• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.1
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• pp.1-18
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• 2020

Objectives: This review is aimed at assessing the efficacy and effectiveness of oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome (OHSS) through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) on oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome. Studies were searched from Journal of Korean Obstetrics and Gynecology, Korean studies Information Service System, Korean Medical Database, China National Knowledge Infrastructure, Cochrane library, PubMed and EmBase up to 7^th November, 2019. Results: Ten RCTs were finally selected. Eight studies intervened with oral Chinese herb medicine, one is intervened with Chinese medicine enema and the other with acupuncture. Eight studies concluded that intervention with oriental medicine significantly decreased OHSS incidence. Five studies showed significantly higher pregnancy rate in the intervention groups. Two studies reported higher ovulation rate and other two studies showed more maturated eggs than the control groups. Four studies showed opposite results in serum Estradiol level. Vascular Endothelial Growth Factor level was significantly lower in the intervention groups in two studies. Conclusions: From ten studies, oriental medicine reduced OHSS incidence rate and showed preventable effectiveness. Further strictly designed studies and acupuncture intervened studies are needed to establish evidences.

• Journal of Korean Medicine for Obesity Research
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• v.7 no.1
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• pp.31-38
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• 2007

Objective : Women's obesity brings prblems not only appearance but also health which men do not have. This study was conducted to investigate the different factors of obesity between men and women. Materials and Methods : We searched papers usin key words (women, gender, and obesity) on pubmed and obesity journal. Result : Women's obesity leads to amenorrhea, abnormal uterine bleeding, infertility, poly cystic ovarian syndrome, abortion, and luteal phase inadequacy. Obesity induces metabolic syndrome, type-2 diabetes, cardiovascular problems, hypertension, cancer, and psychophysiologic diseases. The difference in body morphology and in particular fat distribution between the sexes leads to gender-specific differences in prevalence of chronic diseases, and unique problems for each sex including infertility, problems during pregnancy, polycystic ovarian syndrome, and endometrial carcinoma in women, and prostate and testicular cancer in men. The influence of gender on obesity is had by genetic view, hormones, pregnancy, delivery, and menopause. Conclusion : Obese women have higher risk factors than men by the influence of gender.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.2
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• pp.135-141
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• 2022

Objective: This study investigated the impact of two stimulation protocols using highly purified human menopausal gonadotropin (HP-hMG) on the endocrine profile, follicular fluid soluble Fas levels, and outcomes of intracytoplasmic sperm injection (ICSI) cycles. Methods: This prospective clinical trial included 100 normal-responder women undergoing ovarian stimulation for ICSI; 55 patients received concomitant follicle-stimulating hormone (FSH) plus HP-hMG from the start of stimulation, while 45 patients received FSH followed by HP-hMG during mid/late follicular stimulation. The primary outcome was the number of top-quality embryos. The secondary outcomes were the number and percentage of metaphase II (MII) oocytes and the clinical pregnancy rate. Results: The number of MII oocytes was significantly higher in the concomitant protocol (median, 13.0; interquartile range [IQR], 8.5-18.0 vs. 9.0 [8.0-13.0] in the consecutive protocol; p=0.009); however, the percentage of MII oocytes and the fertilization rate were significantly higher in the consecutive protocol (median, 90.91; IQR, 80.0-100.0 vs. 83.33 [75.0-93.8]; p=0.034 and median, 86.67; IQR, 76.9-100.0 vs. 77.78 [66.7-89.9]; p=0.028, respectively). No significant between-group differences were found in top-quality embryos (p=0.693) or the clinical pregnancy rate (65.9% vs. 61.8% in the consecutive vs. concomitant protocol, respectively). The median follicular fluid soluble Fas antigen level was significantly higher in the concomitant protocol (9,731.0 pg/mL; IQR, 6,004.5-10,807.6 vs. 6,350.2 pg/mL; IQR, 4,382.4-9,418.4; p=0.021). Conclusion: Personalized controlled ovarian stimulation using HP-hMG during the late follicular phase led to a significantly lower response, but did not affect the quality of ICSI.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.64-76
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• 1970

This report will present a clinical and statistical analysis of 210 case of Ectopic pregnancies who were treated at the Department of Obstetrics and Gynecology at Chung Nam Medical Center from January, 1966 to March, 1970. The results obtained are as follows; 1. The total number of Ectopic pregnancies was 8.22%. 2. The occurrence of Ectopic pregnancy was high in June(13.81%), low in October(2.98%). There was a higher occurrence of Ectopic pregnancy in the summer than in the winter. 3. The average age of all patients was 33.25 years. The most frequent age for this type of pregnancy was 31-35 years (32.86%) . The youngest patient was 18 years old and the oldest was 50. 4. Multipara occurred in 82.38% of the cases; Mulipara in 17. 62% and the occurrence of primipara was especially high, 20.95%. 5. 48.09% of the women had previously experienced normal deliveries; 42.8% had received artificial abortions and 5.23% had experienced spontaneous abortions. 3.8% had a previous history of Ectopic pregnancy. It was found that the occurrence of Ectopic pregnancy was more frequent in those women who had a D & C in the Past. 6. The average length of infertility was 21.7 months. The shortest length was 60 days; longest period of infertility was 19 years. 7. The occurrence of Ectopic pregnancy is higher (29.27%) in patient who have experienced only one previous D & C. The total number of patients who received a D & C was 58.57%. 3. Ectopic symptoms appeared during the first 4.7 weeks (mean) and most frequently occurred between the 5th and 6th weeks (48.57%) of pregnancy. The Symptoms were: -99.04% complained of lower abdominal pains. -80.95% experienced abnormal uttering bleeding. -42.38% experienced bleeding before the occurrence of pain. -18.57% experienced pain before the occurrence of bleeding. -8.57% experienced both pain and bleeding. -7.62% experienced only bleeding. -22.86% experienced only pain. 9. In-77.62% of the cases the annexal mass palpated. 91.42% complained of abdominal tenderness. 42.38% complained of pain when the cervix was examined. 10. Culdocentesis was performed in 86.19% of the cases. In 92.82% of the cases the presence of an Ectopic pregnancy was accurately diagnosed 11. 71.90% of the Ectopic pregnancies occurred in the ampule portion of the ovarian tube, of the total number of gestations, 40.95% were tubal abortions and 59.05% were ruptured. The ruptured group occurred more frequently in the islamic portion and interstitial portion of the tube than the aborted group. The aborted group occurred more frequently in the fimbrial extremities of the tube. 12. The blood pressure (systolic) was noted at 119-80mmHg in 81.89% of the total cases. Hemoglobin value was noted at over 8gm/㎗ in 58.57% of the cases. The average blood transfusion was 2.3 pints. 13. In 52.86% of the Ectopic pregnancies the right side of the ovarian tube was affected. The left side of the tube was affected in 47.14% of the cases. 14. 3.33% of the patients were not given an accurate diagnosis. 15. The kinds of operation performed were as follows; Salpingectomy, 41.43%; Adnectomy, 38.57% and Adnectomy with total hysterectomy, 19.05%. 16. The patient mortality rate was significantly small; only 1 case out of 210 died. This patient most likely had a profuse hemorrhage because of a ruptured tube before her admission to the hospital. 17. The patients personal feelings and attitudes must be treated with care. Particularly patients who are concerned about vaginal bleeding or the impossibility of another pregnancy.

• Journal of Yeungnam Medical Science
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• v.37 no.1
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• pp.47-53
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• 2020

Background: This study was conducted to analyze clinical factors that can affect pregnancy rates in normal responders undergoing the freeze-all policy in in vitro fertilization. Methods: We evaluated 153 embryo transfer cycles in 89 infertile women with normal response to controlled ovarian stimulation (COS). After COS, all embryos were cultured to the blastocyst stage, and good quality blastocysts were vitrified for elective frozen-thawed embryo transfer (FET). Clinical variables associated with COS and the results of COS and culture, including the number of retrieved oocytes, fertilized oocytes, and frozen blastocysts were compared between the pregnant group and the non-pregnant group. Results: After a single cycle of COS for each patient, 52 patients became pregnant while 37 did not. Significant differences were observed in the number of matured oocytes, fertilized oocytes, frozen blastocysts, and transferred embryos. The number of frozen blastocysts in the pregnant group was almost twice that in the non-pregnant group (5.6±3.1 vs. 2.8±1.9, p<0.001). The area under the receiver operating characteristic curve for the 4 frozen blastocysts was 0.801 in the pregnant group. Conclusion: In the freeze-all policy, the number of matured oocytes, number of fertilized oocytes, and number of frozen blastocysts might be predictive factors for pregnancy.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.3
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• pp.106-110
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• 2015

Objective: This study aimed to investigate the effect of a new clomiphene citrate (CC) regimen on preventing thin endometrial lining in polycystic ovary syndrome (PCOS) patients receiving CC plus gonadotropin treatment with a timed intercourse cycle. Methods: A total of 114 women with PCOS were included in this trial. Patients were divided into two groups and treated in accordance with the controlled ovarian stimulation (COS) protocol. In group A, 104 COS cycles in 67 patients were included, and in each cycle 150 mg CC was given for three days, starting from day 3. In group B, 69 COS cycles in 47 patients were included, in which 100 mg CC was given for five days, starting from day 3. The thickness of the endometrium was measured on the day of human chorionic gonadotropin (hCG) injection. Timed intercourse was recommended at 24 and 48 hours after the hCG injection. Results: Additional doses of human menopausal gonadotropin and the number of days of hCG administration were not significantly different between the two groups. Endometrial thickness on the day of hCG administration was significantly larger in group A than group B (4$9.4{\pm}2.1mm$ vs. $8.5{\pm}1.7mm$, p=0.004). The pregnancy rate was significantly higher in group A than in group B (38.4% vs. 21.7%, p=0.030). Conclusion: Three-day CC treatment resulted in a significantly higher pregnancy rate than the standard five-day CC treatment in a timed intercourse cycle in PCOS patients. Facilitating adequate endometrial growth via the early discontinuation of CC might be a crucial factor in achieving a higher pregnancy rate.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.1-11
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• 2014

Objectives: To evaluate the effect of acupuncture as an adjunct treatment to increase the success rate of in vitro fertilisation (IVF). Methods: A review of the English and Korean literature was conducted to identify studies on acupuncture as an adjunct treatment to IVF. The main outcome measures were the biochemical pregnancy rate (BPR), the implantation rate (IR), the clinical pregnancy rate (CPR), the miscarriage rate (MR), the on-going pregnancy rate (OPR) and the live birth rate (LBR). Results: Nine meta-analyses of 11 systematic reviews (SRs) were included in this review. In four SRs, the overall IVF outcomes regardless of the procedural steps were documented; two of these SRs reported a significant effect on the CPR. One SR reported that acupuncture at the time of controlled ovarian hyperstimulation had a significant effect on the BPR. Seven SRs reported that acupuncture had no significant impact on transvaginal oocyte retrieval (TVOR). In eight SRs, significant impacts on the CPR, LIBR and OPR were reported when acupuncture was performed around the time of embryo transfer (ET). The results of repeated acupuncture after ET were included in two SRs, which included the same primary studies. The results of the SRs showed that acupuncture had a positive effect on the CPR. Conclusions: When the complete IVF procedure is analysed, there is conflicting evidence in that some reviews have found that acupuncture leads to an increased CPR but others have not. In addition, the reviews presented no evidence to suggest that acupuncture has any specific risks.

• Journal of Embryo Transfer
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• v.30 no.1
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• pp.51-57
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• 2015

This study was aimed to determine the biometry of genital organs, incidence of gynecological disorders and pregnancy loss in Black Bengal goat (Capra hircus). Genitalia of 118 does were collected from local abattoirs. Biometric parameters of genital organs were measured and gross and histopathological examinations were carried out for detection of abnormalities. For gravid uterus, age of the fetus was determined by measuring crown-rump length. There was no significant difference in the length, width and weight of right and left ovaries (P>0.05). However, the number of follicles between left ($5.3{\pm}2.3$) and right ovaries ($7.4{\pm}2.7$) varied significantly (P<0.05). The mean length of right fallopian tube and uterine horn were not varied with those of left fallopian tube and uterine horn. The length of uterine body, cervix and vagina were $1.3{\pm}0.1cm$, $3.3{\pm}0.5cm$ and $6.8{\pm}1.3cm$, respectively. Overall, 29 (24.6%) genitalia had abnormalities. Fifteen genitalia (12.7%) had ovarian abnormalities including ovaro-bursal adhesions (6.8%), parovarian cyst (5.1%) and follicular cyst (0.9%). Uterine abnormalities were found in 12 genitalia (10.2%) and predominant uterine lesion was endometritis (6.8%) followed by adenomyosis (1.7%), hemorrhagic lesion on endometrial surface (0.9%) and cyst in broad ligament (0.9%). In addition, cyst in fallopian tube (0.9%) and vagina (0.9%) were recorded. The proportion of slaughtered pregnant goats was 15.3% (18/118). The pregnancy wastage was highest in the first month (50.0%) followed by second (33.3%) and third (16.7%) month. It can be concluded that ovaro-bursal adhesions, parovarian cyst and endometritis are the gynecological disorders of major concern in Black Bengal goat.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.2
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• pp.76-86
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• 2019

Objective: This study was performed to explore the possibility that each oocyte and its surrounding cumulus cells might have different genetic expression patterns that could affect human reproduction. Methods: Differential gene expression analysis was performed for 10 clusters of cumulus cells obtained from 10 cumulus-oocyte complexes from 10 patients. Same procedures related to oocyte maturation, microinjection, and microarray analyses were performed for each group of cumulus cells. Two differential gene expression analyses were performed: one for the outcome of clinical pregnancy and one for the outcome of live birth. Results: Significant genes resulting from these analyses were selected and the top 20 affected pathways in each group were analyzed. Circadian entrainment is determined to be the most affected pathway for clinical pregnancy, and proteoglycans in cancer pathway is the most affected pathway for live birth. Circadian entrainment is also amongst the 12 pathways that are found to be in top 20 affected pathways for both outcomes, and has both lowest p-value and highest number of times found count. Conclusion: Although further confirmatory studies are necessary, findings of this study suggest that these pathways, especially circadian entrainment in cumulus cells, may be essential for embryo development and pregnancy.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.2
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• pp.87-94
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• 2019

Objective: The primary objective of this study was to compare clinical pregnancy rates in intrauterine insemination (IUI) treatment cycles with transabdominal ultrasound guidance during intrauterine catheter insemination (US-IUI) versus the "blind method" IUI without ultrasound guidance (BM-IUI). The secondary objective was to compare whether US-IUI had better patient tolerability and whether US-IUI made the insemination procedure easier for the clinician to perform compared to BM-IUI. Methods: This was a randomized controlled trial done at the Reproductive Medicine Unit of General Hospital Kuala Lumpur, Malaysia. We included women aged between 25 and 40 years who underwent an IUI treatment cycle with follicle-stimulating hormone injections for controlled ovarian stimulation. Results: A total of 130 patients were recruited for our study. The US-IUI group had 70 patients and the BM-IUI group had 60 patients. The clinical pregnancy rate was 10% in both groups (p> 0.995) and there were no significant difference between the groups for patient tolerability assessed by scores on a pain visual analog scale (p= 0.175) or level of difficulty for the clinician (p> 0.995). The multivariate analysis further showed no significant increase in the clinical pregnancy rate (adjusted odds ratio, 1.07; 95% confidence interval, 0.85-1.34; p= 0.558) in the US-IUI group compared to the BM-IUI group even after adjusting for potential covariates. Conclusion: The conventional blind method for intrauterine catheter insemination is recommended for patients undergoing IUI treatment. The use of ultrasound during the insemination procedure increased the need for trained personnel to perform ultrasonography and increased the cost, but added no extra benefits for patients or clinicians.