• Clinical and Experimental Reproductive Medicine
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• 제34권2호
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• pp.125-131
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• 2007

목 적: 난소 반응이 저하된 환자에서 GnRH agonist flare up protocol과 GnRH antagonist protocol의 효용성을 비교하고자 하였다. 연구방법: 2003년 1월부터 2005년 8월까지 체외수정시술을 받은 환자들 가운데 이전의 체외수정시술 주기에서 5개 이하의 난자가 채취되고 기저 FSH 농도가 12 mIU/ml 이상인 총 144명 가운데 73명은 GnRH agonist flare up요법을 사용하였고 71명은 GnRH antagonist 요법을 사용하였다. 양군간에 주기의 취소율, 채취된 난자수, 양질의 수정란의 수, 착상율, 임신율, 출산율을 비교하였다. 결 과: 각 군간에 나이는 평균 37.4세와 38.1세로 antagonist group에서 높았으나 통계학적 유의성은 없었다. 그 외에 기저 FSH 농도와 이전 주기의 취소율도 통계학적 유의성은 없었다. GnRH agonist flare up 주기와 GnRH antagonist 주기에서 취소율은 각각 30.1%, 53.5%로 GnRH antagonist protocol에서 유의 있게 높게 나타났다. 채취된 난자수도 각각 4.18개와 2.16개로 차이를 보였으며 난소 과자극 기간은 각각 10.5일과 9.2일로 antagonist protocol에서 약간 낮은 모습을 보였다. 최고 혈중 E$_2$의 농도와 good embryo 개수도 GnRH agonist flare up요법에서 유의 있게 높게 나타났다. 각 군에서의 착상율, 이식 주기당 임신율, 이식 주기당 출생율은 GnRH agonist flare up요법에서 약간 높은 경향을 보이기는 하였으나 통계학적인 유의성은 없었다. 결 론: 두 군간의 비교에서 GnRH agonist flare up 요법이 시작 주기당 임신율, 출산율에서 높은 경향을 보였으나 통계학적 의의는 없었다. 하지만 난소기능이 저하된 환자에서 난자의 채취 개수는 GnRH agonist flare up 요법이 GnRH antagonist를 사용한 주기보다 의의있게 높게 나타났다. 이러한 연구 결과로 볼 때 저 반응군에 있어서 GnRH antagonist flare up요법이 저 반응군에 있어 향상된 난소 반응을 기대할 가능성이 높을 것으로 생각된다.

• Clinical and Experimental Reproductive Medicine
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• 제16권2호
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• pp.205-210
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• 1989

To investigate the effects of ovarian cysts on the controlled ovarian hyper-stimulation cycles, 16 patients with 16 paired cycles for IVF-ET were analyzed. These patients had taken both type of cycles, i.e., with cyst(cyst group) and without cyst(control group). Mean diameter of ovarian cysts in cyst group was 18.2mm. There were no significant differences in hormone levels in early follicular phase between two groups. No significant differences were found in total dosage of hMG(IU) administered during the ovarian stimulation $843.8{\pm}123.0$ vs $891.0{\pm}129.8$, serum estradiol level (pg/ml) on the day of hCG administration($1542.8{\pm}1100.6$ vs $1567.5{\pm}1193.0$), the number of aspirated follicles $10.0{\pm}3.4$ vs $11.2{\pm}4.3$ and oocytes $5.3{\pm}3.3$ vs $6.2{\pm}3.1$, the fertilization rate(51.2 % vs 57.2 %) and the cleavage rate(40.5 % vs 52.0 %). Serum estradiol terminal patterns during COH in one group tended to be repeated in the other group. In conclusion, this study suggests that small ovarian cysts do not adversely impact on the controlled ovarian hyperstimulation parameters in IVF - ET program and the presence of small ovarian cyst without concomitant high basal serum estradiol level is not an indication of the cancellation of the controlled ovarian hyperstimulation for IVF-ET.

• 한국중재학회지:중재연구
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• 제13권2호
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• pp.459-488
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• 2004

General interest in the out-of-court dispute resolution system are mounting in Korea, and the spread of ADR(alternative dispute resolution) is the worldwide trend. In addition, it was confirmed that the resolution of disputes by ADR such as the decision based on arbitration made by the Prime Ministerial Administrative Decision Committee is no longer in exclusive possession of the civil case. The activation of ADR could lead to the smooth agreement between parties by getting away from the once-for-all mode of decision such as the dismissal of the application or the cancellation of disposal and the like in relation to administrative cases for the years. In consequence, it is anticipated that the administrative litigation that applicants have filed by not responding to the administrative decision would greatly reduce in the future. But, it would be urgent to provide for the legal ground of the ADR system through the revision of related laws to take root in our society because ADR has no legal binding power relating to the administrative case due to the absence of its legal grounds. The fundamental reason for having hesitated to introduce ADR in relation to the administrative case for the years is the protective interest of the third party as well as the public interest that would follow in case the agreement on the dispute resolution between parties brings the dispute to a termination in the domain of the public law. The disputes related to the contract based on the public law and the like that take on a judicial character as the administrative act have been settled within the province of ADR by applying the current laws such as the Civil Arbitration Law, Mediation Law, but their application to the administrative act of the administrative agency that takes on a character of the public law has been hesitated. But as discussed earlier, there are laws and regulations that has the obscure distinction between public and private laws. But there is no significant advantage in relation to the distinction between public and private laws. To supplement and cure these defects it is necessary to include the institutional arrangement for protection of the rights and benefits of the third party, for example the provision of the imposition of the binding power on the result of ADR between parties, in enacting its related law. It can be said that the right reorganization of the out-of-court dispute resolution system in relation to the administrative case corresponds with the ideology of public administration for cooperaton in the Administrative Law. It is high time to discuss within what realm the out-of-court dispute resolution system, alternative dispute resolution system, can be accepted and what binding power is imposed on its result, not whether it is entirely introduced into the administrative case. It is thought that the current Civil Mediation Law or Arbitration Law provides the possibility of applying arbitration or mediation only to the civil case, thereby opening the possibility of arbitration in the field of the intellectual property right law. For instance, the act of the state is not required in establishing the rights related to the secret of business or copyrights. Nevertheless, the disputes arising from or in connection with the intellectual property rights law is seen as the administrative case, and they are excluded from the object of arbitration or mediation, which is thought to be improper. This is not an argument for unconditionally importing ADR into the resolution of administrative cases. Most of the Korean people are aware that the administrative litigation system is of paramount importance as the legal relief for administrative cases. Seeing that there is an independent administrative decision system based on the Administrative Decision Law other than administrative litigation in relation to administrative cases, the first and foremost task is the necessity for the shift in thinking of people, followed by consideration of the plan for relief of the rights through the improvement of the administrative decision system. Then, it is necessary to formulate the plan for the formal introduction and activation of ADR. In this process, energetic efforts should be devoted to introducing diverse forms of ADR procedures such as settlement conference, case evaluation, mini-trial, summary jury trial, early neutral evaluation adopted in the US as the method of dispute resolution other than compromise, conciliation, arbitration and mediation