• The Journal of Korean Medicine
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• v.43 no.2
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• pp.42-50
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• 2022

Objectives: The purpose of this study is to investigate the characteristics of female infertility patients who come to Korean medicine clinics and analyze the trends of Korean medicine treatment methods and the effects of female infertility by registry data. Methods: We are recruiting study participants from Korean medicine hospitals and clinics. If female infertility patients come, we will ask them to register for this study. After enrollment, we will collect demographic information, treatment methods, pregnancy results, adverse events, and treatment costs. Result: First, we will analyze the characteristics of patients, the status of the use of Korean medicine treatment interventions, the cost status of Korean medicine infertility treatment, and the delivery characteristics of pregnant women after Korean medicine treatment. Second, we will analyze the effectiveness of Korean medicine treatment. The primary outcome is clinical pregnancy rate, and secondary outcomes are 12-week pregnancy maintenance rate, degree of dysmenorrhea and premenstrual syndrome, stress level, and health-related quality of life score. Discussion: This study is the first observational multi-center study in Korea for female infertility. By establishing the registry, we are creating a resource that contains patient-reported outcome measures for female infertility. The registry is expected to provide valuable data for developing Korean medicine Clinical practice guidelines for female infertility.

• 월간산업보건
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• s.351
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• pp.52-62
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• 2017

• Clinical and Experimental Reproductive Medicine
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• v.45 no.3
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• pp.129-134
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• 2018

Objective: In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET). Methods: Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole $40{\mu}m$ in diameter was made in the drilling group. Results: A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar ${\beta}$-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than $17{\mu}m$) according to the LAH method. Conclusion: The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.

• Clinical and Experimental Reproductive Medicine
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• v.45 no.3
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• pp.122-128
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• 2018

Objective: To determine whether fragment removal on in vitro fertilization (IVF) day 2 improved the subsequent development and pregnancy outcomes of fragmented embryos compared to similar-grade embryos without fragment removal. Methods: This study was a retrospective analysis involving 191 IVF cycles in which all embryos had over 10% fragmentation (grade 3 or 4) on day 2 of the IVF-embryo transfer cycle from March 2015 to December 2017. IVF cycles were divided into the fragment removal group (n = 87) and the no fragment removal group (n = 104) as a control cohort. Before fragment removal, embryos with fragmentation on day 2 were incubated in $Ca^{2+}$- and $Mg^{2+}$-free biopsy medium under paraffin oil for 30 minutes. Microsurgical fragment removal was performed with later-assisted hatching and a handmade suction micropipette that had an outer diameter of $30{\mu}m$. Results: There were no significant differences in the characteristics of the patients between the control and the fragment removal groups. After fragment removal and subsequent in vitro culture for 24 hours, the number of blastomeres ($7.1{\pm}1.7$ vs. $6.9{\pm}1.6$) was comparable between the transferred embryos in the two groups, but the morphological grade of the embryos in the fragment removal group ($1.9{\pm}0.7$) was significantly higher than that of the control group ($3.1{\pm}0.5$, p< 0.01). The clinical pregnancy (43.7%) and implantation rates (25.8%) in the fragment removal group were significantly higher than those in the control group (28.8% and 14.0%, respectively; p< 0.05). Conclusion: Early fragment removal on day 2 significantly improved the subsequent development and pregnancy outcomes of fragmented embryos.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.374-383
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• 2018

Background/Aims: There have been numerous efforts to reduce mother-to-child transmission (MTCT) of hepatitis B virus (HBV) with antiviral agents during pregnancy. However, there are limited data regarding the outcomes of pregnant women after delivery. This study was performed to evaluate the efficacy of antiviral agents in preventing MTCT of HBV and maternal long-term outcomes. Methods: The HBV-infected pregnant women treated with antiviral agents to prevent MTCT were retrospectively reviewed. Forty-one pregnant women who received telbivudine or tenofovir during late pregnancy (28-34 week) were analyzed. Hepatitis B virus surface antibody (HBsAb) positivity was tested in 43 infants after 7 months of birth. Eleven mothers were followed >1 year after delivery. Results: The mean HBV DNA titer before antiviral therapy was 8.67 (6.60-9.49) log copies/mL, and the median age at delivery was 32 years (range, 22-40). Eleven patients were treated with tenofovir and 30 with telbivudine. The median duration was 57 days (range, 23-100), and the median HBV DNA titer at birth was 5.06 log copies/mL (range, 2.06-6.50). Antiviral treatments were associated with significant HBV DNA reduction (P<0.001). Among 43 infants (two cases of twins), HBsAb was not detected in two, subsequently confirmed to have HBV infection. Biochemical flare was observed in two of 11 mothers followed >12 months, and an antiviral agent was administered. Conclusions: Antiviral treatment during late pregnancy effectively reduced MTCT. Long-term follow-up should be required in such cases. In addition, given that maternal biochemical flare occurred in 18% of mothers, re-administration of antiviral agents might be required.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.4
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• pp.78-95
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• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.

• The Journal of Korean Medicine
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• v.36 no.2
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• pp.1-7
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• 2015

Objectives: To report on the result of infertility treatment with Korean medicine in clinical settings. Methods: This study was single arm, retrospective observational study. Analysis of the medical records on thirty four infertile women who were treated by acupuncture, moxibustion, herbal medicine(Jokyungjongoktang-gagambang, Sutaehwan-gagambang). Pregnancy rate(PR) and Live birth rate(LBR) were analyzed as the primary outcomes. Changes of AMH, FSH, LH, $E_2$, $P_4$, endometrial thickness, fat mass, and BMI were also analyzed as the secondary outcomes. Results: A total of 34 patients were treated in the traditional Korean medical clinic. Nine patients were dropped, and 25 subjects completed the final examination at the end of this treatment schedule. Five of 25 subjects conceived during treatment, reaching 20% PR and LBR was also 20%. Except for FSH level, the results of the remaining outcome measures, including LFT, showed no significant changes. No serious adverse event has been reported. Conclusion: Although no significant changes in bio-markers were observed, complex treatment using Korean medicine has shown effectiveness on women's infertility. In addition, the safety of the treatment has been verified.

• Women's Health Nursing
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• v.27 no.1
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• pp.27-39
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• 2021

Purpose: This study aimed to review recent findings from birth cohort studies on maternal and child environmental health. Methods: Birth cohort studies regarding environmental health outcomes for mothers and their children were investigated through a systematic review. A literature search was conducted in PubMed, CINAHL, the Cochrane Library, Embase, and RISS to identify published studies using the keywords using a combination of the following keywords: maternal exposure, environmental exposure, health, cohort, and birth cohort. Articles were searched and a quality appraisal using the Newcastle-Ottawa Scale for cohort studies was done. Results: A review of the 14 selected studies revealed that prenatal and early life exposure to environmental pollutants had negative impacts on physical, cognitive, and behavioral development among mothers and children up to 12 years later. Environmental pollutants included endocrine disruptors, air pollution (e.g., particulate matter), and heavy metals. Conclusion: This systematic review demonstrated that exposure to environmental pollutants negatively influences maternal and children's environmental health outcomes from pregnancy to the early years of life. Therefore, maternal health care professionals should take steps to reduce mothers' and children's exposure to environmental pollutants.

• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.517-524
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• 2012

Purpose: To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy. Methods: A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital. Results: There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ${\geq}25$ was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group. Conclusion: The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.4
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• pp.240-246
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• 2016

Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.