• Title/Summary/Keyword: Adverse pregnancy outcomes

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A Review on Female Infertility Treatment in Korean Medicine by Analyzing Case Studies Published in Korean Journal (국내 학술지에 게재된 증례 연구 분석을 통한 여성 난임의 한의학적 치료에 대한 고찰)

  • Young-Eun Kim;Hee-Yoon Lee;Su-In Hwang;Young-Jin Yoon;Jang-Kyung Park
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.1
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    • pp.40-59
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    • 2024
  • Objectives: Since infertility has been big social issue in Korea, this study aims to analyze the domestic study trends in Korean Medicine (KM) for female infertility treatment. Methods: Case studies applying KM treatment on female infertility were selected through 5 domestic journal databases. General characteristics, interventions, outcomes and results and the quality of the reports were analyzed. Especially, the quality assessments of studies were made using CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 14 studies (22 cases) were finally selected for the analyzation. The mean age of the participants was 35.1 and the most common factor of female infertility in this study was Uterine factor. Herbal medicine was applied in all studies, and acupuncture was also used frequently. Most cases reported pregnancy of the participants. According to quality assessment, 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', 'Patient perspective' and 'Informed consent' were showed low reporting rates. Conclusions: Korean Medicine treatment for female infertility is expected to be effective. In quality evaluation, there were some items with low reporting rates. Further clinical studies have to be conducted to establish the evidence for the treatment.

The Effect of the Serum Progesterone and Estradiol Levels of hCG Administration Day on the Pregnancy and Fertilization Rate in IVF-ET Patients (체외수정 과배란 유도에서 hCG 주사 당일의 혈청 Progesterone과 Estradiol 농도가 수정율 및 임신율에 미치는 영향에 관한 연구)

  • Lee, Eun-Sook;Lee, Sang-Hoon;Bae, Do-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.1
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    • pp.51-59
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    • 1996
  • Controlled Ovarian hyperstimulation(COH) is generally used to obtain synchronous high quality oocytes in in vitro fertilization-embryo transfer(IVF-ET). Many investigators have studied the relationship between serum hormone levels and outcomes of IVF-ET because there is no accurate estimation method of oocyte quality. Early premature luteinization of follicles before oocyte retrieval is the most troublesome problem in COH for IVF-ET. Gonadotropin-releasing hormone agonists(GnRH-a) are used as adjuncts with gonadotropins for COH in patients undergoing in IVF. The possible benefits of GnRH-a pretreatment include improving oocyte quality, allowing a more synchronous cohort of follicles to be recruited, and preventing premature lueinization hormone surges. In COH of IVF cycles, we investigated whether an elevated progesterone(P4) level on the day of human chorionic gonadotropin(hCG) administration indicates premature luteinization and is associated with a lower fertilization rate. Many investigators have studied that the lower fertilization rates seen in patients with elevated P4 levels might result from an adverse effect of P4 on the oocytes. We hypothesizes that serum P4 levels around the day of hCG may be helpful prediction of out come in IVF-ET cycles. Success rates after COH of IVF-ET cycles are dependent upon many variable factors. Follicular factors including the number of follicles, follicular diameters and especially serum estradiol(E2) levels as an indirect measurement of follicular function and guality have been thought to influence the outcomes of IVF-ET. To assess whether serum P4 and E2 levels affect the fertilization and pregnancy rate, we reviewed the stimulation cycles of 113 patients (119 cycles) undergoing IVF-ET with short protocol with GnRH-a, from March 1993 to August 1994 retrospectively. The serum P4 and E2 levels were compared on the day of hCG in the pregnant group, 45 patients(47 cycles) and in the non-pregnant group, 68 patients (72 cycles) respectively. The serum E2 level in non-pregnant group was $1367{\pm}875.8$ pg/ml which was significantly lower than that of pregnant group, $1643{\pm}987.9$ pg/ml( p< 0.01 ). And the serum P4 level in non-pregnant group was $2.1{\pm}1.4$ ng/ml which was significantly higher than that of pregnant group, $1.0{\pm}0.7$ ng/ml( p< 0.001 ). The fertilization rate was $61.3{\pm}21.3%$ in pregnant group which was higher than that of non-pregnant group, $41.1{\pm}20.2%$ (p< 0.01). We suggest that the serum levels of P4 and E2 on the day of hCG administration are additional parameters that predict the outcomes of IVF-ET cycles.

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