• Title/Summary/Keyword: Gynecology department

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The Evaluation of the Primary Infertility (원발성(原發性) 불임증(不妊症)의 분석평가(分析評價))

  • Ju, Gap-Soon
    • Clinical and Experimental Reproductive Medicine
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    • v.4 no.2
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    • pp.35-43
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    • 1977
  • A total of 636 patients of primary infertility were analyzed by computer on the basis of statistical evaluation of etiological factors and therapy with the outcome of the pregnancy. In this report, it included the results of the study analyzed the single etioligic factors responsible for the primary infertility with the outcome of the pregnancy. 1. Two hundred and fourty one patients out of a total 636(37.9%) achieved pregnancy. 2. Four hundred and fifty nine patients out of a total 636(72%) had a single etuiologic factor responsible for the primary infertility. 3. One hundred and seventy six patients out of 459 parients (38.3%) who had a single etiologic factor responsible for the primary infertility achieved a pregnancy. 4. The endometriosis was the most frequent responsible factor for the primary infertility. 5. The success rate of the pregnancy was different in each etioligic factor responsible for the primary infertility. The highest success rate of the pregnancy was in the patients who had the intermediate factor responsible for the primary infertility as much as 66.7% of the patients. 6. The expectancy of the pregnancy in terms of the duration of the therapy and the follow-up was variable and depended upon the etiologic factor of the primary infertility.

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The effect of insemination methods on in vitro maturation outcomes

  • Pongsuthirak, Pallop
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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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.

Unexpected Estrogenicity of Endocrine Disruptors may Evoke a Failure of Pregnancy Derived from Uterine Function: Overview of Their Possible Mechanism(s) through Steroid Receptors

  • Dang, V.H.;Nguyen, T.H.;Choi, K.C.;Jeung, E.B.
    • Journal of Embryo Transfer
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    • v.22 no.4
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    • pp.199-208
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    • 2007
  • Although many studies have focused on the biological and toxicological effects of phenol products, in particular, in reproductive tracts, the data about their effects in this estrogenic responsive tissue are much less clear. In addition, the in vitro and in vivo data concerning ED-adverse impacts in other endocrine organs, i.e. pituitary gland, are not understood well either. Thus, a further study is needed for providing a new insight into possible impacts of estrogenic EDs including phenol products in humans and wildlife. A combination of in vitro and in vivo system for examining EDs may bring better understanding into the regulatory mechanisms underlying EDs-induced events. In addition, this information may support for developing optimal screening methods of estrogenic EDs, in particular, phenol products.

Nursing experience of delivery care for married immigrant women in Korea: An application of focus group interview (산부인과 간호사의 결혼이주민 산모 간호경험)

  • Lee, Byoung-Sook;Kim, Min-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.3999-4010
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    • 2015
  • This study aimed to describe and understand the clinical nurses' experience of nursing care for delivery of married immigrant women and then provide useful information for making strategies to improve nursing service for the married immigrant women in delivery. Data were collected with three focus group interviews and a few followed individual interviews and analyzed with qualitative content analysis. As a result, the 35 subcategories and 14 categories were extracted and named according to the five main interview questions. Based on the findings, the programs for nurses providing nursing care for married immigrant women in delivery to improve their language and cultural competencies are recommended.

Successful delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a twin pregnancy

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.135-139
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    • 2018
  • There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

Update on polycystic ovary syndrome

  • Kim, Jin Ju
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.194-197
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    • 2021
  • Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

The impact of COVID-19 on human reproduction and directions for fertility treatment during the pandemic

  • Lee, Dayong
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.4
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    • pp.273-282
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    • 2021
  • Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, resulting in a pandemic. The virus enters host cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2). These enzymes are widely expressed in reproductive organs; hence, coronavirus disease 2019 (COVID-19) could also impact human reproduction. Current evidence suggests that sperm cells may provide an inadequate environment for the virus to penetrate and spread. Oocytes within antral follicles are surrounded by cumulus cells, which rarely express ACE2 and TMPRSS2. Thus, the possibility of transmission of the virus through sexual intercourse and assisted reproductive techniques seems unlikely. Early human embryos express coronavirus entry receptors and proteases, implying that human embryos are potentially vulnerable to SARS-CoV-2 in the early stages of development. Data on the expression of ACE2 and TMPRSS2 in the human endometrium are sparse. Moreover, it remains unclear whether SARS-CoV-2 directly affects the embryo and its implantation. A study of the effect of SARS-CoV-2 on pregnancy showed an increase in preterm delivery. Thus, vertical transmission of the virus from mother to fetus in the third trimester is possible, and further data on human reproduction are required to establish this possibility. Based on analyses of existing data, major organizations in this field have published guidelines on the treatment of infertility. Regarding these guidelines, despite the COVID-19 pandemic, reproductive treatment is crucial for the well-being of society and must be continued under suitable regulations and good standard laboratory practice protocols.

A Study of the Taesangugeupbang (Emergency Prescriptions for Childbirth) in the Context of Related Historical Medical Texts (태산구급방 정본화 연구)

  • Park, Hun-Pyeong
    • The Journal of Korean Medical History
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    • v.32 no.1
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    • pp.1-10
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    • 2019
  • The Taesangugeupbang (Emergency Prescriptions for Childbirth) is a medical text written by Li-Chengong of China in the early 14th century. It incorporates forms of obstetrics and gynecology in use in the Chosun Dynasty and is quoted in the Hyangyakjibsungbang (Compendium of Prescription from the Countryside), the Euibangyoochui (Classified Collection of Medical Prescriptions), and the Taesanjibyo (Collection of Essentials for Childbirth). The recent rediscovery of Taesangugeupbang manuscripts in Japan has enabled full-scale research of this text. This article is based on a study of these manuscripts and attempts to synthesize the text through the various documents. The article suggests that: (1) critical texts for understanding the Taesangugeupbang include the Uijeoggo (A Review of Medical Books), the Euibangyoochui, and the Taesanjibyo; (2) there is a possibility that the Taesangugeupbang had disappeared from use in Joseon by the late 15th century; (3) the Taesangugeupbang complemented the treatment regimen of other texts and influenced the development of early Chosun ophthalmology; (4) The Taesangugeupbang is quoted in many Joseon's medical texts and is related to the author's mentor.

The Systematic Review on Clinical Studies of Traditional Korean Medicine Treatment for Obesity in Menopausal Women (폐경 여성의 비만에 응용되는 한방치료에 대한 문헌 고찰)

  • Nam, Eun Young
    • Journal of Korean Medicine for Obesity Research
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    • v.19 no.1
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    • pp.56-67
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    • 2019
  • Objectives: The purpose of this study is to review clinical studies of herb medicine and acupuncture treatment on obesity in menopausal women. Methods: Key words "Obesity", "Menopause", "Herb medicine", "Acupuncture", "Moxibustion", "Catgut embedding" were searched on 9 database systems (PubMed Central, Cochrane Controlled Register of Trials, Embase, China Academic Journals, Korean Traditional Knowledge Portal, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, National Digital Science Library, DBpia) on April 30th 2019. Results: 1 case report and 17 clinical trials were collected in accordance with the selection and exclusion criteria. Among the 17 trials, 6 were randomized controlled trials, 1 was controlled clinical trial, and 10 were single-arm trials. The types of intervention were herb medicine, electroacupuncture, acupuncture, auricular acupuncture, warm needle acupuncture, moxibustion, laser acupuncture, and catgut embedding. The study design, study results and method of intervention were analyzed. Conclusions: 1 case report described the effectiveness of pharmacopuncture, 4 trials described the effectiveness of herbal medicine, 2 of electroacupuncture, 1 of laser acupuncture, and 2 of catgut embedding. Among the 17 trials, 2 studies showed that herbal medicine treatment was more effective than no treatment or selective serotonin reuptake inhibitors, and 1 study showed that electroacupuncture was more effective than hormone therapy. All of 18 selected studies reported the effectiveness of weight reduction and abdominal obesity reduction after the traditional Korean medicine treatment for obesity in menopausal women.

Predictive capability of fasting-state glucose and insulin measurements for abnormal glucose tolerance in women with polycystic ovary syndrome

  • Chun, Sungwook
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.156-162
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    • 2021
  • Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the "less accurate" category for prediction. Conclusion: Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.