• Title/Summary/Keyword: 불임증

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Comparison between Human Follicular Fluid and SpermGrad for Sperm Preparation in Asthenozoospermia (무력정자증 환자에서 인간 난포액과 SpermGrad를 이용한 정자처리법의 비교)

  • Chung, Youn Kyung;Lee, Jung Ryeol;Moon, Jeong-Hee;Kim, Hyun-Jun;Han, Sang-Hoon;Jee, Byung-Chul;Ku, Seung-Yup;Suh, Chang-Suk;Kim, Seok-Hyun;Choi, Young-Min;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.1
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    • pp.53-60
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    • 2006
  • Objective: We tested the usefulness of swim-down technique using human follicular fluid (hFF) in sperm preparation. Methods: Semen samples were obtained from twelve male partners showing asthenozoospermia (sperm motility < 50%) at the time of routine andrologic evaluation in Seoul National University Bundang Hospital. After dividing into two aliquots, each samples were processed either by swim-down using 100% hFF or density gradient using SpermGrad. Sperm quality was assessed by computer-assisted semen analyzer (CASA). Results: Motility, Rapid motility, VCL (curvilinear velocity), ALH (amplitude of lateral head displacement), and hyperactivated sperms were significantly increased, and LIN (mean linearity) was decreased significantly after sperm preparation in both groups. Motility was significantly higher after swim-down using 100% hFF when compared with density gradient using SpermGrad ($81.2{\pm}4.7$ vs. $67.6{\pm}2.3$, p=0.02) The other parameters assessed by CASA were not different between the two methods. Conclusion: Swim-down method with 100% hFF may be a useful method in preparation of sperm from asthenozoospermia.

The Effects of Vero Cells Coculturing on the Motility of Human Testicular Spermatozoa in an Intracytoplasmic Sperm Injection Program (정자직접주입술에 있어 Vero Cells 공배양이 인간 정소정자의 운동성에 미치는 영향에 관한 연구)

  • Kim, Hyun-Kyoo;Oum, Ki-Boong;Kim, Hyun-Joo;Ko, Jung-Jae;Lee, Sook-Hwan;Yoon, Tae-Ki;Cha, Kwang-Yul
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.225-232
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    • 1997
  • 폐색성 혹은 비폐색성 무정자증에서 부정소 정자채취법 등이 부적절하다고 여겨질때는 정소 조직을 일부 절제하여 그 조직으로부터 정자를 직접 채취하게 되는데 일반적으로 이렇게 정소로부터 추출한 정소정자는 운동성이 전혀 없거나 매우 약한 운동성을 보이는 경우가 많다. 본 연구의 목적은 이러한 정소정자를 Vero cell과 공배양을 시킴으로써 운동성을 획득시키거나 향상시키고 이를 수정시키는 시기까지 지속시킴으로써 정소정자추출술 (TESE)을 시행하는 환자나 의료진들에게 보다 편안하고 융통성있는 시간대를 부여하고, 아울러 정자직접주입술 (ICSI)을 보다 용이하게 하여 성공적인 수정률과 임신율을 얻음에 있다. 또한 ICSI를 시행한 후, 운동성이 향상된 잉여의 정소정자를 냉동보존함으로써 차후에 TESE을 다시 시행치않고도 시험관 아기 시술을 시도할 수 있는 부가적인 잇점도 있다고 할 수 있다. 대상환자군은 정관폐색증(n=11) 혹은 비정관폐색증(n=2)을 보이는 13명의 무정자증의 남성불임환자였으며 난자회수예정일 3일전에 TESE를 시행하여 정소정자를 얻은 후 이를 정자직접주입술이 시행되는 당일까지 Vero cell과 공배양을 실시하였다. Vero cell과의 공배양에 의하여 운동성이 있는 정소정자의 수는 공배양전과 비교하여 평균 3.3배가 증가하였으며, 특히 공배양전에 운동성이 있는 정소정자의 수가 50,000/ml이하의 미약한 운동성만을 보였던 경우 (n=5)에는 공배양 후에 운동성이 있는 정소정자 수의 평균증가율이 7.7배였다. 공배양전 정자운동성이 전혀 없었던 2례의 비정관폐색증환자중 3일간의 공배양을 통하여 1례에서 운동성을 획득한 정소정자를 얻을 수 있었으며 (14,300/ml), 정자직접주입술을 통하여 성공적인 수정 및 임신에 도달할 수 있었다. Vero cell과 공배양을 하고 ICSI했던 결과, 평균 수정률은 75.0% 이었으며 임신율은 61.5%였다.

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A Study of JuJinHyoung(朱震亨)'s Medical thoughts in Oriental Obstetric & Gynecology (단계(丹溪)의 학술사상(學術思想)이 한방부인과학(韓方婦人科學)에 미친 영향(影響)의 고찰(考察))

  • Yoon, Jung Won;Oh, Gue-Suk;Hong, Young-Yook;Lee, Tae-Kyun
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.1
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    • pp.205-229
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    • 1997
  • JuJinHyoung(朱震亨) is a well-known physcian of the four schools in the Jin(金) and Yuan(元) Dynasties. He lived in ZhejiangSheng(浙江省) which located in the southeast region of China. There was humid and heatful climate, this kinds of environments influenced to his medical thoughts. He persisted in the theory that Yang is ever in excess while Yin is ever deficient(陽常有餘陰不足論) and exhorted the therapy of subduing excessive Yang and making up deficient Yin by nourishing it, and he said about the theory of ministerial fire(相火論). So he was regarded as a representative of the nourising Yin school(滋陰派). And he said that the method of "Clearing away heat and nourishing blood" is suitable in pregnancy. So Stucellaria baicalensis GEORGI and Atractylodes macrocephala KOIDZ. Can be apply in case of treatment on Anti-abortion. Thus these theories have influenced on Obstetric & Gynecology in Korea.

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Male Factor Infertility and In vitro Fertilization-Embryo Transfer (남성불임증과 체외수정시술)

  • Kim, Sun-Haeng;Jung, Rae-Hwan;Ku, Pyong-Sahm
    • Clinical and Experimental Reproductive Medicine
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    • v.19 no.1
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    • pp.71-79
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    • 1992
  • In vitro fertilization and embryo transfer (IVF & ET) is widely used for the males with subnormal or abnormal semen quality, as this was recommended in view of the relatively small numbers of spermatozoa required for fertilization and subsequent pregnancies could be obtained. The aim of this study is to know how the various functional parameters of spermatozoa in semen analysis affect the outcome IVF. This study was carried out between 1988-1989, with male factor patients selected on the basis of the semen quality. The selection criteria was based upon the mean values of concentration,% motility and % normal morphology from at least two semen analysis. There is a significant decrease in the fertilization and embryo transfer rates in the study group compared with control group (35.9% vs. 68% and 48.6% vs. 85.5% respectively), however, there was no significant difference in the pregnancy or delivery rates (19.6% vs. 21.4% and 60.0% vs. 62.5% respectively) per embryo transfer cycles. Fertilization rate is variously affected by the type and degree of sperm defect. No pregnancy was occurred in triple defect group and asthenoteratospermia group. There is no significant increase in the abortion rate in the male factor group. Improvement have to be made with the fertilization rate, as the pregnancy rate per OPU cycle in male factor group is still lower than that of normal group (9.5% vs. 18.3%). In conclusion, IVF can be used as a treatment for male factor infertility and the preparation of the semen sample can be modified to improve sperm recovery and obtain fertilization from abnormal semen samples.

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A Clinical Investigation in Primary Male Infertility During Recent 5 Years (최근 5년간 원발성 남성불임증 환자의 임상적 분석)

  • Kim, Tae-Hyoung;Kim, Kyung-Do;Kim, Sae-Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.3
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    • pp.253-259
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    • 1994
  • A clinical investigation was undertaken on primary male infertility patients of recent 5 years. The results obtained were as follow: 1. Suspective etiologic factors were: 1) testicular failure, 36.1 %; 2) varicocele, 18.7%; 3) endocrine abnormality, 13.5%; 4) obstruction, 13.5%; 5) idiopathic, 10.9%; 6) cryptorchidism, 2.6%; 7) necrospermia, 0.9%. 2. On semen analyses, azoospermia was found in 55.8%, single abnormal parameter in 21.5 %, and multiple/all abnormal parameter in 22.7% of the 163 cases. 3. For the evaluation of the sensitivity and specificity of noninvasive variables in predict in obstruction as the cause of azoospermia in patient who had undergone testicular biopsy, the testicular size and serum follicle-stimulating hormone(FSH) level revealed 100% of sensitivity. 4. Among the 43 patients with a testicular biopsy confirmed diagnosis there was a significant difference in testicular size, ejaculate volume(p<0.0001) and serum FSH(p<0.0001) between patients with testicular failure and those with ductal obstruction. 5. Of 93 treated patients with primary male infertility, 42 were managed by medical treatment including endocrine treament, retrograde ejaculation treatment, infection treatment and observation; 29 were managed by surgical treatment including varicocelectomy, vasovasostomy, vasoepididymostomy and TUR of ejaculatory duct; 20 were managed by sperm preparation treatment including artificial insemination(AI), electroejaculation plus AI and vibration ejaculation plus AI ; 2 were managed by microscopic epididymal sperm aspiration plus IVF, repectively. 6. 42 patients who could be followed-up, 21 patients(50%) impregnated their wives.

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Study on The Infertility Rate of Korean Women (한국 부인의 불임증실태에 관한 고찰)

  • 홍문식;김택일
    • Korea journal of population studies
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    • v.5 no.1
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    • pp.133-144
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    • 1982
  • One of the primary objectives of Korean family planning program is to assist parents in having the number of children they want, both by providing fertility-en-hancing services to infecund and subfecund women and by providing fertility-limitation services to fecund women. As far as fertility-enhancing services to infecund and subfecund women is concerned, there has been little effort from the national family planning program, So far, there is no any basic data on infertility prevalence rate among the Korean women. Therefore, an attempt has been made to review data of 1976 and 1978 fertility and family planning surveys in order to estimate the level of infertility rate among the Korean women. In the 1978 survey 3. 7 percent of the current married women responded that they were physically infertile while in the 1976 survey physically infer-tile women was calculated as 3 percent of the total ever married women which is similar level of 1978 data of 3.7 percent. Mean age at first marriage of Korean women is 23 and most of the women are married in the high fecund age. Only 0.3 percent of the respondents married age 30. in addition, the rate of women with no children among the ever married women whose married duration is more than 5 year is very low;2. 5 percent among 5-9 years, 1. 4 percent among 10- 14 years; 1.8 precent among 15-19 years; 1.0 percent among 20-24 years; and 0. 7 percent among 25 or more years of marriage duration. If we consider those data shown above, it is manifest that infertility rate of Korean women is less than 5 percent level which is much lower than the 10 percent level of infertility rate in the United States of America. However, this kind of estimation is still not able to show definite data on fertility rate. Therefore, a nationwide planned survey should be carried out as early as possible to figure out the real situation of infertility rate in Korea.

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Discovery of UBE2I as a Novel Binding Protein of a Premature Ovarian Failure-Related Protein, FOXL2 (조기 난소 부전증 유발 관련 단백질인 FOXL2의 새로운 결합 단백질 UBE2I의 발견)

  • Park, Mira;Jung, Hyun Sook;Kim, Hyun-Lee;Pisarska, Margareta D.;Ha, Hye-Jeong;Lee, Kangseok;Bae, Jeehyeon;Ko, Jeong-Jae
    • Development and Reproduction
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    • v.12 no.3
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    • pp.289-296
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    • 2008
  • BPES (Blepharophimosis/Ptosis/Epicanthus inversus Syndrome) is an autosomal dominant disorder caused by mutations in FOXL2. Affected individuals have premature ovarian failure (POF) in addition to small palpebral fissures, drooping eyelids, and broad nasal bridge. FOXL2 is a member of the forkhead family transcription factors. In FOXL2-deficient ovaries, granulosa cell differentiation dose not progress, leading to arrest of folliculogenesis and oocytes atresia. Using yeast two-hybrid screening of rat ovarian cDNA library with FOXL2 as bait, we found that small ubiquitin-related modifier (SUMO)-conjugating E2 enzyme UBE2I protein interacted with FOXL2 protein. UBE2I also known as UBC9 is an essential protein for processing SUMO modification. Sumoylation is a form of post-translational modification involved in diverse signaling pathways including the regulation of transcriptional activities of many transcriptional factors. In the present study, we confirmed the protein-protein interaction between FOXL2 and UBE2I in human cells, 293T, by in vivo immunoprecipitation. In addition, we generated truncated FOXL2 mutants and identified the region of FOXL2 required for its association with UBE2I using yeast-two hybrid system. Therefore, the identification of UBE2I as an interacting protein of FOXL2 further suggests a presence of novel regulatory mechanism of FOXL2 by sumoylation.

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The Effect of Rubus coreanum Miquel Against Lipopolysaccharide-induced Oxidative Stress and Lipid Metabolism (복분자 추출물이 LPS로 유도된 산화적 스트레스와 지질대사에 미치는 영향)

  • Kim, In-Deok;Kang, Kum-Suk;Kwon, Ryun-Hee;Yang, Jeong-Ok;Lee, Joong-Sook;Ha, Bae-Jin
    • Journal of Food Hygiene and Safety
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    • v.22 no.3
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    • pp.213-217
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    • 2007
  • LPS induces the synthesis of several inflammatory cytokine, chemokine, NO and inflammation in the liver of rats. The purpose of this study was to investigate the preventive effects of Rubus coreanum Miquel (RCM) In lipid metabolism. RCM of 100 mg/kg concentration was intraperitoneally administered into rats at dose of 1.5ml/kg for 20 days. On the day 21, 1.5ml/kg of LPS was injected 4 hours before anesthetization. We examined the lipid-related functions by measuring the levels of triglyceride (TG), total cholesterol (TC), total lipid (TL), high-density lipoprotein cholesterol (HDL-C) in serum and malondialdehyde(MDA) in liver tissue. The results showed that LPS treatment increased the values of TG, TC, TL and MDA, decreasing that of HDL-C. But RCM pretreatment decreased the high values of TG, TC, TL and MDA to the low values and increased the low value of HDL-C to the high value. These results suggested that RCM could be used as the potential candidate for the lipid metabolism natural supplement.

Studies on the Improvement of Fertilization and Development Rates Using ICSI with In Vitro Matured Bovine Oocytes (소 체외성숙 난자에 ICSI에 의한 수정율의 향상에 관한 연구)

  • 정진호;김상근
    • Korean Journal of Animal Reproduction
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    • v.25 no.3
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    • pp.259-267
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    • 2001
  • This study was carried out to investigate on the improvement of fertilizing and developing ability of in vitro matured oocytes from sperm density, motility and PVP(polyvinylpyrrolidone), HA(hyaluronic acid) concentrations, sperm capacitation and intact, free-zona of bovine oocytes obtained by intracytoplasmic sperm injection(ICSI). 1. The fertilization and cleavage rates of bovine oocytes obtained by ICSI treated 0.01, 0.02, 0.03, 0.05% of PVP concentrations were 72.7∼90.9% and 38.5∼54.5%, respectively and these values of 0.02% addition of PVP were higher than other concentrations of PVP 2. The fertilization and cleavage rates of bovine oocytes obtained by ICSI treated 0.01, 0.02% HA and 0.02% PVP + HA concentrations were 72.7%, 40.9% and 81.8%, 54.5% and 83.3%, 37.5%, respectively. and these values of 0.02% addition of PVP + HA were lowe than other concentrations of HA. 3. The fertilization and cleavage rates of bovine oocytes obtained by ICSI treated fresh and frozen sperm were 93.3%, 85.7% and 60.0%, 46.7%, respectively and these values of fresh sperm injection were higher than frozen sperm. 4. The fertilization and cleavage rates of bovine oocytes obtained by ICSI capacitated sperm of heparin, BFF and His methods were 86.7%, 78.9%, 65.0% and 61.9%, 52.6%, 50.0%, respectively. 5. The fertilization and cleavage rates of zona-intact and zona-free bovine oocytes obtained by ICSI were 84.2%, 78.3% and 57.9%, 34.8%, respectively. 6. The fertilization and cleavage rates of bovine oocytes obtained by IVF or ICSI were 63.3∼64.6%, 88.2∼90.0% and 26.7∼29.2%, 52.9∼67.5%, respectively. This ICSI method improved high fertilization rates of bovine oocytes.

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Clomiphene Citrate on Male Infertility (남성 불임증 환자에 대한 Clomiphene의 효과)

  • Lee, Kang-Hyun;Lee, Hee-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.8 no.2
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    • pp.45-55
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    • 1981
  • Clomiphene citrate. antiestrogen, was given to 39 infertile males whose spermatogenesis were disturbed and the efficacy of the drug was evaluated at the Department of Urology in 1980. (Table 1). Patients were divided into 3 clinical observation groups such as group I composed of 19 cases of idiopathic azoospermia, group II consisted of 15 cases of oligospermia following the vasovasostomy, and group III comprised 5 cases of testicular azoospermia. (Table 2). Clinical characteristics of these patients were as follows: Age of the patients ranged from 26 to 43 years old with mean of 34, and that of their wives ranged from 24 to 41 years old with mean of 31. Duration of marital life ranged from 1 to 21 years with mean of 5 years. Sizes of testis ranged from 6 to 25 ml with mean of 16 ml. Coital frequency ranged from 0.5 to 6 per week with mean of 2.4 per week. Levels of plasma FSH ranged from 3.15 to 23.06 lU/1 with mean of 8.15 lU/1, those of LH ranged from 2.98 to 19.89 lU/1 with mean of 8.18 lU/1 and those of testosterone ranged from 3.09 to 9.97 ng/ml with mean of 6.48 ng/ml. (Table 3). Clomiphene citrate was given in dosage of 50 mg per day (in d.) orally to 31 patients for 3 to 9 months and in dosage of 100 mg per day (b.i.d.) orally to 8 patients for 3 to 9 months. (Table 8). Semen samples were analysed monthly on each patient by routine analysis techniques. For the assessment of the efficacy of Clomiphene citrate on faulty spermatogenesis following empirical criteria were used: For semen quality: Improvement (I) represents that semen parameter increased more than 25% from basal level after the treatment, Unchange (U) expresses that semen parameter increased less than 25% of basal level or not changed after the treatment and Deterioration (D) means that semen parameter decreased from basal level after the treatment. For fertility unit (total counts ${\times}$ motility ${\times}$ morphology ${\div}10^6$): Improvement (I) represents that fertility unit increased more than 10 units after the treatment, Unchange (U) expresses that fertility unit increased less than 10 units or not changed after the treatment, and Deterioration (D) means that fertility unit decreased after the treatment. (Table 4). Results obtained from the Clomiphene therapy were as follows: Changes of spermiograme before and after the Oomiphene therapy shown in the Table 5. Sperm counts increased from 23 to 31 ${\times}10^6$/ml in group I, from 17 to 29 ${\times}10^6$/ml in group II. Other parameters of spermiogramme were not changed significantly after the treatment. Fertility units increased from 14 to 18 units after the treatment in group I, and from 16 to 18 units after the treatment in group II. Effectiveness of Clomiphene citrate on spermatogenesis was summarised in the Tables 6 and 7. After the treatment, sperm count increased in 11 patients, motility increased in 6 patients, morphology increased in 4 patients and fertility units increased in 9 patients. No sperm could be produced by Clomiphene citrate in group III of testicular azoospermia. Dosage of 50 mg of Clomiphene citrate per day for 3 to 6 months was proved to be the most effective in the present series. (Table 8). Pregnancy occurred in 2 patients after the treatment. No particular side effects were noted by the treatment. Pharmacologic compounds used for male infertility were shown in the Table 9. Reported results of Clomiphene citrate were shown in the Table 10.

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