• 한국인구학
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• 제17권2호
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• pp.77-97
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• 1994

Despite the fact that the national family planning program in korea has accomplished its primary goals of fertility reduction and universal contraceptive use, the induced abortion is still high and there has been an increasing trend in the population sex ratio at birth. It seems that the changes in the imbalance of sex ratio have originated from traditonal boy preference. This indicates that much of the current family planning program can be overhauled, so that the program quality could be better controlled, by preventing the number of unwanted pregnancies and the imbalance of sex ratios. This paper aims, therefore, to examine the determinants of induced abortion through the investigation of pregnancy outcomes and their changes over time and to study the interaction between induced abortion, boy preference and the imbalance of sex ratio in Korea. The abortion rate had increased rapidly until the mid-1980s when there were about the same number of abortions as live births. Thereafter, the abortion rate has been maintained at this high level. By parity it shows a much higher abortion rate for a higher parity at all time. From the first parity, the sex composition of previous children stands out as the most important factor in deciding the pregnancy outcome at all time. The probability of a pregnancy ending in an abortion increases substantially when parents already had a son. The decline of the desired family size and the sustained strong son preference has made the sex of children a more important factor in the determination of the pregnancy outcome. Women's education has had consistently positive effects on the probability of a pregnancy ending in an abortion, but the effect shows a steady decline over time. The premarital pregnancy and urban residence also increase the abortion probability. This study suggests that the main concerns of the family planning program should be to strengthen the social support policies so as to weaken the son preference value leading to a balanced sex ratio and prevention of induced abortions.

• 대한한방부인과학회지
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• 제36권3호
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• pp.173-195
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• 2023

Objectives: To investigate and analyze the assessment indicators and tools used in clinical practice to assess Korean medicine (KM) treatment for infertility, and to establish a basis for assessment tools to diagnose and assess infertility. Methods: Relevant studies published until March 2023 were extracted from Pubmed, Research Information Sharing Service, and National Digital Science Library databases. Results: Sixty-four studies comprising 4,105 patients were included. We investigated pregnancy outcomes, and assessed pregnancy- and childbirth-related factors, overall health, reproductive health, and mental health. Pregnancy result was most common primary outcome. Ongoing pregnancy, stillbirth, miscarriage, and ectopic pregnancy rates were suggested as indicators of pregnancy and childbirth-related assessment. Overall health was most commonly assessed with Likert and Visual analogue scale (VAS). Among reproductive health variables, menstrual history was most frequently assessed. Moreover, indicators such as reproductive function, sexual intercourse, and gynecological disease were assessed. The Infertility Stress Scale and the Fertility Quality of Life tool (FertiQoL) were used to assess mental health. Conclusions: Subjective scales and objective assessment tools, such as the Likert scale and blood tests/ultrasonography, respectively, are used to assess KM infertility treatment. Inconsistent assessment tools make quantitative analyses more challenging. The development of a standardized mental and physical function assessment questionnaire with confirmed reliability and validity ensure the effectiveness of KM infertility treatment, and promote future studies on infertility treatment.

• Clinical and Experimental Reproductive Medicine
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• 제44권4호
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• pp.224-231
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• 2017

Objective: We studied the association between sperm DNA fragmentation (SDF) and several clinical in vitro fertilization outcomes. Methods: We retrospectively analyzed 169 consecutive fresh IVF cycles. Semen was collected on the day of oocyte retrieval, and we assessed standard semen parameters and the SDF level (by terminal deoxynucleotidyl transferase dUTP nick-end labeling). Poor ovarian response (POR) was defined as the collection of three or fewer mature oocytes. Oocytes were inseminated by the conventional method or intracytoplasmic sperm injection. Results: SDF did not affect the fertilization or pregnancy rate, but did have a significant effect on the miscarriage rate. In the miscarriage group (n = 10), the SDF level was significantly higher (23.9% vs. 14.1%) and number of mature oocytes was significantly lower (4.3 vs. 7.6) than in the live birth group (n = 45). Multiple regression analysis showed that SDF was an independent predictor of miscarriage (odds ratio, 1.051; 95% confidence interval, 1.001-1.104). The cutoffs for the SDF level and number of mature oocytes that could predict miscarriage were > 13% and ${\leq}3$, respectively. In the low-SDF group (${\leq}13%$), the miscarriage rate was similar in POR patients and those with a normal ovarian response (NOR; 14.2% vs. 4.3%). In the high-SDF group ( > 13%), the miscarriage rate was significantly higher in the POR group than in the NOR group (60.0% vs. 13.3%, p= 0.045). Conclusion: Our study demonstrated that a high SDF level ( > 13%) was associated with a high miscarriage rate, and that it mainly contributed to miscarriage in the POR group. The results suggest that SDF measurements should be considered in couples with POR in order to predict the prognosis of the pregnancy.

• Journal of Nutrition and Health
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• 제33권3호
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• pp.263-270
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• 2000

The purpose of this study was to evaluate the concentration of vitamin B6 in 16 pregnant-infant pairs and 15 nonpregnant women and to investigate the relationships between vitamin B6 status of maternal-umbilical cord plasma and pregnancy outcomes. dietary intake was obtained from semiquantitative frequency questionnaire. The daily mean energy and protein intakes were higher than the recommended dietary allowance, while daily vitamin B6 was only 74% of RDA in pregnant and 73% of RDA in nonpregnant women. The main sources of vitamin B6 were vegetables and fruits in pregnant women, while cereal and starch in nonpregnant women. The plasma PLP and PL levels of pregnant women were 14.85nmol/l and 20.56nmol/l, significantly lower than those of nonpregnant women. the PLP/PL ratios of pregnant and nonpregnant women were 1.65 and 0.33, indicating that the levels of vitamin B6 was altered during pregnancy. The PLP and PL levels of umbilical cord plasma were 63.55nmol/l and 32.25nmol/l, respectively. The vitamin B6 levels of umbilical cord plasma were significantly higher than that of maternal plasm. This finding indicates that the uptake of vitamin B6 in the fetus may be due to an active placental transport mechanism. The PLP level of maternal plasma correlated positively with that of umbilical cord plasma, showing the PLP concentration of umbilical cord plasma is affected by maternal vitamin B6 status. The maternal plasma PL level showed a positive correlation to infant birth weight. The positive association has bee also found between plasma PL level of umbilical cord and Apgar 1 min score.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1609-1613
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• 2015

Purpose: To determine the rate of lymph node metastasis, oncologic and pregnancy outcomes in apparent early-stage malignant ovarian germ cell tumor (MOGCT). Materials and Methods: Medical records of apparent early-stage MOGCT patients undergoing primary surgical treatment at Siriraj Hospital, Bangkok, Thailand, between January 2006 and December 2013, were retrospectively reviewed. Results: Thirty-eight patients had apparent stage I-II MOGCT. The mean age was $22.1{\pm}7.7years$ (median, 20.8 years; range, 7.7-35.6 years). The mean tumor size was $17.8{\pm}6.5cm$ with a median of 20 (range 4-30) cm. Three most common histopathologies were dysgerminoma (12 patients, 31.6%), immature teratoma (12 patients, 31.6%), and endodermal sinus tumor (6 patients, 15.8%). Twenty-seven of 38 patients underwent lymphadenectomy; 13 patients (48.2%) were stage IA and 8 patients (29.6%) were stage IC. The rate of retroperitoneal nodes metastasis was 7.4% (2/27 patients). At 26.1 months of median follow-up time (range 1.9-88.5 months), 9 patients retained fertility functions, with uneventful pregnancies in 3 of these. Only one patient (2.6%) had progression of disease at 4.9 months after surgery. The 5-year survival rate was 97.4%. Conclusion: As the rate of pelvic or para-aortic node metastasis in MOGCT is considerable, lymphadenectomy should be incorporated in surgical staging procedures.

• Clinical and Experimental Reproductive Medicine
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• 제29권4호
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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.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.233-239
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• 2016

Objective: Uterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on in vitro fertilization outcomes via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate. Results: A total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n = 681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25-2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n = 1,020; OR, 1.57; 95% CI, 0.92-2.67) or the miscarriage rate (n = 456; OR, 0.76; 95% CI, 0.44-1.33). Conclusion: The results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• 한국동물생명공학회지
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• 제38권3호
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• pp.151-157
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• 2023

Background: The potential impact of aqueous extracts from Psidium guajava leaves on the reproductive system of female rabbits was evaluated. Methods: Twenty-eight rabbits, aged five to six months were utilized. Rabbits were divided into four groups and were randomly assigned to receive one of the following oral doses of the guava leaf extracts: 0 (control group), 10, 20, or 30 mg/kg of body weight. After a treatment period of 30 days, blood was collected via jugular venipunture and the serum was extracted for the assessment of serum biochemical traits levels. The females were bred and monitored throughout their pregnancy to ascertain reproductive outcomes. Results: The results indicated that the guava leaf extract significantly increased the body weight of the rabbits during both pre- and post-pregnancy compared to the control group (p < 0.05). The litter size at three weeks post-birth, prolificity rate, FSH, LH, and protein levels were notably higher (p < 0.05) at a dose of 20 mg/kg of body weight. The viability rate three weeks post-birth increased with escalating extract doses, and the highest values were observed at doses of 20 and 30 mg/kg of body weight (p < 0.05). Conclusions: This study demonstrated that, the aqueous extract of guava leaves appears to stimulate the production of FSH, LH and enhance body weight, prolificity, and pregnancy outcomes in mammals. As such, it is suggested that a dose of 20 mg/kg body weight could be beneficial in improving the reproductive performance of female.

• Clinical and Experimental Reproductive Medicine
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• 제51권2호
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• pp.158-162
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• 2024

Objective: The aim of this study was to compare the outcomes of in vitro fertilization (IVF) in patients with a poor ovarian response who used methyltestosterone, versus those using a placebo, in an infertility clinic setting. Methods: This clinical trial included 120 women who had undergone IVF with intracytoplasmic sperm injection due to poor ovarian reserve and infertility. The study took place at the Yas Infertility Center in Tehran, Iran, between January 1, 2018 and January 1, 2019. In the intervention group, 25 mg of methyltestosterone was administered daily for 2 months prior to the initiation of assisted reproductive treatment. The control group was given placebo tablets for the same duration before starting their cycle. Each group was randomly assigned 60 patients. All analyses were performed using SPSS ver. 23 (IBM Corp.). Results: The endometrial thickness in the intervention group was 7.57±1.22 mm, whereas in the control group, it was 7.11±1.02 (p=0.028). The gonadotropin number was significantly higher in the control group (64.7±13.48 vs. 57.9±9.25, p=0.001). However, there was no significant difference between the two groups in the antral follicular count. The chemical and clinical pregnancy rates in the intervention group were 18.33% and 15% respectively, compared to 8.33% and 6.67% in the control group. The rate of definitive pregnancy was marginally higher in the intervention group (13.3% vs. 3.3%, p=0.05). Conclusion: The findings of this study suggest that pretreatment with methyltestosterone significantly increases endometrium thickness and is associated with an increase in the definitive pregnancy rate.