• Clinical and Experimental Reproductive Medicine
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• 제37권2호
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• pp.153-158
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• 2010

목 적: 과배란유도 후 자궁강내 인공수정 시술시 황체기 보강으로서 경구 미분화 프로게스테론 투여법과 경구 디드로게스테론 투여법의 임상적 효용성을 비교하고자 하였다. 연구방법: 2007년 1월부터 2009년 8월까지 시행된 과배란유도 후 자궁강내 인공수정 시술 183주기를 후향적으로 분석하였다. 과배란유도는 성선자극호르몬 단독 또는 클로미펜과 성선자극호르몬의 병합요법을 사용하였다. 136주기에서는 황체기 보강으로서 경구 미분화 프로게스테론을 하루 300 mg으로 투여하였고 47주기에서는 디드로게스테론을 일일 20 mg으로 투여하였다. 결 과: 여성의 연령, 불임 인자, 성숙난포수 ($\geq$16 mm), 총운동성정자수, triggering 날의 자궁내막 두께는 두 군간 유의한 차이가 없었다. 자궁내 태낭이 확인되는 임상적 임신율은 미분화 프로게스테론 투여군에서 21.3%, 디드로게 스테론 투여군에서 19.1%로 차이가 없었다 (p=0.92). 유산율은 미분화 프로게스테론 투여군에서 다소 높은 경향을 보였으나 통계학적인 차이는 없었다 (34.5% vs. 11.1%, p=0.36). 결 론: 황체기 보강으로서 경구 디드로게스테론 투여법은 경구 미분화 프로게스테론 투여에 비하여 비슷한 임신율과 유산율을 보였다. 그러나 상대적으로 디드로게스테론 투여군의 수가 적어 좀더 많은 환자를 대상으로 한 전향적 연구가 필요하다.

• Clinical and Experimental Reproductive Medicine
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• 제28권1호
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• pp.47-53
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• 2001

Objective: This study is to investigate the clinical efficacy of low-dose FSH regimen, comparing with clomiphene citrate and human menopausal gonadotropin (CC/hMG) regimen. Methods: Retrospective study of the ovulatory factor infertility 39 patients who had been treated by intrauterine insemination (IUI). The 31 cycles of 21 patients were stimulated by CC/hMG regimen, the 22 cycles of 18 patients were stimulated by low-dose FSH regimen. We compared the rate of clinical pregnancy, multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) of both group. Results: The rate of clinical pregnancy of the CC/hMG group was 25.7% per cycle, and that of the low-dose FSH group was 54.5% per cycle. The low-dose FSH group showed a higher rate of clinical pregnancy per cycle than CC/hMG group (p=0.028). However, no differences was found statistically in the rate of multiple pregnancy and OHSS between CC/hMG group (22.2%, 5.7%) and low-dose FSH group (33.3%, 13.6%). Conclusion: This study showed that the low-dose FSH regimen is superior to CC/hMG regimen in getting clinical pregnancy, but dose not reduce the ovulation induction complications.

• Journal of Korean Biological Nursing Science
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• 제17권2호
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• pp.211-217
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• 2015

Purpose: The purpose of this study is to identify factors influencing the pregnancy rate among unexplained infertile couples who received treatments of assisted reproductive technology (ART) and intra-uterine inseminations (IUI). Methods: The medical records of 24,201 cases of unexplained infertility among a total of 31,684 intrauterine insemination treatment cases, (which benefited by 'National Medical-aid Program for ART in 2011') were used for this analysis. Results: Woman's age (OR=0.94), frequency of IUI (OR=0.86), and treatment type (OR=1.54) were significant factors on pregnancy rates in the logistic regression analysis. Conclusion: Factors, such as the age of the infertile woman, frequency of IUI, and treatment type used to induce ovulation were shown to positively influence pregnancy rate. However, the age of the spouse was not a significant variable. Infertile couples having unprotected sexual intercourse with unexplained infertility had priority. The results demonstrated that about 70% of infertile Korean couples had unexplained infertility. This was a higher rate of unexplained infertility than that of the clinical standard. Therefore, we should assess for causes through future studies. In addition, affective or emotional factors influencing unexplained infertility need to be researched further.

• Clinical and Experimental Reproductive Medicine
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• 제38권3호
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• pp.164-167
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• 2011

Objective: There are limited data regarding the significance of elevated serum CA-125 level during IUI cycles, even though it is used widely during the initial evaluation of infertile patients. The aim of this study was to investigate the prognostic value of serum CA-125 levels during IUI cycles. Methods: Among the patients with controlled ovarian stimulation and IUI cycles at Seoul National University Hospital from Jan 2005 through Dec 2009, 92 cases with no identified endometriotic lesion, ovarian tumor, salpingeal lesion, or uterine myoma were selected. To compare the clinical characteristics between the pregnancy group and the non-pregnancy group, the Mann-Whitney U test and Fisher's exact test were used. Results: The overall pregnancy rate was 18.5% (17/92). The pregnancy group showed a higher number of follicles 16 mm in diameter ($p$=0.036), endometrial thickness ($p$ <0.001), ampules of gonadotropin ($p$=0.009), and higher body mass index ($p$=0.022) than the non-pregnancy group. No significant difference was observed in the serum CA-125 level or the proportion of patients with CA-125 exceeding 17 IU/mL between the two groups. Conclusion: The prognostic value of serum CA-125 level among infertile patients with IUI cycles is considered limited.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.389-398
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• 1999

Objective: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). Method: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days starting on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG $5,000{\sim}10,000$ IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. Results: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol ($E_2$) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. Conclusion: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.

• Clinical and Experimental Reproductive Medicine
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• 제37권2호
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• pp.169-172
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• 2010

역 사정은 남성불임 원인의 하나인데, 이를 해결 하기 위해서는 사정 후 방광으로부터 정자를 회수하여 보조생식술을 시행함으로써 불임을 극복할 수 있다. 배우자의 뇨로부터 정자를 회수한 후 인공수정을 시도하여 많은 임신이 보고되고 있는데, 본원에서는 Clomiphene Citrate와 hMG를 사용하여 배란을 유도하고, 뇨와 함께 채취된 정액을 10% serum substitute supplement가 첨가된 modified Ham's F-10을 이용하여 뇨의 산성도와 삼투압 조절 후, 정자의 운동성을 유지하여 인공수정을 실시하였는데 성공적인 임신을 경험하여 문헌고찰과 함께 간략히 보고하는 바이다.

• Clinical and Experimental Reproductive Medicine
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• 제37권2호
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• pp.135-142
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• 2010

목 적: 과배란유도하 자궁강내 인공수정시술을 받는 불임 환자들을 대상으로 연성자극요법의 효과를 성선자극호르몬분비호르몬 길항제 다회투여법과 비교, 평가하고자 본 연구가 시행되었다. 연구방법: 불임 환자 80명을 연성자극요법군 (n=40)과 성선자극호르몬분비호르몬 길항제 다회투여법군 (n=40)으로 무작위로 1:1로 배정하였다. 두 군 모두에서 질식초음파상 평균 직경이 18 mm에 도달한 난포가 1개, 또는 17 mm에 도달한 난포가 2개 이상 관찰될 때, 재조합 사람융모성성선자극호르몬 250 ${\mu}g$을 1회 투여했으며, 이 후 36~40시간째에 자궁강내 인공수정이 시행되었다. 결 과: 과배란유도를 위해 사용된 재조합 사람난포자극호르몬의 총용량과 투여일수는 연성자극요법군에서 유의하게 적었다 (p<0.001, p<0.001). 두 군 모두에서 조기 황체화호르몬 급상승은 관찰되지 않았다. 시술 주기당 임상적 임신율, 자연유산율, 다태임신율, 중증 난소과자극증후군의 발생빈도는 두 군간에 차이를 보이지 않았다. 결 론: 연성자극요법은 성선자극호르몬분비호르몬 길항제 다회투여법에 비하여 재조합 사람난포자극호르몬을 적은 용량, 짧은 기간 사용하면서도 유사한 임신율을 나타내므로, 과배란유도하 자궁강내 인공수정을 시행 받는 환자를 위한 환자 친화적이고 효과적인 과배란유도법이 될 수 있을 것이다.

• Clinical and Experimental Reproductive Medicine
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• 제34권3호
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• pp.159-166
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• 2007

목 적: 불임 부부에서 자궁강내 정자주입술 시행 후 연속하여 시행한 자궁강내 정자주입술 및 전환하여 시행한 체외수정시술이 정액검사소견에 미치는 영향을 알아보고자 하였다. 연구방법: 진단적 목적으로 컴퓨터정액분석기를 이용한 정액검사 (computer-assisted semen analysis (CASA))를 시행한 후 자궁강내 정자주입술을 시행하였으나 임신에 실패한 53예를 대상으로 하였다. 자궁강내 정자주입술 시행 후 38예의 환자에서는 두 번째 자궁강내 정자주입술을 시행하였고 (Group 1), 15예의 환자에서는 체외수정시술을 시행하였다 (Group 2). 이들에서 두 번째 불임시술을 위해 채취한 정액의 양 (volume), 정자의 농도 (concentration), 운동성 (motility), 총운동성정자수 (total motile sperm count) 등의 컴퓨터정액분석소견을 이전에 자궁강내 정자주입술 시 시행한 정액검사소견과 비교하였다 결 과: 대상 불임 부부간의 남편 연령, 첫 번째 시술과 두 번째 시술 사이의 시간 간격, 불임의 원인 등에는 유의한 차이가 없었다. Group 1에서 첫 번째 시행 시의 정액검사소견의 정상 여부와 관계없이, 정자의 운동성은 첫 번째 자궁강내 정자주입술 시행 시보다 두 번째 자궁강내 정자주입술 시행 시에 통계적으로 유의하게 감소하였다. Group 2에서는 첫 번째 자궁강내 정 자주입술 시보다 체외수정시술 시 정자의 농도, 정자의 운동성, 총운동성정자수에서 통계적으로 유의하게 감소하였다. Group 2의 하위그룹 분석에서는 자궁강내 정자주입술 시행 시 정상 정액소견을 보인 경우는 체외수정시술 시 정자의 농도와 총운동성정자수가 유의하게 감소하였으나, 자궁강내 정 자주입술 시행 시 비정상 정액소견을 보인 경우에는 체외수정시술 시 정자의 운동성이 유의하게 감소하였다. 결 론: 자궁강내 정자주입 술 시행 후 임신에 실패하여 체외수정시술을 시행하게 된 환자의 정액검사소견은 자궁강내 정 자주입술을 계속 시행 받은 환자군에 비해 더 악영향을 받는다. 그 이유를 설명하기 위해 심리적 스트레스에 대한 후속적인 연구가 필요할 것으로 사료된다.

• 대한간호학회지
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• 제50권5호
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• pp.671-685
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• 2020

Purpose: The purpose of this study was to develop a Coping Scale for Infertility-Women (CSI-W). Methods: The initial items were based on an extensive literature review and in-depth interviews with seven infertile women. Forty-three items were derived from a pilot survey. Data were collected from 216 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale. Results: Seven factors containing 28 items (four factors containing 17 items for active coping and three factors containing 11 items for passive coping) were extracted from the exploratory factor analysis to verify the construct validity. The four factors of active coping were confrontation, self-control, seeking social support (spouse), and seeking social support (colleagues and experts). The three factors of passive coping were distancing, escape, and avoidance. These items were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (active coping: Cronbach's α = .78; passive coping: Cronbach's α = .81). Conclusion: As its validity and reliability have been verified through various methods, the CSI-W can contribute to assessing the coping strategies of infertile women.

• 대한한방부인과학회지
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• 제28권2호
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• pp.120-132
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• 2015

Objectives : This study aims to assess whether Korean medical treatment in infertile couple is effective on clinical pregnancy. Methods : Korean medical treatment using herbal medicine, acupuncture and moxibustion was performed to thirty-one women and one man of infertility from March 2013 to April 2015. Results : After the treatment, nine patients (eight women and 1 man) of infertility became pregnant (28.13%) in thirty-two patients. In nine patients with pregnancy, five patients became spontaneous pregnant. Two patients became pregnant with in vitro fertilization (IVF), and other two patients became pregnant with intrauterine insemination (IUI). Factors influenced pregnancy assessed a shorter duration of infertility. After the treatment, survey of satisfaction in Korean medical treatment in infertility was done. Out of thirty-two patients, convenience and reliability of Korean medical treatment was reported by who had an experience of sterilization surgery. After the assessment, seven patients who had an experience of sterilization surgery and beame pregnant were having more convenience than twelve patients who were not pregnant despite sterilization surgery. Conclusions : This study suggests Korean medical treatment is useful for infertile women and men, in reverse proportion to shorter duration of infertility.