• Title/Summary/Keyword: polycystic Ovarian Syndrome

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Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

A Case Study on Korean Medicine Treatment for the Oligomenorrhea with Increased Anti-mullerian Hormone Level (AMH 수치가 상승된 희발월경 환자 증례보고)

  • Hong, Ka-Kyung;Kang, Su-Jin;Kim, Sun-Kyung;Kim, Song-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.152-163
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    • 2018
  • Objectives: In recent studies, increased AMH level has been suggested as objective surrogate marker for diagnosis PCOS, one of the major causes of oligomenorrhea. The purpose of this study is to report the clinical effect of Korean medicine treatment on oligomenorrhea patient with increased Anti-mullerian hormone level, who can be diagnosed who can be ruled out PCOS. Methods: A 27 year old woman with oligomenorrhea was enrolled in this study. We measured serum hormone levels and ruled out PCOS. The patient received Korean medicine treatment for 3 months, we assessed the result of treatment through observation of the menstrual cycle and follow-up measurements of serum hormone levels. Results: 1. The patient had menstrual cycle regularly. 2. Increased serum AMH level of the patient decreased from 12.16 ng/ml to 8.51 ng/ml. 3. The other serum hormone levels such as testosterone, LH/FSH ratio decreased Conclusion: This case shows that Korean medicine treatment could have a beneficial effect on menstrual cycle and decrease the increased serum hormone levels of ruled out PCOS patient.

A Review of the Utility of Bee Venom on Gynecological Disorders (자궁난소질환에 대한 봉독(Bee Venom)을 활용한 국내외 연구 동향 분석)

  • Lee, Jin-Wook;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Yang, He-Rynn;Kim, Nam-Hoon;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bok;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.100-113
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    • 2017
  • Objectives: Bee Venom has been used to relieve pain and to treat various diseases, such as arthritis, cancer and skin disease. Although Bee Venom has used extensively in gynecological fields, we don't have enough evidence with it. This study is to investigate efficacy and safety of Bee Venom on women by investigating papers, then we are going to suggest the direction of research. Methods: We searched for papers which had Bee Venom from Pubmed, OASIS, Journal of Korean Obstetrics & Gynecology, Journal of Korean Medicine up to August 2017, then classified according to the type of studies. Results: Eleven papers have been finally selected. One paper was a case report about atypical squamous cells of undetermined significance. Four papers were in vivo studies about 1 endometriosis and 1 polycystic ovarian syndrome and 2 human cervical cancer. Among eight papers that were in vitro studies, four papers were reported about ovarian cancer and four papers reported about human cervical cancer. Among ten papers that were experimental studies, two papers have been studied both in vivo and in vitro. Most of studies have shown that Bee Venom is useful for gynecological disorders. Conclusions: It has been identified that Bee Venom could be a good treatment for female disorder. However, more clinical reports and well-designed studies will be needed.

The Effect of Follicle-Stimulating Hormone Receptor (FSHR) Polymorphism on Outcomes of Controlled Ovarian Hyperstimulation (COH) and In-vitro Fertilization and Embryo Transfer (IVF-ET) (체외수정시술시 난포자극호르몬 수용체 유전자 다형성이 과배란유도 및 임신 결과에 미치는 영향)

  • Yoon, Ji-Sung;Choi, Young-Min;Lim, Kyung-Sil;Hur, Chang-Young;Kang, Young-Je;Jung, Jae-Hoon;Lee, Won-Don;Lim, Jin-Ho;Hwang, Kyu-Ri;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.31 no.2
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    • pp.133-139
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    • 2004
  • Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.

The Comparion of Pregnancy Outcomes between GnRH Agonist and GnRH Antagonist Cycles in Women with Advanced Age (37세 이상의 환자에서 체외수정시술시 GnRH Agonist 주기와 GnRH Antagonist 주기의 비교 연구)

  • Park, Chan Woo;Cha, Sun Wha;Kim, Hae Suk;Kim, Hye Ok;Yang, Kwang Moon;Kim, Jin Young;Song, In Ok;Yoo, Keun Jae;Kang, Inn Soo;Koong, Mi Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.261-268
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    • 2005
  • Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.