• 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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• 제44권1호
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• pp.33-39
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• 2017

Objective: The aim of this study was to assess the changes of follicular fluid (FF) and serum levels of cerebellin precursor protein 1 (cbln1) and betatrophin in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a gonadotropin-releasing hormone (GnRH) antagonist protocol. Methods: Twenty infertile women with PCOS and 20 control women diagnosed as poor responders undergoing ovarian stimulation with a GnRH antagonist were included. Blood samples were obtained during ovum pick-up. Follicular fluid from a dominant follicle was collected from the subjects. Using enzyme-linked immunosorbent assays, FF and serum levels of cbln1 and betatrophin were measured in both groups of participants. Metabolic and hormonal parameters were also determined and correlated with each other. Results: Both groups of women had similar serum and FF betatrophin levels ($55.0{\pm}8.9ng/mL$ vs. $53.1{\pm}10.3ng/mL$, p=0.11). The serum and FF betatrophin levels of poor responders were found to be similar ($49.9{\pm}5.9ng/mL$ vs. $48.9{\pm}10.7ng/mL$, p=0.22). Conversely, the FF cbln1 levels of PCOS women were found to be significantly higher than the serum cbln1 levels ($589.1{\pm}147.6ng/L$ vs. $531.7{\pm}74.3ng/L$, p<0.02). The FF cbln1 levels of control participants without PCOS were significantly higher than their serum cbln1 levels ($599.3{\pm}211.5ng/L$ vs. $525.3{\pm}87.0ng/L$, p=0.01). Positive correlations were detected among body mass index, insulin resistance, serum insulin, total testosterone, and betatrophin levels in the PCOS group. Conclusion: Follicular fluid betatrophin and cbln1 concentrations may play a pivotal role on follicular growth in PCOS subjects undergoing IVF/ICSI with an antagonist protocol.

• 한국수정란이식학회:학술대회논문집
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• 한국수정란이식학회 2002년도 국제심포지엄
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• pp.112-112
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• 2002

Under normal conditions, women produce a single dominant follicle that participates in a single ovuation each menstrual cycle. But Polycystic ovary syndrome(PCOS) conditions, folliculogenesis does not proceed normally. This condition leads to the accumlation of large numbers of small graffian follicles in which the theca interstitial cells (TIC) produce abnormally large amounts of androgen. PCOS is probably the most common endocrine disorder, affecting women of reprodutive age with 5-10% prevalence estimate. Chronic anovulation, hyperandrogenism, hirsutism, obesity, infertility and polycystic ovaries are clinical hallmarks of women with PCOS. Its etiology remains unknown. To investigate the gene expression pattern of ovary in PCO-induced rat, we used cDNA expression analysis. Total RNA was extracted from the ovary of PCO-induced rat and reverse-transcribed in the presence of［$\alpha$$^{32}$P］-dATP Which were hybridized to Atlas$^{TM}$ Rat Toxicology 1.2 array (Clontech) representing approximately 1176 rat genes. We compared gene expression between ovary of pco-induced immature female rats and control. Differential gene expression profiles were revealed (LIFR-alpha, ADRA1A, Heat shock 90-kDa protein A, PDGFRA). Reverse transcription-polymerase chain reaction(RT-PCR) was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the altered expression of genes and PCO is a matter of further investigation. This study was supported by Korea Science and Engineering Foundation(KOSEF)

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 The 5th Biannual Meeting of Pacific Rim Society for Fertility and Sterility
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• pp.157.2-157.2
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• 2006

• 대한한방부인과학회지
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• 제35권2호
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• pp.87-105
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• 2022

Objectives: The purpose of this study is to analysis the Clinical Study Trends on Korean Medicine Treatment for Polycystic Ovary Syndrome. Methods: The key words such as 'polycystic ovary syndrome', 'polycystic ovarian syndrome', 'korean medicine', 'herbal medicine', 'acupuncture' are used for the research through 'OASIS', 'KCI', 'KISS', 'RISS'. Results: Ten clinical studies with 73 patients were selected. All studies were the noncomparative studies, and 8 case reports, 1 case series, 1 retrospective chart review. Symptoms accompanied by PCOS were oligomenorrhea, amenorrhea, irregular menstruation, hirsutism, acne, obesity etc. The most used treatment was herbal medicine in all studies with 72 patients (98.6%). The most frequently used acupuncture and moxibustion point was respectively 合谷 (LI4) and 關元 (CV4). The duration of treatment was between 3 months and 10 months, the average 159 days. Outcome measurements were Recovery of menstrual cycle (97.6%), Hormone test (23.8%), Sonogram (61.9%), Indexes of obesity (23.8%). In terms of menstrual recovery, 35 patients (85.4%) have recovered from menstruation in 8 studies with 41 patients. In hormone tests, all 10 patients have decrease of LH/FSH ratio and LH in 3 studies with 10 patients. Through sonogram, Ovulation menstruation was confirmed in all 6 patients. In all 10 patients of 3 studies evaluating weight before and after treatment, weight was reduced. Conclusions: The effect on Korean Medicine treatment for Polycystic Ovary Syndrome had mostly positive results. However, Further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Polycystic Ovary Syndrome.

• 한국융합학회논문지
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• 제13권3호
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• pp.337-343
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• 2022

본 연구는 다낭난소증후군 여성의 불안, 우울, 스트레스를 평가하고, 발병 위험인자에 대하여 살펴보고자, 다낭난소증후군 여성을 대상으로 Beck's 우울증(BDI) 및 우울 불안 스트레스 척도(DASS) 설문을 시행하였고, 항뮐러리안호르몬(AMH), 총 테스토스테론, 황체형성호르몬(LH), 난포자극호르몬(FSH), 에스트라디올(E2), 지질대사검사 및 당부하검사(OGTT)를 시행 후 분석하였다. 설문지를 완전히 작성하여 회수된 52명의 환자군과 29명의 건강한 가임기 여성 대조군을 분석하였다. 다낭난소증후군 환자 중 BDI>13점, DASS>10점인 우울증 38.5 %, DASS>8점인 불안 23.1 %, DASS>15점인 스트레스 30.8 %로 대조군에 비해 유의하게 높았다. 총 테스토스테론, LH 및 AMH는 우울증 및 스트레스와 유의한 상관관계를 보였고, 체중 및 체질량지수도 우울증과 유의한 상관관계를 보였다. 당뇨병과 고지혈증으로 진단된 여성에서 우울증과 스트레스가 높았다. 다낭난소증후군 여성은 우울증, 불안 및 스트레스에 더 취약한 것으로 나타나, 조기진단과 치료가 중요하다.

• Clinical and Experimental Reproductive Medicine
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• 제28권2호
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• pp.141-145
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• 2001

Objective: We inversigated Small Heterodimer Partner (SHP) gene mutation in Korean Polycystic Ovarian Syndrome (PCOS) patients. SHP protein regulates the activity of nuclear receptors which regulate the cellular development and differentiation. Recently, the mutation of SHP gene was found in the obesity and diabetes patients in Japanese group, and suggested that its mutation may involved in pathogenic mechanism of PCOS. Methods: This study was performed in 20 PCOS patients and 20 normal women. The DNAs were extracted from the peripheral bloods, and amplified at each exon (1 and 2) of SHP gene by PCR method. Subsequently, each PCR product was digested with the restriction enzyme indicated below for studying restriction fragment length polymorphism (RFLP). After enzyme digestion, the results of RFLP were compared PCOS patients with control women to find any sequence variation. Results: We examined 9 regions of exon 1 with Msp I, Pvu II, Dde I and 3 regions of exon 2 with Pst I, Dde I. There is no heterozygous or homozygous mutation in patients and control women at these restriction sites. Conclusion: The genetic analysis at our restriction sites in the SHP gene did not show any genetic variation in Korean PCOS patients. Our PCR-RFLP analysis was not covered the entire SHP gene (68 bp/1,006 bp), we need to further analysis of the entire SHP gene.

• Clinical and Experimental Reproductive Medicine
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• 제39권4호
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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.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2006년도 The 5th Biannual Meeting of Pacific Rim Society for Fertility and Sterility
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• pp.156.1-156.1
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• 2006

• Applied Microscopy
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• 제41권2호
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• pp.109-116
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• 2011

다낭성 난소증후군(polycystic ovary syndrome, PCOS)은 내분비 및 대사장애로 호르몬 불균형 상태를 야기하여 가임기 여성의 불임 및 여러 합병증을 유발한다. 폐경기 여성의 호르몬대체 치료에 사용되는 estradiol valerate (EV)는 과다 투여 시 PCOS를 유발하는 것으로 알려졌다. 신경성장인자(nerve growth factor, NGF)는 발생 중인 신경세포의 생존과 성숙을 조절하는 인자로 난소에서도 합성되고, EV 처리에 의해 유도된 다낭성난소(polycystic ovary, PCO)에서 발현이 크게 증가하는 것으로 보고됐다. 따라서 본 연구에서는 난소유래 세포인 CHO 세포주와 다낭성 난소를 이용해 호르몬 불균형 상태인 PCOS 진단 시 NGF가 생물학적 표지인자로서 사용될 수 있는 가능성을 규명하고자 하였다. CHO 세포에 EV 2 mg과 3 mg 처리는 초기에 세포증식을 억제했으나 1 mg 처리는 영향을 미치지 않음으로써 실험 시 최적농도로 사용하였다. 하지만 농도별 EV 처리에 따른 CHO 세포의 형태학적 차이는 관찰되지 않았다. CHO 세포에 EV 처리 후 NGF mRNA 및 단백질 발현은 대조군에 비해 30분 후 크게 증가하였고, 다수의 난포낭이 관찰된 PCOS 조직에서도 정상군에 비해 크게 증가하였다. 따라서 이상의 결과들을 종합하면 EV 처리 후 난소에서 유도되는 NGF 과발현은 비정상적 난포발달을 유도하는 인자로 작용할 것으로 보이며, 다낭성난소 진단 시 표지인자로서 사용될 수 있을 것으로 생각된다.