• 제목/요약/키워드: Hydrosalpinx

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난관수종액이 정자의 운동성에 미치는 영향에 관한 연구 (Study on the Effect of Hydrosalpinx Fluid on Sperm Motility)

  • 김태철;이상훈;김동호;배도환;허민
    • Clinical and Experimental Reproductive Medicine
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    • 제26권1호
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    • pp.21-29
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    • 1999
  • This study was performed to identify the effect of the hydrosalpinx fluid on sperm motility. It has been reported that the patients with hydrosalpinx show the outstandingly lower success rate than other patients having infertility by different factors. It is unclear that the cause of it is influenced by hydrosalpinx fluid directly or by secondary chronic inflammation of endometrium. We wanted to know if the hydrosalpinx fluid influences sperm motility parameters directly such that it is related to the development of infertility. Therefore, using computer assisted semen analyzer (CASA), we observed, from February to July, 1997, how sperm motility, sperm progressive motility, sperm curvilinear velocity, sperm lateral head displacement, sperm straightness and sperm linearity change after treating normal sperm with hydrosalpinx fluid to evaluate sperm function on infertility. The result was that the study group (n=32) has the tendency to differ from the control group (n=32) on sperm motility, progressive motility, curvilinear velocity, lateral head displacement, straightness and linearity. We concluded that the hydrosalpinx fluid, with varying degree, directly has the harmful effects on sperm motility parameters, that is, curvilinear velocity, lateral head displacement and linearity of sperm which are related to the hyperactivation, hence decreased capacitation.

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Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

  • Na, Eun Duc;Cha, Dong Hyun;Cho, Jung Hyun;Kim, Mi Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • 제39권4호
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    • pp.182-186
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    • 2012
  • Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

Endometrial fluid associated with Essure implants placed before in vitro fertilization: Considerations for patient counseling and surgical management

  • Sills, E Scott;Walsh, David J;Jones, Christopher A;Wood, Samuel H
    • Clinical and Experimental Reproductive Medicine
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    • 제42권3호
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    • pp.126-129
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    • 2015
  • Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

여성 불임환자 30례의 임상결과보고 (Case Reports of 30 Female Infertility)

  • 김미선
    • 대한한방부인과학회지
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    • 제30권3호
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    • pp.128-135
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    • 2017
  • Objectives: This study is to report the effects of acupuncture, moxibustion and herbal medicine on infertility. Methods: From February 2015 to December 2016, 44 women with infertility were treated with acupuncture, moxibustion and herbal medicine. 6 months later, follow up and analysis were performed. Results: Of the total 44 women, 19 were successful in pregnancy. Of the 30 women who were contacted by follow-up after 6 months, 19 (63.3%) were successful in pregnancy. 6 of the 8 women who had abortion experience and 5 of the 6 women without the symptoms were pregnant. And 2 with dysmenorrhea, women with follicular development failure, hydrosalpinx, ectopic pregnancy, anovulatory infertility patients, polycystic ovary syndrome were all successfully pregnant. Conclusions: This study suggests that acupuncture, moxibustion and herbal medicine are useful and shows possibility to increasing pregnancy rates.

인체의 난관수종액이 생쥐의 배아발달에 미치는 영향: II. 포배기내의 세포 수에 미치는 영향 (Adverse Effect of Human Hydrosalpingeal Fluid on the Development of Mouse Embryo (II))

  • 궁미경;전진현;송상진;송지홍;홍수정;유근재;손일표;김정욱;강인수
    • Clinical and Experimental Reproductive Medicine
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    • 제26권2호
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    • pp.213-217
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    • 1999
  • In our previous study, we observed that hydrosalpingeal fluid (HSF) adversely effect mouswe embryo development and hatching. The aim of this study was to evaluate the effect of HSF as assessed by the blastocyst development rate (BDR) and by cell counting in vitro. HSF was collected from ninie patients undergoing salpingoneostomy to correct hydrosalpinx. Two-cell embryos were obtained from superovulated ICR mice. T6 medium and $T6{\pm}0.4%$ bovine serum albumin were used as control media. T6 medium containing 10% or 50% HSF and 100% HSF from each patient were used as test media. Nine to 15 embryos were cultured in micro drops prepared from each of these media. To assess the total cell number within each blastocyst, the blastocysts were fixed and stained with Hoechst 33342 to facilitate cell counting. The mean BDR in two control media were 88.89% and 85.40%. The mean BDR in media containing 10%, 50%, 100% HSF were 85.87%, 89.58% and $75.57%^*$, respectively ($^*$: p<0.05). The overall mean cell count $({\pm}SEM)$ in control media were $87.6{\pm}9.65\;and\;90.12{\pm}11.38$. The BDR was affected adversely only by 100% HSF and not in media containing 10% or 50% HSF. Mean cell counts were decreased significantly only in blastocysts cultured 100% HSF ($63.8{\pm}13.66$; p<0.01) but not in blastocysts cultured in 10% or 50% HSF ($91.3{\pm}12.44\;and\;82.9{\pm}18.27$, respectively). Thus, it is concluded that HSF has no embyotoxic effect but has a mildly negatively effect on embryonic growth and development.

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골반경수술의 부인과적 응용 (Gynecologic Application of the Pelviscopic Surgery)

  • 고석봉;이재열;이영기;박윤기;이두진;이태형;이승호
    • Journal of Yeungnam Medical Science
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    • 제11권1호
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    • pp.127-134
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    • 1994
  • 1991년 5월 1일부터 1993년 7월 31일까지 영남대학교 의과대학 부속병원 산부인과에서 시행한 136례의 골반경수술에서 다음과 같은 결론을 얻었다. 환자의 나이 분포는 19세에서 55세였고 평균 나이는 31.2세였다. 평균 분만력은 0.96이었으며 거의 대부분의 환자는 2회 이하의 분만력을 보였다. 골반경수술의 가장 많은 적응증은 난관 임신이었고 그 다음으로는 난소낭종이었다. 시술 방법은 주로 난관절제술(58.8%)과 난소난관절제술(16.3%)이었고 입원기간은 평균 2.1일이었고 모든 경우에는 특별한 합병증이 없었다. 이러한 연구결과로 보아 골반경수술은 경제적으로나 사회적으로 또 미용학적으로도 좋은 결과를 보였으며 앞으로 다른 많은 부인과 환자에게 안전하게 적용할 수 있으리라 사료된다.

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복강경하(腹腔鏡下)에서의 Hysterosalpingogram (Combined Hysterosalpingography and Laparoscopy in Infertility)

  • 구병삼
    • Clinical and Experimental Reproductive Medicine
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    • 제7권1_2호
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    • pp.11-20
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    • 1980
  • Hysterosalpingograms (H.S.G.) have been done for several decades to determine causative factors in female infertility. However, the H.S.G. only reverals uterine cavity and tubal patency or inpatency. The author prefers to find more details in regard to the status and condition of the female reproductive organs and their surrounding tissue as they pertain to infertility. H.S.G. in combination with laparoscopic examination reveals the following results. Preparation and method of performance of H.S.G. during laparoscopy in a healthy reproductive age women are as follows. When laparoscopy is not contraindicated, NPO is ordered with routine bowel preparation. Analgesics administered by injection prior to procedure are valium 10mgs and pethidine 50-100mgs. The radiographic procedure is the same as for any HSG technique. During laparoscopy a solution of 3 to 10 ccs. of 60% hypaque sodium is used. Fluroscopic scout films are obtained A-P and oblique views as well as a delayed check film. 1. Age distribution of primary and secondary infertility in this studies involving tubal factors was as follows: 20-29 age group showed 46% incidence and in the 30-39 age group, 50% incidence. Duration of infertility in this study group was the following: 1-2 years showed 26.7%, 3-5 years 53.8%, and 6-9 years 13.3%. 2. Indications of laparoscopic examination were as follows: Secondary infertility in 35% of the cases, obscure tubal occlusion on previous H.S.G. in 25%, unknown origin in 11.7%, and the remaining cases included pelvic pain, small masses, dysmenorrhea, and uterine anomaly. The laparoscopic examination showed clearly the reproductive organs and the surrounding tissues in the pelvic cavity. The abnormal tubal findings there revealed were tuberculous salpingitis and hydrosalpinx in 10% each, endometriosis and peritubabl adhesions in 6.7% each, biconuate uterus in 3.3%. The remaining 58.3% of the cases showed normal findings. Laparoscopic observation for possible myoma nodules, streak ovary, and peritubal adhesions was also done at this time. 3. Comparative tubal findings in combined H.S.G. and laparoscopic examination revealed the following. Bilateral tubal occlusion was present in 14% (7cases) on laparoscopic examination but on H.S.G. 38% (19 cases) were noted. However, tubal occlusion and peritubal adhesions were found in 26% (13 cases) upon laparoscopy and only 8% (4 cases) on H.S.G. examination alone. Normal pelvic findings were present in 60% (27 cases).

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난관수종액이 생쥐 배아발달에 미치는 영향 (Effect of Human Hydrosalpingeal Fluid on the Development of Mouse Embryo)

  • 박준철;김정아;김동자;배진곤;김종인;이정호
    • Clinical and Experimental Reproductive Medicine
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    • 제37권2호
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    • pp.125-134
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    • 2010
  • 목 적: 난관수종액내의 사이토카인 농도를 측정하고, 사이토카인 농도가 다른 난관수종액을 이용하여 생쥐 배아 발생에 미치는 영향을 비교하고자 하였다. 연구방법: 난관수종액은 자궁난관 조영술에서 난관수종이 진단되어 복강경을 통한 난관 절제술을 시행하는 경우 난관 절제술 전에 난관으로부터 채취한 다음 3,000 rpm에서 10분간 원심분리시킨 후 상층액만을 $-20^{\circ}C$에서 보관하였다. 난관수종액의 사이토카인의 조성 및 농도를 확인하기 위하여 interleukin (IL)-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-$\alpha$, interferon (IFN)-$\gamma$, vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), monocyte chemotactic protein (MCP)-1 등을 ELISA 방법으로 측정하였다. 기본 배양액에 난관수종액을 5%, 10%, 30%의 비율로 첨가하여 각 군별로 배반포로의 발달을 관찰하였다. 결 과: 난관수종액내에서 IL-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, IFN-$\gamma$, VEGF, EGF, MCP-1가 검출되었으며, 그 농도에 있어서는 큰 차이를 보였다. 정상 혈청 농도에 비하여 난관수종액-1은 IL-6, IL-10이 증가되어 있었고, 난관 수종액-2는 IFN-$\gamma$, MCP-1 및 VEGF가 증가되어 있었다. 각 난관수종액의 Th1/Th2 비는 HSF-1의 경우 IFN-$\gamma$:IL-10이 3.69로 정상인 데 비하여 HSF-2의 경우 IFN-$\gamma$:IL-10이 61.14로 크게 증가되어 있었다. 난관수종액을 포함하지 않는 배양액에서는 배반포기 발달률은 76.7%이었고, 난관수종액-1군은 74%로 대조군과 차이를 보이지 않았지만, 난관수종액-2군의 경우 27.7%로서 대조군 및 난관수종액-1군과도 유의한 차이를 보였다. 난관수종액-1의 경우 난관수종액 농도에 따른 차이는 없었으며, 난관수종액-2군의 경우 농도에 증가함에 따라 배반포로의 발달이 감소하기는 하였지만 통계적으로 유의하지는 않았다. 결 론: 난관수종액마다 사이토카인의 조성이 다르며 이에 따라 생쥐 배아발달에 미치는 영향이 다를 수 있다. 염증성 사이토카인이 증가된 난관수종액이 배아발달에 악영향을 미칠 것으로 추정된다. 특정 사이토카인에 의한 작용을 규명하기는 위해서는 향후 지속적인 연구가 필요할 것으로 생각된다.