• 대한한방부인과학회지
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• 제30권2호
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• pp.144-152
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• 2017

Objectives: The aim of this case is to report the effects of oriental medicine on one patient with primary amenorrhea for endometrial preparation and implantation. Methods: A patient with primary amenorrhea had symptoms of sleep disorder, diarrhea, colpoxerosis. For preparing endometrium and implantation in oocyte donation after one previous failure, she was treated by twice a day herb medication for 75 days. And we observed the effects of treatments by improvement of symptoms and following up endometrial proliferation ultrasonography. After implantation, for maintaining pregnancy and live birth, she was also treated by twice a day herb medication for 45 days. Results: After treatments, Symptoms of sleep disorder, diarrhea, colpoxerosis were improved and the thickness of endometrium was prepared for implantation in oocyte donation. So she was pregnant and gave birth to a healthy baby 36 weeks later. Conclusions: This case shows that oriental medicine has its effective implementation for the implantational surroundings on patients with primary amenorrhea in oocyte donation programs.

• Clinical and Experimental Reproductive Medicine
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• 제24권2호
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• pp.167-177
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• 1997

Oocyte donation program developed to reach the pregnancy in those patients suffering from premature ovarian failure or surgery induced menopause, particularly in their reproductive age. With technical advances and popularity of ART (assisted reproductive technology), the indication of oocyte donation program extended to low responders, and even to naturally menopaused patients that has led them quite successfully to getting in pregnancy. The purpose of this study was to evaluate which one is involved in the decline of fertility between the oocyte and uterine factor. One hundred five cycles of oocyte donation program were performed in 84 patients from Jan., 1993 to Dec., 1996. Oocytes were donated from healthy, young, fertile anonymous donors or relatives or infertile patients with supernumerary oocytes. The study population was divided into 3 groups according to the age of recipients. Group 1 was less than 35 years old, Group 2 was between 35 to 39 years old, and Group 3 was more than 39 years old. The results were as follows: The mean age of oocyte donor was $31.5{\pm}3.3$ (range; 25-36). The mean concentration of basal serum FSH and peak serum estradiol were not different among groups. The mean number of oocytes retrieved from donors, embryos transferred to recipients, and fertilization rate were not different among groups. The clinical pregnancy rate was 37.3% in Group 1, 31.6% in Group 2, and 31.6% in Group 3, respectively. The spontaneous abortion rate was 16.0% in Group 1, 16.7% in Group 2, and 16.7 in Group 3, respectively. The multiple pregnancy rate was 20.0% in Group 1, 16.7% in Group 2, 16,7% in Group 3, respectively, The implantation rate was 11.3% in Group 1, 10.3% in Group 2 and 10.0% in Group 3, respectively. All of the pregnancy outcomes were not different statistically among groups. In conclusion, endometrial receptivity does not seem to be impaired as age increases with transfer of good quality embryos and adequate endometrial preparation.

• Clinical and Experimental Reproductive Medicine
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• 제47권2호
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• pp.130-134
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• 2020

Objective: The aim of this study was to compare the effects of conventional insemination (in vitro fertilization [IVF]) and intracytoplasmic sperm injection (ICSI) on the fertilization, developmental competence, implantation potential, and clinical pregnancy rate of embryos derived from in vitro matured oocytes of patients with polycystic ovary syndrome (PCOS). Methods: A prospective study was carried out among 38 PCOS patients who had undergone In vitro maturation (IVM) treatment. In total, 828 immature oocytes were collected from 42 cycles and randomly assigned for insemination by IVF (416 oocytes) or ICSI (412 oocytes). After fertilization, the embryos were cultured until the blastocyst stage and single embryos were transferred after endometrial preparation and under ultrasound guidance. Results: No significant differences were found in the maturation rate (78.1% vs. 72.6% for IVF and ICSI insemination, respectively; p= 0.076), fertilization rate (59.4% vs. 66.9% for IVF and ICSI insemination, respectively; p= 0.063), or the formation of good-quality blastocysts (40.9% vs. 46.5% for IVF and ICSI insemination, respectively; p= 0.314). Implantation and clinical pregnancy also did not show significant differences. Conclusion: There was a comparable yield of in vitro matured oocytes derived from PCOS patients in terms of fertilization, blastocyst formation, implantation rate, and clinical pregnancy between IVF and ICSI insemination. These findings provide valuable insights for choosing assisted reproductive treatment in women with PCOS, as IVM offers promising outcomes and is less invasive and less costly.

• Clinical and Experimental Reproductive Medicine
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• 제8권2호
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• pp.1-11
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• 1981

The quantitative analyses of the phosphatase activity in the endometrium of the rat ovariectomized on Day 2 of pregnancy was carried out in comparison with the intact one, in order to investigate the hormonal dependency of the uterus prior to the implantation, and to study the phosphatase activity in the endometrial tissues in vitro incubated in different acidity of the medium. The results obtained were as follows: 1. The activity of the total phosphatase was the highest at Day 3 of pregnancy of the intact animals irrespective of acidity of the medium. However, the ovariectomized rat showed its peak somewhat delayed. The time of the highest activity of the enzymes was matched with the time of high secretion of the ovarian hormones. 2. The activity of acid phosphatase in the endometrium was twice or four times as much high as that of neutral or alkaline phosphatase, respectively. 3. The activity of alkaline phosphatase was rather steady in Day 3 through Day 5 of the pregnancy of the rat intact or ovariectomized but with low level compared to those of other phosphatase. 4. The present re~lt indicated more important role by $Mg^{2+}$-dependent phosphatase than by $K^+$-dependent one for the preparation for decidualization.

• Clinical and Experimental Reproductive Medicine
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• 제30권3호
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• pp.193-202
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• 2003

Objective: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. Methods: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness $\geq$7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. Results: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. Conclusions: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.

• Clinical and Experimental Reproductive Medicine
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• 제11권2호
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• pp.41-49
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• 1984

임신직후 자궁조직은 난소 스테로이드 호르몬에 의하여 분화한다. 착상전 여러 단계에 있는 자궁조직내의 cAMP의 함량을 측정함으로서 cAMP와 호르몬과의 관계를 규명할 목적으로 흰쥐를 재료로 해서 본 실험을 행하였다. 임신제 2일에 난소를 제거하고 즉시, 제3, 또는 제 4일에 estradiol과 progesterone 을 각각 혹은 동시에 주사한 뒤 대조군인 정상임신군, 난소제거군, 난소제거후 호르몬주사군의 자궁조직에서 cAMP농도를 competitive protein-binding assay로 측정하여 이를 각각 비교하였다. 본 연구결과는 다음과 같았다. 정상임신군인 경우 자궁조직이 분화해 갈수록 자궁조직내 cAMP의 농도는 낮아지고 있다. 난소제거군에서는 임신기간이 길수록 자궁조직내의 cAMP농도가 높아진다. 난소제거후 progesterone 혹은 progesterone 과 estradiol을 주사한 실험군에서는 임신 제 6일이 되면 cAMP 농도가 정상임신군과 난소제거군의 중간수치를 보여준다. 한편, estradiol 단독주사인 경우는 임신제3, 제6일의 자궁조직내의 cAMP의 농도는 크게 감소한다. 이처럼 estradiol의 영향아래 세포분열등 분화가 왕성한 자궁조직에서는 cAMP 농도가 크게 낮아지지만 자궁조직의 분화가 억제된 상태에서는 cAMP의 농도가 반대로 높아진다. 난자, 배아 또는 여러 형태의 세포에서처럼 cAMP의 농도는 세포의 대사에 크게 영향을 주고 있다는 것을 알 수 있었다.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.95-103
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• 2003

Objective : To assess and compare the clinical outcomes between GnRH agonist long protocol and GnRH antagonist short protocol in oocyte donation program. Materials and Methods: Of total 18 oocyte donation cycles, controlled ovarian hyperstimulation (COH) were performed with GnRH agonist long protocol and GnRH antagonist short protocol in initial 9 cycles and later 9 cycles, respectively. Oral estradiol valerate and progesterone in oil we re administrated to all recipients for endometrial preparation. Oral estradiol administration was started from donor cycle day 1 after full shut down of gonadal axis with GnRH agonist in patients with ovarian function. Progesterone was injected from oocyte retrieval day of donor initially, then continuously till pregnancy 12 weeks if pregnancy was ongoing. We compared the parameters of clinical outcomes, such as number of the retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate, COH duration, total gonadotropin dose for COH between GnRH agonist long protocol group and GnRH antagonist group. Statistical analysis was performed using Mann-Whitney test, p<0.05 was considered as statistically significant. Results: The number of retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate were $14.89{\pm}7.83$, 81%, 64%, 78%, 31%, 78%, respectively in GnRHa long protocol group and $11.22{\pm}8.50$, 79%, 64%, 67%, 34%, 56%, respectively in GnRH antagonist group. There was no significant differences in parameters of clinical outcomes between 2 groups (all p value >0.05). Duration and total gonadotropin dose for COH were $10.94{\pm}1.70$ days and $43.78{\pm}6.8$ vials in 18 cycles, $12.00{\pm}1.73$ days and $48.00{\pm}6.93$ vials in agonist group, $9.88{\pm}0.78$ days and $39.55{\pm}3.13$ vials in antagonist group, respectively. In GnRH agonist long protocol group, significantly longer duration and higher gonadotropin dose for COH were needed (p=0.012). Conclusion: In oocyte donation program, clinical outcomes from controlled ovarian hyperstimulation with GnRH antagonist were comparable to those from GnRH agonist long protocol group, so controlled ovarian hyperstimulation with GnRH antagonist may be effective as GnRH agonist long protocol. At least there may not be harmful effects of GnRH antagonist on oocyte development and quality.

• 한국발생생물학회지:발생과생식
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• 제11권1호
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• pp.1-11
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• 2007

착상기 이전 자궁에서 특이적 자궁내막 준비가 진행되어야 하는데, 이는 자궁 내막의 점진적 분화로 배아의 착상과 성공적 임신에 절대적으로 필요하다. 배아 발생 동안에 관찰되는 조직의 재구성은 세포외 기질을 포함한 다양한 요인에 의해 조절된다. 임신 동안에 관찰되는 극적인 변화로는 배아의 이동, 탈락막 반응, 태반의 분화를 그 예로 들 수 있다. 배아와 자궁간의 성공적 착상을 위한 변화들은 배아와 자궁의 착상을 위한 능력 갖출 수 있도록 한다. 이러한 변화과정 중에, 콜라겐이 주성분인 세포외 기질의 극적인 변화가 진행된다. 이러한 변화는 매우 복잡하여 그 기작을 밝히는 것은 쉽지 않으나, 최근 들어 PCR-select cDNA subtraction 방법, microarry 방법 등 대단위 유전자 동정 방법들을 이용하여 많은 후보 유전자가 동정되었다. 스테로이드 호르몬은 임신과 임신 유지에 중요한 역할을 수행하며, 세포외 기질의 재구성을 엄격하게 성스테로이드 호르몬에 의한 유전자 네트워크를 통하여 조절한다. 자궁의 세포외 기질의 병리적 조절이 당뇨병 등에서 보고되고 있다. 세포외 기질의 재구성은 착상과 태아와 자궁의 발달을 이해하는 데 중요하고, 또한 생식과 관련된 질병을 극복하는 데 중요하다. 비록 세포외 기질의 구성성분이 매우 다양하고 복잡하여 논의할 것이 무척 많으나, 본 종설에서는 착상기를 전후한 시기에 콜라겐의 변화를 중심으로 논하였다.

• 한국수정란이식학회지
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• 제26권3호
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• pp.209-214
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• 2011

임신의 성립 및 유지에 중요한 자궁 내막과 호르몬의 변화는 생식기관에서 발현되는 K$_{2P}$ 통로의 발현을 변화시킬 수 있다. 본 연구는 한우의 임신 자궁 내막에서 K$_{2P}$ 통로의 발현 변화가 나타나는지 그리고 프로게스테론에 의해 그 발현량이 변화되는지를 확인하고자 수행하였다. 역전사중합효소 중합반응과 웨스턴블닷 분석을 통하여 임신한 한우의 자궁 내막에서 mRNA와 단백질의 발현 변화를 조사하였다. TREK-1을 제외한 K$_{2P}$ 통로의 mRNA 발현량이 임신 자궁 내막에서 변화되었다. mRNA가 크게 변화되는 TASK-3, TREK-2, TRAAK 및 TRESK의 단백발현 변화량을 임신 자궁 내막에서 확인하였는데, TREK-2와 TRESK만 mRNA 발현 변화 양상과 동일하게 임신 자궁 내막에서 각각 7.9배, 2배 증가하였다. 자궁 내막세포에 프로게스테론(10 ${\mu}g$/mL)을 처리하였을 때 TREK-2와 TRESK는 자궁 내막 조직에서 보여준 결과와 유사하게 단백 발현량이 각각 10배, 6배 증가하였다. 이상의 결과로부터 K$_{2P}$ 통로, 특히 TREK-2와 TRESK는 프로게스테론 변화에 의해 임신 자궁 내막에서 발현량이 증가할 것으로 생각된다. 그리고 증가된 TREK-2와 TRESK는 임신에 의해 유발되는 생리학적 변화를 조절하는데 기여할 것으로 생각된다.