1B in FCFs. These results suggest that RPL15 and MAP1B may be involved in the regulation of pathological processes in bovine FCOs and may help to establish a bovine gene data-base for the discrimination of FCOs from normal ovaries.

초음파검사 및 호르몬검사에 의한 젖소 번식검진과 발정유도 I. 정기적인 번식검진 및 번식장애 치료 (Reproductive Monitoring and Estrus Induction using Ultrasonography and Hormone Assay in Dairy Cows I. Periodical Examination of Reproductive Status and Treatment of Reproductive Dysfunctions)

  • 오기석;박상국;김방실;고진성;신종봉;백종환;홍기강;문광식;임원호
    • 한국임상수의학회지
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    • 제20권3호
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    • pp.369-375
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    • 2003
  • The ultrasonography was performed in 77,924 subestrous dairy cows from 680 dairy farms at 57 districts. The cows were examined for confirmation of resumption of ovaries and uterus after 30 days postpartum, for early pregnancy diagnosis after 30 days post-insemination, confirmation of pregnancy at 8 month post-insemination, and for diagnosis of reproductive dysfunctions, respectively. The results of reproductive examination by ultrasonography in 77,924 dairy cows were ovarian disorders 35,452 (46.8%), uterine disorders 10,721 (13.8%), pregnancy and pregnant failure 24,044 (30.8%), adhesion of reproductive tracts 167 (0.2%), freematins 13 (0.01%) and others 6,527 (8.4%) cows, respectively. The 13,732 (49.6%) cows out of 27,694 cows were treated for silent heat or error of estrus detection, 3,473 (12.5%) cows for follicular cysts, 815 (3.0%) cows for luteal cysts, 606 (2.2%) cows for inactive ovaries, 4 (0.01%) cows for granulosa cell tumors, and 6,455 (23.3%) cows for endometritis, respectively. The indices of reproductive efficiencies before (2001-08-10) and after (2003-07-20) periodical examination of reproductive status were as follows; the mean intercalving interval were shortened from 471 days to 383 days, the mean interval calving to conception were shortened from 187 days to 99 days, the mean interval calving to first service were shortened from 105 days to 67 days, the mean cows showing heat by 60 days postpartum were increased from 33% to 89%, the mean conception rate to first service were increased from 43% to 68%, and the mean service per conception were shortened from 2.6 times to 1.8 times, respectively. These results suggest that periodical examination of reproductive status would be useful for the improvement of the reproductive performance in dairy cows.

An update of preimplantation genetic diagnosis in gene diseases, chromosomal translocation, and aneuploidy screening

  • Chang, Li-Jung;Chen, Shee-Uan;Tsai, Yi-Yi;Hung, Chia-Cheng;Fang, Mei-Ya;Su, Yi-Ning;Yang, Yu-Shih
    • Clinical and Experimental Reproductive Medicine
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    • 제38권3호
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    • pp.126-134
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    • 2011
  • Preimplantation genetic diagnosis (PGD) is gradually widely used in prevention of gene diseases and chromosomal abnormalities. Much improvement has been achieved in biopsy technique and molecular diagnosis. Blastocyst biopsy can increase diagnostic accuracy and reduce allele dropout. It is cost-effective and currently plays an important role. Whole genome amplification permits subsequent individual detection of multiple gene loci and screening all 23 pairs of chromosomes. For PGD of chromosomal translocation, fluorescence $in-situ$ hybridization (FISH) is traditionally used, but with technical difficulty. Array comparative genomic hybridization (CGH) can detect translocation and 23 pairs of chromosomes that may replace FISH. Single nucleotide polymorphisms array with haplotyping can further distinguish between normal chromosomes and balanced translocation. PGD may shorten time to conceive and reduce miscarriage for patients with chromosomal translocation. PGD has a potential value for mitochondrial diseases. Preimplantation genetic haplotyping has been applied for unknown mutation sites of single gene disease. Preimplantation genetic screening (PGS) using limited FISH probes in the cleavage-stage embryo did not increase live birth rates for patients with advanced maternal age, unexplained recurrent abortions, and repeated implantation failure. Polar body and blastocyst biopsy may circumvent the problem of mosaicism. PGS using blastocyst biopsy and array CGH is encouraging and merit further studies. Cryopreservation of biopsied blastocysts instead of fresh transfer permits sufficient time for transportation and genetic analysis. Cryopreservation of embryos may avoid ovarian hyperstimulation syndrome and possible suboptimal endometrium.

한우에서FSH-P와SUPER-OV에 의한 체내 수정란 생산에 관한 연구 II.계절 및 채란일에 따른 체내 수정란 생산에 영향을 미치는 요인 (Studies on In Vivo Embryo Production by FSH-P and SUPER-OV in Korean Native Cattle III. The Factors Influencing In Vivo Embryo Production on Days and Seasons of Flushing)

  • 김흥률;김덕임;박철진;김창근;정영채;이종완
    • 한국수정란이식학회지
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    • 제12권1호
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    • pp.57-66
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    • 1997
  • This study was carried out to establish an effective and practical system for commercialization of embryo production techniques by analyzing several factors influencing in vivo embryo production on days and seasons of flushing in Korean native cattle. In vivo embryos were flushed 226 times from 128 donors. The results obtained for the factors influencing in vivo embryo production on days and seasons of flushing were as follows :1.The percentages of fertilized, transferable and freezable embryos by seasons were significantly different in both FSR-P and SUPER-OV(P<0.01). The percentages of them were highest in sunrrner with FS H-P and highest in autumn with SUPER -OV.2. The production of transferable and freezable embryos by flushing days was highest in 8 days with FSH-P, and there was no difference between 7 and 8 days for SUP ER-OV. 3. The failure rates of recovery were 17.0% in SUPER-OV and 21.2% in FSH-P, respectively. The donors superovulated but failed recovery were 8.5% in SUPER-OV and 12.9% in FSH-P, respectively. Nonsuperovulated donors was 8.4% and donors giving less than 2 eggs at recovery was 8.4% in both FSH -P and SUPER-OV 4. The donors returned to normal estrus after superovulation were 34.1% after 1 cycle,39.4% after 2 cycles, and 16.7% after 3 cycles by FSH-P, respectively. For SUPER-OV, they were 55.3, 33.0 and 9.6%, respectively. Generally, normal estrus after the treatment of superovulation was earlier and the occurrence of ovarian cyst was also lower in SUP ER-OV than in FSH-P.5.The percentages of blastocyst in embryos flushed at 7~8 days after estrus were 21. 9% and 54.3% in FSH -P and SUPER-OV, respectively. The development of embryos was faster in SUPER-OV than in FSH-P.(Key words : in vivo embryo, flushing days, superovulation, FSH-P, SUPER-OV)

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