• Clinical and Experimental Reproductive Medicine
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• v.40 no.4
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• pp.143-147
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• 2013

Oocyte in vitro maturation (IVM) is an assisted reproductive technology in which oocytes are retrieved from the antral follicles of unstimulated or minimally stimulated ovaries. IVM of human oocytes has emerged as a promising procedure. This new technology has advantages over controlled ovarian stimulation such as reduction of costs, simplicity, and elimination of ovarian hyperstimulation syndrome. By elimination or reduction of gonadotropin stimulation, IVM offers eligible infertile couples a safe and convenient form of treatment, and IVM outcomes are currently comparable in safety and efficacy to those of conventional in vitro fertilization. IVM has been applied mainly in patients with polycystic ovary syndrome or ultrasound-only polycystic ovaries, but with time, the indications for IVM have expanded to other uncommon situations such as fertility preservation, as well as to normal responders. In this review, the current clinical experiences with IVM will be described.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.98-102
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• 2011

Objective: To investigate the effects of pioglitazone on controlled ovarian stimulation (COS), IVF outcomes, and follicular fluid (FF) cytokine concentrations in patients with polycystic ovary syndrome (PCOS). Methods: Eighty-six infertile patients with PCOS resistant to clomiphene citrate were randomized to receive pioglitazone (30 mg/day) or placebo on the starting day of oral contraceptive (OC) pretreatment, followed by an IVF protocol using a GnRH antagonist. Pioglitazone or placebo was administered once daily from the starting day of OC to the day of hCG injection. Results: Total dose and days of recombinant follicle-stimulating hormone administered, and the numbers of retrieved and mature oocytes, were significantly lower in the pioglitazone group than in the control group. FF tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-6 (IL-6) concentrations at oocyte retrieval were also significantly lower in the pioglitazone group. The clinical pregnancy rate was higher and the incidence of severe ovarian hyperstimulation syndrome was lower in the pioglitazone group, but the differences were not statistically significant. Conclusion: Pioglitazone reduces FF TNF-${\alpha}$ and IL-6 levels, and may improve ovarian response to COS in patients with PCOS.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.1
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• pp.122-137
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• 2018

Objectives: This study is to review the effect of Korean medicinal herbs on treatment of polycystic ovary induced rat models reported in domestic & foreign journals. Methods: 7 electronic databases (Pubmed, CNKI, EMBASE, Oasis, RISS, CENTRAL, Koreankt) were searched with term as polycystic ovary, and study reports on polycystic ovary impairment with Korean medicinal herbs. After selecting several studies, the analysis was focused on items reflected in the Rotterdam criteria for diagnosis of polycystic ovary syndrome such as hyperandrogenism (HA), ovarian weight, the number of follicle cysts, estrous cycles, and etc. Results: 15 studies were reviewed. As a polycystic ovary induction material, estradiol valerate (EV) was used in 9 studies, testosterone propionate (TP) in 2 studies and dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), Poretsky's method and letrozole (LE) was used in rest 4 studies, respectively. Tribulus terrestris (TT), Nardostachys jatamansi (NJ), Lycii cortex (LC), Cinnamomum cassia kees (CCK) and Atractylodis macrocephalae koidz (AMK) produced statistically significant results related to hyperandrogenism. In ovarian weight, Silybum marianum (SM), AMK and Alllium sativum (AS) were statistically significant. In the the number of follicle cysts, SM and TT were statistically significant. In estrous cycles, AMK, NJ, TT and Coix lacryma-jobi (CL) were statistically significant. Conclusions: Based on the diagnosis criteria of Rotterdam, TT, NJ, AMK, SM, AS, and CL produced statistically significant results in rat model.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.2
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• pp.50-59
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• 2019

Anti-$M{\ddot{u}}llerian$ hormone (AMH), a peptide growth factor of the transforming growth $factor-{\beta}$ family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a "fertility test."

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.3
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• pp.47-56
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• 2016

Objectives: We evaluated the effect of Korean medical treatment in case of irregular menstruation (amenorrhea, oligomenorrhea) due to Polycystic ovarian syndrome (PCOS).Methods: 20 Amenorrhea or oligomenorrhea Patients with PCOS were treated with Korean medical treatment at least 3 months. We analyzed clinical data of 20 patients and checked effectiveness of treatment through the change of menstrual pattern.Results: After Korean medical treatment, Patients who complained menstrual irregularity due to PCOS were improved in menstrual condition. Among 14 amenorrhea patients, 12 patients (85.7%) started menstruation within 3 months. Among 6 Oligomenorrhea patients, 4 patients (66.7%) got better menstruation pattern than before.Conclusions: PCOS Patients who got Korean medical treatment showed better condition in menstruation pattern. Amenorrhea patients started menstruation without contraceptive pill and oligomenorrhea patients got better menstruation cycle.

• Journal of Yeungnam Medical Science
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• v.29 no.2
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• pp.73-76
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• 2012

More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-${\alpha}$, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.4
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• pp.39-53
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• 2018

Objectives: The purpose of this review was to overview and evaluate the efficacy of electroacupunture for women with polycystic ovarian syndrome (PCOS) Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in PubMED, EMBASE, OASIS, and Google scholar, up to May 2018. Data were extracted regarding hyperandrogenism, obesity and hyperinsulinemia indices. The risk of bias was assessed. Results: Five RCTs were included for analysis. In one RCT, electroacupuncture group had significantly lower free testosterone and testosterone, compared to no treatment group. However, The other RCTs showed no significant difference between two groups. For LH/FSH, Ferriman Gallway score, anti-mullerian hormone, body mass index, weight and waist, and insulin, electroacupuncture group showed no significant difference, compared to physical exercise, no treatment, and sham acupuncture group. Conclusions: Only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of electroacupuncture for treatment of PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.3
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• pp.146-151
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• 2017

Objective: To identify differences in the expression of the genes for peroxisome proliferator-activated receptor $(PPAR)-{\gamma}$, cyclooxygenase (COX)-2, and the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor $(TNF)-{\alpha}$ in granulosa cells (GCs) from polycystic ovary syndrome (PCOS) patients and controls undergoing controlled ovarian stimulation. Methods: Nine patients with PCOS and six controls were enrolled in this study. On the day of oocyte retrieval, GCs were collected from pooled follicular fluid. Total mRNA was extracted from GCs. Reverse transcription was performed and gene expression levels were quantified by realtime quantitative polymerase chain reaction. Results: There were no significant differences in age, body mass index, and total gonadotropin dose, except for the ratio of luteinizing hormone to follicle-stimulating hormone between the PCOS and control groups. $PPAR-{\gamma}$ and COX-2 mRNA was significantly downregulated in the GCs of PCOS women compared with controls (p= 0.034 and p= 0.018, respectively), but the expression of IL-6 and $TNF-{\alpha}$ mRNA did not show significant differences. No significant correlation was detected between the expression of these mRNA sequences and clinical characteristics, including the number of retrieved oocytes, oocyte maturity, cleavage, or the good embryo rate. Positive correlations were found among the $PPAR-{\gamma}$, COX-2, IL-6, and $TNF-{\alpha}$ mRNA levels. Conclusion: Our data may provide novel clues regarding ovarian GC dysfunction in PCOS, and indirectly provide evidence that the effect of $PPAR-{\gamma}$ agonists in PCOS might result from alterations in the ovarian follicular environment. Further studies with a larger sample size are required to confirm these proposals.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.2
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• pp.141-151
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• 1998

Objectives: To determine whether the body weight, body mass index (BMI), and basal serum level of LH, FSH, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) are related to the ovarian response to clomiphene citrate (CC) in patients with polycystic ovarian syndrome (PCOS). Materials and Method: From January 1996 to June 1997, total 57 patients with PCOS were enrolled in the present study. Women who had other infertility factors were excluded from our study. The ovulation induction using CC was used in all patients. The patients were grouped into 50 mg group, 100 mg group, and 150 mg group according to their daily CC dose. The patients were also grouped to ovulatory and non-ovulatory group. The body weight, BMI, and basal serum level of LH, FSH, T, DHEA-S were measured in all patients on the 2nd or 3rd day of the menstrual cycle. Results were analysed with Student's t-test and Fisher's exact test. Results: The body weight and BMI of the nonovulating group were significantly higher than those of the ovulating group in all groups (50, 100, 150 mg of CC). However, there were no significant differences of the level of LH and FSH between ovulating and nonovulating groups in all CC groups (50, 100, 150 mg). The level of T of nonovulating group was significantly higher in 50 and 100 mg of CC groups, but not in 150 mg group. The level of DHEA-S of the non-ovulating group is significantly higher in 50 mg group, but not in 100 and 150 mg groups. Conclusion: The body weight and BMI could be useful predictors of ovarian response to CC in patients with PCOS, and basal T and DHEA-S also might be useful in cases of low-dose CC treatment.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.1
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• pp.84-98
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• 2007

Purpose : Polycystic ovarian syndrome(PCOS) is a endocrine disorder and still remains as one of the common causes of anovulation in women of reproductive age. There are some evidences that nerve growth factor(NGF) is involved in the pathogenesis of PCOS. In this research, the effects of ShingihwanhapChangbudodam- Tang(SCT) on the estradiol valerate(EV)-induced polycystic ovary(PCO) were investigated in rats. Methods : PCO was induced by single intramuscular injection with EV(4mg) in female rats. Rats in PCO control group(n = 8) were EV injected and orally administrated distilled water for sixty days. Rats in SCT-treated group(n = 8) were EV injected and orally administrated SCT for same duration. The weights of body, ovary and adrenal gland were measured. And also, ovarian histopathology and NGF immunohistochemistry were performed. Results : The weights of ovaries in SCT-treated group were significantly increased compared with control group. The numbers of secondly and mature follicles, and corpora lutea in SCT-treated group were significantly increased compared with control group. The numbers of atretic follicles were significantly decreased compared with control group. The expression of NGF positive reaction in the ovarian granulosa cells of SCT-treated group were lesser observed than control group. Conclusion : From the these results, we concluded that ShingihwanhapChangbudodam-Tang(SCT) has inhibitory effect on the development of EV-induced polycystic ovary. And it's effect may be related with decreased NGF activities in the ovary.