• Clinical and Experimental Reproductive Medicine
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• 제38권3호
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• pp.159-163
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• 2011

Objective: To compare the IVF outcomes of mild ovarian stimulation with conventional ovarian stimulation in poor responders. Methods: From 2004 to 2009, 389 IVF cycles in 285 women showed poor responses (defined as either a basal FSH level ${\geq}$12 mIU/mL, or the number of retrieved oocytes ${\leq}$3, or serum $E_2$ level on hCG day <500 pg/mL) were analyzed, retrospectively. In total, 119 cycles with mild ovarian stimulation (m-IVF) and 270 cycles with conventional ovarian stimulation (c-IVF) were included. Both groups were divided based on their age, into groups over and under 37 years old. Results: The m-IVF group was lower than the c-IVF group in the duration of stimulation, total doses of gonadotropins used, serum $E_2$ level on hCG day, the number of retrieved oocytes, and the number of mature oocytes. However, there was no significant difference in the number of good embryos, the number of transferred embryos, the cancellation rate, or the clinical pregnancy rate. In the m-IVF group over 37 years old, the clinical pregnancy rate and live birth rate were higher when compared with the c-IVF group, but this result was not statistically significant. Conclusion: In poor responder groups, mild ovarian stimulation is more cost effective and patient friendly than conventional IVF. Therefore, we suggest that mild ovarian stimulation could be considered for poor responders over 37 years old.

• Reproductive and Developmental Biology
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• 제38권4호
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• pp.165-170
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• 2014

Cows may suffer impaired ovarian function, often accompanied by reduced conception rates and increased embryonic loss. Cystic ovarian disease (COD) is one of the most frequently diagnosed gynecological findings in dairy cattle. It causes temporary infertility and is likely to affect reproduction as well as production parameters in cattle. Therefore, the purpose of this study was to determine the expression patterns of apoptosis (Bcl-2, Bax), implantation (E-cadherin) and immune related proteins (TNF-${\alpha}$, IL-10) in uterine endometrium of Hanwoo (Korean native cattle) with ovarian cyst and normal ovarian follicles. In the Western blot analysis, the expression of anti-apoptotic Bcl-2 protein was significantly higher in endometrium with normal ovarian follicles, whereas expression of pro-apoptotic Bax protein was significantly lower. Also, the expressions of E-cadherin and TNF-${\alpha}$ proteins were significantly higher in uterine endometrium with normal ovarian follicles. On the other hand, the expression of IL-10 protein was significantly lower in uterine endometrium with normal ovarian follicles. Taken together, our results provided that the expressions of apoptosis, adhesion and immune related proteins in uterine endometrium with ovarian cyst were showed the aberrant patterns, and we suggest that different expression changes of these proteins may be affect to pregnancy ability of cattle.

• 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.

• Clinical and Experimental Reproductive Medicine
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• 제17권1호
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• pp.29-44
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• 1990

In 105 patients with the past history of poor response to the previous controlled ovarian hyperstimulation(COH) due to poor follicular growth or premature LH surge, the effectiveness of pituitary suppression with gonadotropin-releasing hormone agonist(GnRH agonist) in IVF/GIFT program was evaluated in 112 cycles of COH using a combination regimen of Leuprolide acetate (Lupron TAP Pharmaceuticals, USA) and FSH/hMG or pure FSH from May to December, 1989 at SNUH. Starting on day 21 of the menstrual cycle(MCD #21, Day 1), Lupron (1.0mg/day, subcutaneous) was administered once a day till next MCD #3(suppression phase). After the confirmation of pituitary suppression, ovarian follicular growth was stimulated with FSH/hMG or pure FSH from MCD #3(Day + 1), and Lupron was continued with hMG or FSH until hCG administration (D 0) (stimulation phase). After suppression phase, serum E2 level decreased from 183.7${\pm}$95.1(Day 1) to 17.4${\pm}$12.3pg/ml (Day +1), and serum progesterone level from 19.17${\pm}$8.67 to 0.12${\pm}$0.05ng/ml. But there was no decresas in serum LH and FSH levels; LH from 12.74${\pm}$6.21 to 15.49${\pm}$4.93mIU/ml,FSH from 7.60${\pm}$3.84 to 8.58${\pm}$3.15 rnlU/ml. There was no occurrence of premature LH surge during COH. Eleven cycles(9.8%) were cancelled due to poor follicular growth during stimulation phase, and 3 cycles (3.0%) failed in the transvaginal oocytes fretrieval. Serum E2 level was 1366.8${\pm}$642.4 on D 0 and 1492.3${\pm}$906.9pg/ml on D+1. 7.00${\pm}$3.32 follicles(FD${\geq}$12mm) were observed on D 0, and 6.11${\pm}$4.15 oocytes were retrieved, with the oocyte retrieval rate per follicle of 95.0%. 3.59${\pm}$2.57 oocytes were fertilized and cleaved with the oocyte cleavage rate of 55.7%. In 83 IVF patients, 4.08${\pm}$2.39 embryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET 2.39 mebryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET of 19.3%. In 6 GIFT patients, 7.83${\pm}$3.31 oocytes were retrieved and transferred with maximum number of 6, but no pregnancy was obtained. When compared with the previous 108 cycles of COH using FSH/hMG or pure FSH regimen, the cancellation rate during COH was significantly decreased, and all the parameters of the outcome of COH including the pregnancy rate were increased. These data suggest that GnRH agonist therapy for pituitary suppression is an effective adjunct to the current gonadotropin regimens for COH in IVF/GIFT and can increase the probability of oocytes retrieval and pregnancy, especially in the previous poor responders.

• 대한의생명과학회지
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• 제9권1호
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• pp.29-36
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• 2003

Progesterone levels in the blood plasma or skim milk of cows are considered to be very useful indicator fur the detection of estrus cycle and early pregnancy diagnosis. During 13 to 14 days after estrus the level of progesterone in plasma or skim milk were not different between the inseminated arid non-inseminated cows. In the pregnant cows the peak level of progesterone reached on 14th day after artificial insemination (AI), but in the absence of conceptus the level declines after the 14th day slowly, and then very rapidly towards the basal level after the 17th day. This low level persists about 4 days, including those of estrus and ovulation a highly characteristic pattern which differs so markedly from that in the pregnant cows. Progesterone levels in blood plasma or skim milk can provided a reliable diagnosis of early pregnancy and monitoring ovarian activity in cows. The mean $\pm$ standard deviation of milk urea nitrogen(MUN) and protein concentration in the cows at 9 herds were 17.7$\pm$2.35 mg/dL and 3.2$\pm$0.17%, respectively. The days of nonpregnant after parturition was shorter in the cows in which the lower level of MUN than higher level of MUN concentration.

• 대한수의학회지
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• 제27권2호
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• pp.347-359
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• 1987

To investigate the changes of pituitary gland associated with ovarian cyst in Korean native cattle, pituitaries and ovaries were collected from 54 Korean native cattle at abbatoir. Pituitaries were stained with HerIant pituitary stain method and all the tissues were examined under light microscope. The results obtained were summarized as follows; 1. The delta cells and beta cells in the pars distalis were dull blue and violet in colors respeetively. Basophil size in the follicular phase and pregnant groups was larger than those of luteal phase and ovarian dysfunction groups. 2. The numbers of delta cells in the pars distalis of follicular cyst group were larger than those of remaining groups (p<0.01). 3. The distribution of delta cells in the acidophil zone was greater than that in the basophil zone of the follicular cyst and follicular phase groups. 4. The granulations of delta cells were more intensive in follicular cyst, follicular phase and pregnancy groups than in luteal phase and ovarian dysfunction groups (p<0.01). 5. The numbers of beta cells in follicular phase and ovarian dysfunction groups were larger than those in luteal phase and follicular cyst groups respectively (p<0.01). 6. In all groups, the distribution of beta cells was greater in basophilic zone than in acidophilic zone (p<0.01).

• 대한한방부인과학회지
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• 제31권3호
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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.

• 대한한방부인과학회지
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• 제27권3호
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• pp.135-142
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• 2014

Objectives: The purpose of this study is to report the effects of herbal medicine on infertility caused by premature ovarian failure. Methods: The patient in this case was 38-year-old female. The patient was diagnosed premature ovarian failure by serum hormone assay. The chief complain is amenorrhea and infertility. She was treated by traditional treatment, such as herbal medicine (Buickjihwang-hwan), acupuncture and moxibustion. Results: After the treatment, the patient recovered the menstrual cycle and became pregnancy and delivery. Conclusions: This case shows that traditional Korean treatment might be effective in infertility caused by premature ovarian failure.

• Clinical and Experimental Reproductive Medicine
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• 제48권3호
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• pp.198-202
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• 2021

Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.319-322
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• 2020

Adrenal rest tumors are a rare extra-adrenal complication of congenital adrenal hyperplasia (CAH) in women although they are more commonly found in the testes of male patients with CAH. An ovarian adrenal rest tumor (OART) may coexist with CAH or imitate its symptoms without CAH. In this case report, we present the case of a woman with OART without CAH, whose main complaint was infertility and who had a baby after successful surgical treatment.