• Clinical and Experimental Reproductive Medicine
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• 제37권1호
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• pp.65-72
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• 2010

목 적: 본 연구는 체외수정술에서 배양 3일째 2개의 난할단계 배아 (2ET)와 3개의 난할단계 배아 (3ET)를 이식했을 때 각각의 임신성적을 비교하기 위하여 시행하였다. 연구방법: 2007년 1월부터 2009년 6월까지 한 명의 불임전문 의사에게 시술받은 2ET군 100명을 환자의 나이와 체외수정 주기의 특성을 고려하여 3ET군 100명과 비교한 후향적 환자군-대조군 연구를 시행하였으며, 두 군 모두 양질의 배아만을 이식하였다. 각각의 임신율, 착상율, 다태임신율을 비교하였다. 결 과: 환자의 특성, 체외수정 주기 및 배아의 특징은 두 군 간에 차이를 보이지 않았다. 2ET군과 3ET군 모두 비슷한 임신성적을 보여주었다; 착상율 (41.0% vs. 35.3%), 임신율 (58.0% vs. 60.0%), 임상적임신율 (55.0% vs. 59.0%), 진행임신율 (51.0% vs. 55.0%). 두 군 모두 높은 다태임신율을 보여주었으나, 3ET군에서 유의하게 더 높은 전체 다태임신율과 삼태임신율을 보여주었다 (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036). 결 론: 나이가 ��고 양질의 배아를 가진 좋은 예후를 예측할 수 있는 여성에서 체외수정술 시행 시 배양 3일째 2개의 배아를 이식하더라도 3개의 배아를 이식했을 때와 비슷한 임신성적을 얻을 수 있고, 다태임신 (특히, 삼태임신)을 줄일 수 있다.

• 대한간호학회지
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• 제42권4호
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• pp.477-485
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• 2012

Purpose: This study was done to evaluate the effects of antenatal depression on birth outcomes. Methods: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. Results: Level of antenatal depression was associated with low birth weight ($x^2$=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. Conclusion: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy $BMI{\geq}23kg/M^2$ should be monitored and managed to ensure favorable birth outcomes.

• Journal of Gastric Cancer
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• 제16권4호
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• pp.271-276
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• 2016

Pregnancy-associated gastric cancer is extremely rare. In many cases, it is diagnosed at an advanced stage because the symptoms during pregnancy are generally overlooked. We report three cases of gastric cancer during pregnancy with various outcomes. The first case included a patient with stage IV gastric cancer who received palliative chemotherapy. This patient had a preterm birth and died 7 months after diagnosis. The second case received neoadjuvant chemotherapy during pregnancy and a total gastrectomy was performed after delivery. She then received adjuvant chemoradiotherapy. This patient developed pulmonary metastasis and died of recurrence 41 months after surgery. In the third case, a distal subtotal gastrectomy was performed at week 14 of pregnancy, with no complications. The patient received adjuvant chemoradiotherapy. She is currently without recurrence 14 months after surgery. In patients with pregnancy-associated gastric cancer, treatment decisions are predominantly influenced by clinical stage and gestational age at diagnosis.

• Clinical and Experimental Reproductive Medicine
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• 제20권1호
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• pp.71-78
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• 1993

Since the successful advent of IVF-ET, reproductive surgeons have been forced to compare pregnancy outcomes of surgical procedures for tubal infertility with those of IVF-ET. The current study was designed in an effort to determine the usefulness of pre-operative infertility work-up, especially diagnostic laparoscopy, in predicting the pregnancy rate and in assessing the reversal feasibility. 109 patients who underwent a microsurgical tubal reversal were reviewed. The patients were followed over one year. The total intrauterine pregnancy, spontaneous abortion, and ectopic pregnancy rates were 66.4%, 3.7%, and 7.3%, respectively. The result showed that the use of loupe might increase the chance of the ectopic pregnancy. I found that the final tubal length, especially the longest tubal length, the site of reanastomosis, and the methods of sterilization affected the pregnancy rates. A 85% intrauterine pregnancy rate was achieved in the patients with good preoperative assessments(Group II-1). There was only 10% incidence of intrauterine pregnancy in the patients with bad assessments(Group II-2). It is concluded that the pre-operative infertility work-up, especially diagnostic laparoscopy, is a good diagnostic tool in assessing the reversal feasibility.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1357-1362
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• 2016

Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Sixty-three patients met the criteria. The median age was 30.0 years and almost 90% were referral cases. Nearly 40% of the studied patients presented with vaginal bleeding while 22.2% were asymptomatic. The most common antecedent pregnancy was hydatidiform mole (57.1%) followed by term pregnancy (20.6%). The median interval time from antecedent pregnancy to the development of GTN was three months and the median pretreatment B-hCG was 58,274 mIU/ml. Stage III (74.6%) was the most common staging followed by stage IV (20.6%) and stage II (4.8%). The most frequent surgery was hysterectomy (31.7%). Thoracotomy and craniotomy were performed in three and two patients, respectively. The most common first line chemotherapy regimen was methotrexate and folinic acid (36.5%) followed by EMA (etoposide, methotrexate, actinomycin D) (34.9%), EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (17.5%) with the remission rate of 66.7%. Nearly one-third of the patients were given a subsequent chemotherapy regimen after failure with the first line therapy and showed a final response rate of 73.0%. However, in stage IV, the response to first line treatment was only 38.5%. In conclusion, the outcomes of metastatic GTN were poor especially with the higher stages.

• Clinical and Experimental Reproductive Medicine
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• 제28권4호
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• pp.307-315
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• 2001

Objective: To evaluate the clinical outcomes and influencing factors of in vitro fertilization and embryo transfer (IVF-ET) in patients with failed pregnancy after microsurgical reversal of tubal sterilization. Materials and Methods : From January, 1997 to December, 2000, IVF-ET was performed in two groups; the study TR (tubal reanastomosis) group consisted of 147 cycles in 66 patients with failed microsurgical reversal of tubal sterilization, and the control group of 115 cycles in 67 patients with bilateral tubal occlusion (BTO). The two groups were evaluated and compared for clinical characteristics, clinical pregnancy rates, and factors influencing the outcomes of IVF-ET. Results: Compared with the control BTO group, age and the previous parity were significantly higher ($36.3{\pm}2.7$ vs. $33.6{\pm}2.0$ years, p<0.05; $1.6{\pm}0.7$ vs. $0.2{\pm}0.4$, p<0.05), and the clinical pregnancy rate per cycle was significantly lower (23.8% (35/147) vs. 29.3% (34/115), p<0.05) in the TR group. Difference in the clinical pregnancy rates was age-related, since there was no significant difference between the two groups, except for the previous parity ($1.6{\pm}0.7$ vs. $0.1{\pm}0.3$, p<0.05), when the patients aged 37 years or older were excluded. No difference was found in terms of the following: the proportion of controlled ovarian hyperstimulation (COH) cycles with GnRH agonist ultrashort protocol, the duration of COH, the dosage of gonadotropins used, and the numbers of oocytes retrieved and of embryos transferred, irrespective of age correction. Conclusions: The outcomes of IVF-ET following the failed microsurgical reversal of tubal sterilization depend upon patient age. The previous fertility of patients does not seem to be a factor of better IVF-ET prognosis.

• Clinical and Experimental Reproductive Medicine
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• 제43권2호
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• pp.126-132
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• 2016

Objective: The purpose of this study was to identify useful clinical factors for the identification of patients with polycystic ovary syndrome (PCOS) who would benefit from in vitro maturation (IVM) treatment without exhibiting compromised pregnancy outcomes. Methods: A retrospective cohort study was performed of 186 consecutive patients with PCOS who underwent human chorionic gonadotropin-primed IVM treatment between March 2010 and March 2014. Only the first IVM cycle of each patient was included in this study. A retrospective case-control study was subsequently conducted to compare pregnancy outcomes between IVM and conventional in vitro fertilization (IVF) cycles. Results: Through logistic regression analyses, we arrived at the novel finding that serum $anti-M{\ddot{u}}llerian$ hormone (AMH) levels and the number of fertilized oocytes in IVM were independent predictive factors for live birth with unstandardized coefficients of 0.078 (95% confidence interval [CI], 1.005-1.164; p=0.037) and 0.113 (95% CI, 1.038-1.208; p=0.003), respectively. Furthermore, these two parameters were able to discriminate patients who experienced live births from non-pregnant IVM patients using cut-off levels of 8.5 ng/mL and five fertilized oocytes, respectively. A subsequent retrospective case-control study of patients with PCOS who had serum AMH levels ${\geq}8.5ng/mL$ showed that IVM had pregnancy outcomes comparable to conventional IVF, and that no cases of ovarian hyperstimulation syndrome were observed. Conclusion: Serum AMH levels are a useful factor for predicting pregnancy outcomes in PCOS patients before the beginning of an IVM cycle. IVM may be an alternative to conventional IVF for PCOS patients if the patients are properly selected according to predictive factors such as serum AMH levels.

• Clinical and Experimental Reproductive Medicine
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• 제40권3호
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• pp.122-125
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• 2013

Objective: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.

• 대한지역사회영양학회지
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• 제8권2호
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• pp.138-148
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• 2003

Morning sickness during pregnancy is a very common functional problem with different kinds of symptom, but little data are available concerning the nutrition intervention program fur pregnant women in local area. A total of 152 pregnant women who had experienced morning sickness were surveyed to investigate the relationships between morning sickness, nutrient intakes and pregnancy outcome. The results showed that prevalent symptoms were nausea (68.4%), heartburn (59.2%), morning sickness (48.7%), vomiting (42.1%), and constipation (44.7%). The onset of the symptom occurred during the first 3 months (9.3 $\pm$ 2.3 weeks) ; 21.1% of the subjects was experienced two symptom at the same time. This significantly correlated with vomiting (p < 0.01), nausea (p < 0.001), morning sickness (p < 0.001), and heartburn (p < 0.01) with pregnancy weight. There were also correlations between the four symptoms and nutrient intakes. Mean birth weight of 21 newborns was 3.06 $\pm$ 0.42 kg, and the one and five minutes of Apgar scores were 7.74 $\pm$ 0.99 and 8.84 $\pm$ 0.69, respectively. There were negative correlations between vomiting and pregnancy outcomes (p < 0.05). Our data support that morning sickness, especially vomiting during pregnancy is associated with Apgar score and body weight of newborn. (Korean J Community Nutrition 8(2) : 138~148, 2003)

• 대한지역사회영양학회지
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• 제14권3호
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• pp.327-339
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• 2009

It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with various sociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102-item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake ${\le}$ EAR, group II: EAR < Fe supplement intake ${\le}$ 3 times of EAR, group III: 3 times of EAR < Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5 ${\pm}$ 38.6 mg/day, 30s: 77.3 ${\pm}$ 47.8 mg/day, p < 0.0116) and experience of childbirth (1st pregnancy: 70.9 ${\pm}$ 41.2 mg/day, 2nd pregnancy: 64.5 ${\pm}$ 39.5 mg/day, ${\ge}$ 3rd pregnancy: 94.4 ${\pm}$ 63.8 mg/day, p < 0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.