• Title/Summary/Keyword: Ovarian pregnancy

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Comparison of assisted reproductive technology outcomes in infertile women with polycystic ovary syndrome: In vitro maturation, GnRH agonist, and GnRH antagonist cycles

  • Choi, Min Hye;Lee, Sun Hee;Kim, Hye Ok;Cha, Sun Hwa;Kim, Jin Young;Yang, Kwang Moon;Song, In Ok;Koong, Mi Kyoung;Kang, Inn Soo;Park, Chan Woo
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.4
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    • pp.166-171
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    • 2012
  • Objective: We compared the assisted reproductive technology (ART) outcomes among infertile women with polycystic ovary syndrome (PCOS) treated with IVM, conventional IVF, GnRH agonist, and GnRH antagonist cycles. Methods: The prospective study included a total of 67 cycles in 61 infertile women with PCOS. The women with PCOS were randomized into three IVF protocols: IVM/IVF with FSH and hCG priming with immature oocyte retrieval 38 hours later (group A, 14 cycles), GnRH agonist long protocol (group B, 14 cycles), and GnRH antagonist multi-dose flexible protocol (group C, 39 cycles). IVF outcomes, such as clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR), were compared among the three groups. Results: Age, BMI, and basal FSH and LH levels did not differ among the three groups. The number of retrieved oocytes and 2 pronucleus embryos was significantly lower in group A compared with groups B and C. The CPR, IR, MR, and LBR per embryo transfer showed no differences among the three groups. There was no incidence of ovarian hyperstimulation syndrome in group A. Conclusion: The IR, MR, and LBR in the IVM cycles were comparable to those of the GnRH agonist and GnRH antagonist cycles. The IVM protocol, FSH and hCG priming with oocyte retrieval 38 hours later, is an effective ART option that is comparable with conventional IVF for infertile women with PCOS.

Prostaglandin $E_2$ and $F_{2{\alpha}}$ Concentrations in Follicular Fluid after Different Ovarian Hyperstimulation Methods (과배란유도방법에 따른 난포액내의 Prostaglandin $E_2$$F_{2{\alpha}}$ 농도의 변동에 관한 연구)

  • Lee, Jin-Yong;Yoon, Bo-Hyun;Kim, Jung-Gu;Moon, Shin-Yong;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.1
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    • pp.17-24
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    • 1988
  • Follicular fluid(FF) prostaglandin $E_2$(PG$E_2$) and $PGF_{2{\alpha}}$ levels were compared in 3 groups of spontaneously ovulatory women undergoing ovulation induction with clomiphene citrate (CC) alone or with human menopausal gonadotropin(hMG) (14 patients), hMG(9 patients), or pure FSH/hMG(11 patients) for the purpose of in vitro fertilization. FF volume aspirated did not differ significantly according to the maturity of the oocyte. According to hyperstimulation regimens, the volume of FF from which preovulatory occytes were obtained was significantly less in the hMG-treated group than in the other groups. In follicles of preovulatory oocytes, FF PG$E_2$ values were significantly lower in the FSH treated group than in the Cc.treated or hMG-treated group, and FF $PGF_{2{\alpha}}$ values were significantly higher in the hMG-treated group than in the CC-treated or FSH-treated group. In follicles of immature or atretic oocytes, there was no significant difference in FF PG$E_2$ and PG$F_{2{\alpha}}$ concentrations of the similar morphology of the oocyte according to hyperstimulation regimens. In all cycles, FF PG$E_2$ and PG$F_{2{\alpha}}$ values of preovulatory oocytes were not significantly different from those of immature oocytes, but those of atretic oocytes were relatively lower than those of fertilizable oocytes and it was statistically signifincant in PG$E_2$ values of CC-treated group. In all treatment groups, FF PG$E_2$ and PG$F_{2{\alpha}}$ levels did not show and close relationship with the success of fertilization in vitro and of pregnancy after embryo transfer. Above results suggested that FF PG$E_2$ and PG$F_{2{\alpha}}$ be involved in oocyte maturation and ovulation, but their relationship with the success of in vitro fertilization was not found.

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Gynecologic Application of the Pelviscopic Surgery (골반경수술의 부인과적 응용)

  • Koh, Seok-Bong;Lee, Jae-Yeoul;Lee, Young-Gi;Park, Yoon-Kee;Lee, Doo-Jin;Lee, Tae-Hyung;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.127-134
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    • 1994
  • The aim of this study was to identify the usefulness of pelviscopy in treatment besides its diagnostic value. The advantages of pelviscopic surgery are low cost, rapid recovery, good cosmetic effect, low incidence of complication and postoperative adhesion. So most of the pelvic exploration in gynecologic patients are replaced by the pelviscopic surgery these days. Pelviscopic surgery was performed on 136 patients at the Department of Obstetrics and Gynecology, College of Medicine, Yeungnam University from May 1991 to July 1993. The results obtained were as follows : The age distribution of the patients was from 19 to 55 with age of 31.2 years, and the mean parity was 0.96, the most common indication of pelviscopic surgery was tubal pregnancy(66.9%), the second most common indications was ovarian cyst(10.3%) and the other indications were endometriosis, corpus luteum cyst rupture, parovarian cyst, foreign body, tubal ligation, hydrosalpinx, uterine myoma and diagnostic procedure. The main types of surgery were salpingectomy in 58.8% and salpingoophorectomy in 16.3%. The mean duration of hospitalization was 2.1 days without specific complications. According to these results, it was postulated that the pelviscopic surgery was a useful operative tool in gynecologic treatment and its application could be extended to many other areas of gynecology with safety by the development of surgical techniques and instruments.

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The effect of Jackyakgamcho-tang on Follicular Maturation and Estrogen Production in the Immature Rat (작약감초탕이 미성숙 흰쥐에서 난포성숙 및 Estrogen생성에 미치는 효과)

  • Jung, Ki-Kyung;Kang, Seog-Youn;Kim, Tae-Gyun;Kim, Chang-Ok;Moon, A-Ree;Ryu, Kyung-Za;Lee, Song-Deuk;Ryeu, Hang-Mook;Kim, Seung-Hee
    • Korean Journal of Pharmacognosy
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    • v.28 no.3
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    • pp.104-111
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    • 1997
  • The traditional herbal medicine, Jackyakgamcho-tang(JGT), was reported to decrease serum testosterone levels and make pregnancy possibel in anovulatory woman and rat. JGT contains Paeoniae Radix(PR) and Glycyrrhizae Radix(GR) in equal amount. This study was designed to investigate the effect of JGT and its components(PR, GR, paeoniflorin and glycyrrhizin) on uterine and ovarian responses, follicular development, and estrogen secretion in the immature rat. The samples(water extracts of JGT, PR, GR; pure compound of paeoniflorin and glycyrrhizin) were administered orally to rats from the 21th day of age to the 28th or 30th days of age for 7 or 9 days. JGT(400mg/kg) and PR(100mg/kg, 200mg/kg) treatments significantly increased serum estradiol above levels in control rats, but both GR and glycyrrhizin had no effect on this parameter. Gross observation and histological analysis revealed that an increased number of growing follicules was observed in the ovaries of JGT and PR treated rat. However the lutenized follicles and ova present in the oviducts were not observed in all rats except one treated with estrogen as a positive control. These results indicate that JGT stimulates the estrogen production and follicular maturation in the immature rat and PR is the main component to induce such reaction.

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An Epidemiological Study on the Complications caused by the Sterilization Program (불임시술의 합병증에 관한 역학적 연구)

  • Hong, Myung-Sun
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.138-153
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    • 1996
  • Intending to offer basic information for a prospective health services in Korea, this study is to investigate the complication caused by sterilization in goverment family planning program from 1962 to 1995. The results are as follows: 1. Total number of sterilization performed during the period from 1962 to 1995 were 1.367,772 cases of male sterilization and 2,889,635 cases of female sterilization. 2. Incidence of the complication caused by sterilization operation from 1980 to 1995 were 1,883(0.20%) out of 925,801 cases in vasectomies and 15,866(0.70%) out of 2,256,020 cases in tubal sterilizations. 3. Major complications in vasectomy were epididymities of 658 cases (34.9%), vas recanalization of 326 cases(17.3%), hematoma of 266 cases(14.1%), scrotal abscess of 184 cases(9.8%), sperm granuloma of 76 cases(4.0%),and other of 373 cases(19.8%). On the other hand, in tubal sterilization, ectopic pregnancy was the most significant complication of 15,078 cases (95.0%) among 15,866 total complications, followed by pelvic inflammatory diseases of 155 cases(0.9%), peritonities of 96 cases(0.6%), ovarian & tubal bleeding of 31 cases(0.2%), intestinal perforation of 16 cases (0.1%), uterine bleeding of 14 cases(0.1%), uterine cervix laceration of 1 case (0.1%), and other of 271 cases(1.7%), while 161 pregnancies(0.1%) were terminated and 43 cases(0.3%) with normal delivery. 4. The occurrence rate of the complication for each period showed that most of the complication cases by vasectomy occurred in a year after the operation -the cases were 1,256 (66.7%). 254 cases(13.5%) occurred between the next year and the 2nd year, 138 cases (7.3%) between the 2nd year and the 3rd year, 73 cases(3.9%) between the 3rd year and the 4th year, 52 cases(2.8%) between the 4th year and the 5th year, 31 cases(1.6%) between the 5th year and the 6th year, 79 cases(4.2%) over the 6th year. Tubal sterilization indicated that the occurred complication cases in a year were 2,175 cases(13.7%), 2,113 cases(13.3%) occurred between the next year and the 2nd year, 2,082 cases(13.1%) between the 2nd year and the 3rd year, 2,049 cases (12. 9%) between the 3rd year and the 4th year, 1,819 cases(11.5%) between the 4th year and the 5th year, 621 cases(10.2%) between the 5th year and the 6th year, 4,007 cases(25.3%) over the 6th year. 5. For the cost of complication treatment, total \7,928,229,000 were paid as medical expenditure in which \609,438,000 for vasectomy and \7,318,791,000 for tubal sterilization. Accordingly per capita expenses were \345,000 for vasectomy and \467,000 for tubal sterilization. As the proportion of government sterilization program was decreased after 1988, that of private sterilization program would be increased. So it is recommended to set a guideline for the private sterilization program and to continue government sterilization program for the lower class.

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Comparison of follitropin ${\beta}$ administered by a pen device with follitropin ${\beta}$ administered by a conventional syringe in patients undergoing IVF-ET

  • Kang, Hyuk-Jae;Kim, Chung-Hoon;Ahn, Jun-Woo;Lee, Hyang-Ah;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.1
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    • pp.37-41
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    • 2011
  • Objective: To compare the effectiveness and convenience of a pen device for the self-administration of follitropin ${\beta}$ with a conventional syringe delivering follitropin ${\beta}$ solution in patients undergoing IVF-ET. Methods: GnRH agonist long protocol was used for controlled ovarian stimulation (COS) in all subjects. A total of 100 patients were randomized into the pen device group or the conventional syringe group on the first day of COS. Local tolerance reactions were assessed within 5 minutes, at 1 hour and at 3 hours after each injection. On the day of hCG injection, patients were asked to rate their overall pain and convenience experienced with self-injection on a visual anlaogue scale (VAS). Results: There were no differences in patients' characteristics between the two groups. The duration of COS was significantly shorter in the pen device group than in the conventional syringe group. Patients included in the pen device group needed a significantly smaller amount of follitropin ${\beta}$. However, no differences between the two groups were found in IVF results and pregnancy outcome. The incidence of local pain within 5 minutes, at 1 hour and at 3 hours after the injection was significantly lower in the pen device group. VAS scores indicated that injections using the pen device were significantly less painful and more convenient. Conclusion: The pen device for self-administration of follitropin ${\beta}$ is less painful, safer and more convenient for the patients, and can be more effective because of the shorter duration and smaller dose of follitropin ${\beta}$ when compared with the conventional syringe.

Nonmonotonic Effects of Chronic Low-Dose Di(2-ethylhexyl) Phthalate on Gonadal Weight and Reproduction

  • Cha, Sunyeong;Jung, Kayeon;Lee, Min Young;Hwang, Yeon Jeong;Yang, Eunhyeok;Lee, Sung-Ho;Jung, Hyo-il;Cheon, Yong-Pil
    • Development and Reproduction
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    • v.22 no.1
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    • pp.85-94
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    • 2018
  • Endocrine disruptors have been concerned in toxicology but now challenged as physiological point especially concerned with exposing dose and period. In this study the low-dose chronic administration of di(2-ethylhexyl) phthaltae (DEHP) during reproductive period was examined to evaluate the possible roles. Adult male and female CD-1 mice were exposed to DEHP with drinking water containing $133{\mu}g/L$ and $1,330{\mu}g/L$ DEHP in water according to OECD 433 guide line and sacrificed just after weaning. The weights of uterus and ovary were decreased by drinking of $1,330{\mu}g/L$ DEHP water. There was not adverse effects on either accumulated mating rate and mating rate depend on estrus stage, pregnancy duration, and sex ration at birth. However, the accumulated rate of successful delivery and litter size were significantly high at $1,330{\mu}g/L$ DEHP water. The number of epididymal sperm was significantly increased by drinking of $1,330{\mu}g/L$ DEHP water. In addition, the number of follicles (primary, secondary, tertiary) were more many than control at $1,330{\mu}g/L$ DEHP water drunk mother. Though further studies are needed to identify what are the mechanism of DEHP in folliculogenesis and spermatogenesis. From this study we firstly report the effect of low-dose chronic administration of DEHP with drinking could change the ovarian follicle population size and spermatogenesis rate. Put together, those finding is different from previous high-dose effects and suggest the physiological role of DEHP in gonads and uterus.

Effects of Concentrate Feeding Level after Sexual Maturity on the Growth and Breeding Performances, Blood Composition, and Ultrasonic Carcass Traits in Hanwoo Cows (성 성숙기 이후 농후사료 급여수준이 한우 암소의 성장과 번식능력, 혈액성상 및 초음파 도체성적에 미치는 영향)

  • Jeong, Chan Sung;Jang, Sun Sik;Lee, Sung Sill;Moon, Yea Hwang
    • Journal of agriculture & life science
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    • v.50 no.4
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    • pp.113-125
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    • 2016
  • This study was conducted to investigate the effect of low feeding level of concentrate after sexual maturity(14 month old) on the growing and breeding performances in Hanwoo cows. Eighteen cows(average body wt. 251kg) were alloted to two groups by completely randomized design, and fed a commercial formula feed by 0.8%(T1) and 1.2%(T2) of body weight for 30 months of total experimental period(feeding trial of 20 months, breeding trial of 10 months). When the results of this experiment compared to the Korean feeding standard for Hanwoo(2012), the reason of low growing performance in T1 was induced from low protein intake rather than energy. The change of body size by feeding levels was significantly appeared at chest width and body length, particularly chest width of cows in T1 was rather reduced by 3.7% in the final than the initial measurement. Ovarian size of T1 was only 63% of T2, and pregnancy rate(33.3% : 77.8%) and birth wight of calf(22.5kg : 29.5kg) were also seriously repressed by low intake of dietary protein after sexual maturity in Hanwoo cow. It was appeared that the growing and breeding performances of Hanwoo cows were more affected by the level of dietary protein rather than energy in the feeding after sexual maturity.

Evaluation of Ovary Dose of Childbearing age Woman with Breast cancer in Radiation therapy (가임기 여성의 방사선 치료 시 난소 선량 평가)

  • Park, Sung Jun;Lee, Yeong Cheol;Kim, Seon Myeong;Kim, Young Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.145-153
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    • 2021
  • Purpose: The purpose of this study is to evaluate the ovarian dose during radiation therapy for breast cancer in women of childbearing age through an experiment. The ovarian dose is evaluated by comparing and analyzing between the calculated dose in the treatment planning system according to the treatment technique and the measured dose using a thermoluminescence dosimeter (TLD). The clinical usefulness of lead (Pb) apron is investigated through dose analysis according to whether or not it is used. Materials and Methods: Rando humanoid phantom was used for measurement, and wedge filter radiation therapy, 3D conformal radiation therapy, and intensity modulated radiation therapy were used as treatment techniques. A treatment plan was established so that 95% of the prescribed dose could be delivered to the right breast of the Rando humanoid phantom 3D image obtained using the CT simulator. TLD was inserted into the surface and depth of the virtual ovary of the Rando hunmanoid phantom and irradiated with radiation. The measurement location was the center of treatment and the point moved 2 cm to the opposite breast from the center of the Rando hunmanoid phantom, 5cm, 10cm, 12.5cm, 15cm, 17.5cm, 20cm from the boundary of the right breast to the center of treatment and downward, and the surface and depth of the right ovary. Measurements were made at a total of 9 central points. In the dose comparison of treatment planning systems, two wedge filter treatment techniques, three-dimensional conformal radiotherapy, and intensity-modulated radiation therapy were established and compared. Treatments were compared, and dose measurements according to the use of lead apron were compared and analyzed in intensity-modulated radiation therapy. The measured value was calculated by averaging three TLD values for each point and converting using the TLD calibration value, which was calculated as the point dose mean value. In order to compare the treatment plan value with the actual measured value, the absolute dose value was measured and compared at each point (%Diff). Results: At Point A, the center of treatment, a maximum of 201.7cGy was obtained in the treatment planning system, and a maximum of 200.6cGy was obtained in the TLD. In all treatment planning systems, 0cGy was calculated from Point G, which is a point 17.5cm downward from the breast interface. As a result of TLD, a maximum of 2.6cGy was obtained at Point G, and a maximum of 0.9cGy was obtained at Point J, which is the ovarian dose, and the absolute dose was 0.3%~1.3%. The difference in dose according to the use of lead aprons was from a maximum of 2.1cGy to a minimum of 0.1cGy, and the %Diff value was 0.1%~1.1%. Conclusion: In the treatment planning system, the difference in dose according to the three treatment plans did not show a significant difference from 0.85% to 2.45%. In the ovary, the difference between the Rando humanoid phantom's treatment planning system and the actual measured dose was within 0.9%, and the actual measured dose was slightly higher. This did not accurately reflect the effect of scattered radiation in the treatment planning system, and it is thought that the dose of scattered radiation and the dose taken by CBCT with TLD inserted were reflected in the actual measurement. In dosimetry according to the with or without a lead apron, when a lead apron was used, the closer the distance from the treatment range, the more effective the shielding was. Although it is not clinically appropriate for pregnancy or artificial insemination during radiotherapy, the dose irradiated to the ovaries during treatment is not expected to significantly affect the reproductive function of women of childbearing age after radiotherapy. However, since women of childbearing age have constant anxiety, it is thought that psychological stability can be promoted by presenting the data from this study.

The Effect of the Serum Progesterone and Estradiol Levels of hCG Administration Day on the Pregnancy and Fertilization Rate in IVF-ET Patients (체외수정 과배란 유도에서 hCG 주사 당일의 혈청 Progesterone과 Estradiol 농도가 수정율 및 임신율에 미치는 영향에 관한 연구)

  • Lee, Eun-Sook;Lee, Sang-Hoon;Bae, Do-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.1
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    • pp.51-59
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    • 1996
  • Controlled Ovarian hyperstimulation(COH) is generally used to obtain synchronous high quality oocytes in in vitro fertilization-embryo transfer(IVF-ET). Many investigators have studied the relationship between serum hormone levels and outcomes of IVF-ET because there is no accurate estimation method of oocyte quality. Early premature luteinization of follicles before oocyte retrieval is the most troublesome problem in COH for IVF-ET. Gonadotropin-releasing hormone agonists(GnRH-a) are used as adjuncts with gonadotropins for COH in patients undergoing in IVF. The possible benefits of GnRH-a pretreatment include improving oocyte quality, allowing a more synchronous cohort of follicles to be recruited, and preventing premature lueinization hormone surges. In COH of IVF cycles, we investigated whether an elevated progesterone(P4) level on the day of human chorionic gonadotropin(hCG) administration indicates premature luteinization and is associated with a lower fertilization rate. Many investigators have studied that the lower fertilization rates seen in patients with elevated P4 levels might result from an adverse effect of P4 on the oocytes. We hypothesizes that serum P4 levels around the day of hCG may be helpful prediction of out come in IVF-ET cycles. Success rates after COH of IVF-ET cycles are dependent upon many variable factors. Follicular factors including the number of follicles, follicular diameters and especially serum estradiol(E2) levels as an indirect measurement of follicular function and guality have been thought to influence the outcomes of IVF-ET. To assess whether serum P4 and E2 levels affect the fertilization and pregnancy rate, we reviewed the stimulation cycles of 113 patients (119 cycles) undergoing IVF-ET with short protocol with GnRH-a, from March 1993 to August 1994 retrospectively. The serum P4 and E2 levels were compared on the day of hCG in the pregnant group, 45 patients(47 cycles) and in the non-pregnant group, 68 patients (72 cycles) respectively. The serum E2 level in non-pregnant group was $1367{\pm}875.8$ pg/ml which was significantly lower than that of pregnant group, $1643{\pm}987.9$ pg/ml( p< 0.01 ). And the serum P4 level in non-pregnant group was $2.1{\pm}1.4$ ng/ml which was significantly higher than that of pregnant group, $1.0{\pm}0.7$ ng/ml( p< 0.001 ). The fertilization rate was $61.3{\pm}21.3%$ in pregnant group which was higher than that of non-pregnant group, $41.1{\pm}20.2%$ (p< 0.01). We suggest that the serum levels of P4 and E2 on the day of hCG administration are additional parameters that predict the outcomes of IVF-ET cycles.

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