• Clinical and Experimental Reproductive Medicine
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• v.31 no.3
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• pp.191-200
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• 2004

Objective: To compare the clinical efficacy of double intrauterine insemination with single intrauterine insemination in GnRH antagonist combined ovarian hyperstimulation (Mild ovarian hyperstimulation) Materials and Methods: From Jan. 2001 to Jul. 2004, a retrospective clinical analysis was done of a total of 295 cycles in 170 patients who underwent ovarian hyperstimulation for ART (assisted reproductive technique). Subjects were divided into three groups; only clomiphene citrate ovarian hyperstimulation (n=55, 95cycles), GnRH antagonist combined ovarian hyperstimulation (soft ovarian hyperstimulation) (n=66 99cycles), and GnRH agonist combined ovarian hyperstimulation (short protocol) (n=49, 101cycles) Each group were randomly devided into two subgroups. One group underwent single IUI and the other group underwent double IUI. Results: GnRH antagonist group and GnRH agonist group had similar pregnancy rate. In GnRH antagonist Group, pregnancy rate was 36.1% in single IUI subgroup and was 36.6% in double IUI subgroup. These finding were not statistically significant. And Pregnancy rate was 20.8% in single IUI subgroup and was 19.3% in double IUI subgroup in single clomiphene citrate group, and 36.3% in single IUI subgroup and was 33.3% in double IUI subgroup in GnRH agonist group. These finding were not statistically significant, too. Conclusion: Pregnancy rate of GnRH antagonist was high and complication rate such as OHSS and multiple pregnancy was lower. In GnRH antagonist group, to compare with single IUI and double IUI, the result do not statistically differ. So GnRH antagonist single injection with single IUI was relatively comparable ART in infertiliry patient.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.2
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• pp.103-112
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• 2018

Objectives: The aim of this paper is to report that herb medicine effects on four infertility patients with ovarian cysts and the menstrual irregularity as a result of ovarian hyperstimulation syndrome. Methods: Four infertility patients with ovarian cysts had the same symptom of menstrual irregularity for preparing In Vitro Fertilization (IVF). They were treated by twice a day herb medication Changbudodam-tang. Then we observed the effects of treatments by regularity of menstruation, checking with ultrasonography of ovarian cyst size. Results: After herb treatments, the sizes of ovarian cysts decreased and one of them disappeared. Above all, menstrual regularity was recovered for preparing IVF. So they could have a positive progress of IVF. Conclusions: These cases show that herb medicine has its effective treatments for the implantational surroundings on infertility patients with ovarian cyst and menstrual irregularity because of ovarian hyperstimulation syndrome.

• 대한생식의학회:학술대회논문집
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• 2006.06a
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• pp.163.1-163.1
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• 2006

• Clinical and Experimental Reproductive Medicine
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• v.28 no.4
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• pp.265-270
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• 2001

Objective : The aim of this study was to evaluate the outcome the GnRH antagonist (Cetrotide) short protocol in controlled ovarian hyperstimulation comparing with GnRH agonist long protocol. Materials and Method: From July 2000 to November 2001, 26 patients, 28 cycles were performed in controlled ovarian hyperstimulation by GnRH antagonist and GnRH agonist. GnRH antagonist (Cetrotide) was administered in 12 patients (14 cycles, Group 1) and GnRH agonist (Lucrin, Sub Q, Group 2) in 14 patients (14 cycles). Ovulation induction was performed by hMG (Pergonal) in group 1, and by Combo (Metrodine HP + Pergonal) in group 2. We compared the fertilization rate, good quality embryo, and clinical pregnancy rate between the two groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: Ovarian hyperstimulation syndrome did not occurred in which estradiol (E2) level was $3874{\pm}809\;pg/ml$ and the number of retrieved oocytes was $18.4{\pm}2.4$. The number of used gonadotropin ampules was significantly decreased in Group 1 (26.0 vs. 33.1, p<0.04). There were no significant difference in the number of preovulatory oocyte ($10.6{\pm}6.9$ vs. $10.0{\pm}6.1$), fertilization rate ($74.8{\pm}23.4$ vs. $72.2{\pm}21.8$), good quality embryo ($58.7{\pm}23.6$ vs. $38.7{\pm}36.6$), and embryo transfer ($4.3{\pm}1.6$ vs. $4.4{\pm}1.6$). Although the age of the group 1 was older than the group 2 (34.4 vs. 30.8), there was no significant difference in clinical pregnancy rate (50.0% vs. 57.1%). Conclusions: We suggest that GnRH antagonist was a safe, effective, and alternative method in the controlled ovarian hyperstimulation, especially in PCOD patients who will be develop the ovarian hyperstimulation syndrome.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.3
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• pp.121-130
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• 2018

Objectives: The purpose of this study is to report the effects of Korean medical treatment in ovarian disorder patients resistant to controlled ovarian hyperstimulation. There are some case-reports about effectiveness of the Korean medical treatment to treat ovulation disorder and become pregnant, but cases are still deficient. Methods: The patient was diagnosed possibility of premature ovarian failure by serum hormone assay and underwent hyperstimulation to freeze oocyte. But ovary had no response to hyperstimulation. She was treated by Korean medical treatment, such as herbal medicine, acupuncture and moxibustion. Results: After the treatment, the patient recovered from irregular ovulation & menstrual cycle and became pregnant and gave birth. Conclusions: This case shows the Korean medical treatment might be effective in ovarian disorder patients resistant to hyperstimulation.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.251-258
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• 2002

Objective : The aim of this study was to evaluate the outcomes of the GnRH antagonist (Cetrotide) minimal stimulation protocol comparing with GnRH agonist combined long step down stimulation protocol in PCOS patients. Materials and Method: From Apr 2001 to May 2002, 22 patients (22 cycles) were performed in controlled ovarian hyperstimulation using by GnRH antagonist and GnRH agonist for PCOS patients. GnRH antagonist (Cetrotide) combined minimal stimulation protocol was administered in 10 patients (10 cycles, Study Group) and GnRH agonist long step down stimulation protocol was administered in 12 patients (12 cycles, Control Group). We compared the pregnancy rate/cycle, total FSH (A)/cycle, Retrieved oocyte/cycle, the incidence of ovarian hyperstimulation syndrome, multiple pregnancy rate between the two groups. Student-t test were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: Group of GnRH antagonist (Cetrorelix) minimal stimulation protocol produced fewer oocytes (6.4 versus 16.3 oocytes/cycle) using a lower dose of FSH (22.2 versus 36.1 Ample/cycle) and none developed OHSS and multiple pregnancy. Although the trends were in favour of the GnRH antagonist (Cetrorelix) protocol, the differences did not reach statistical significance. This was probably due to small sample size. Conclusion: The use of GnRH antagonist reduce the risk of ovarian hyperstimulation and multiple pregnancy. We suggest that GnRH antagonist might be alternative controlled ovarian hyperstimulation method, especially in PCOS patients who will be ovarian high response.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.2
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• pp.57-62
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• 2017

The purpose of this paper is to assimilate all data pertaining to the use of gonadotropin-releasing hormone (GnRH) antagonists in in vitro fertilization cycles after ovulation trigger to reduce the symptoms of ovarian hyperstimulation syndrome (OHSS). A systematic review of the literature was performed to identify all studies performed on the use of a GnRH antagonist in IVF cycle post-ovulation trigger with patients at high risk for OHSS. Ten studies were identified and reviewed. Descriptions of the studies and their individual results are presented in the following manuscript. Due to significant heterogeneity among the studies, it was not possible to perform a group analysis. The use of GnRH antagonists post-ovulation trigger for treatment of OHSS has been considered for almost 20 years, though research into its use is sparse. Definitive conclusions and recommendations cannot be made at this time, though preliminary data from these trials demonstrate the potential for GnRH antagonists to play a role in the treatment of OHSS in certain patient populations.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.1
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• pp.192-206
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• 2005

Objective : To know about ovarian hyperstimulation syndrome pathophysiology, risk factors and clinical features and to research the trend of the study related to OHSS. Methods : We referred a PubMed site by using searching word of "ovarian hyperstimulation syndrome"(Limits: 1 Year, only items with abstracts, Human). Results : 28 journals with 49 papers were searched. Conclusion 1. The study of OHSS subjects on pathophysiology, prevention and medical treatment. 2. As OHSS is an exaggerated response to ovulation induction therapy, it's emphasized that aspect of prevention OHSS. 3. Preventing OHSS are the following. The first is to give a GnRH agonist or antagonist in substitute for hCG. The second is to screen out prevalence of thrombophilia. The third is to monitor $E_2$ levels. The forth is to aspirate of Mediculous follicle. The fifth is cryopreservation of all embryos. The sixth is that administration of albumin for treatment of OHSS. But, it's not useful to administration of albumin for prevention of OHSS. 4. There's no therapy of OHSS. But, there's only symptomatic treatment of OHSS.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.259-267
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• 2002

Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.4
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• pp.141-149
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• 2014

Objectives: The purpose of this study is to report the effects of herbal medicine and acupuncture on ovarian hyperstimulation syndrome (OHSS). Methods: A patient who had OHSS with edema and pain of left leg as chief complaints was treated by herbal medicne and acupuncture for 11days. We evaluated the results of treatment by change of symptoms, circumference of left leg, Visual Analogue Scale about left leg pain and walking time. Results: After treatment, symptoms of OHSS were almost improved. Circumference and pain of left leg were reduced and walking time was incresed after treatment. Conclusions: This study suggests that Korean medicine mainly herbal medicine and acupuncture is effective on OHSS.