Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.
Copper T 380A intrauterine devices were inserted to nine thousand and nine hundred twenty women by 51 KAVS-member physicians since January 1, 1993 through December 31, 1993. This study was undertaken for the clinical analysis on a total of 9,920 women wearing Copper T 380A to grasp the effectivness as well as the expulsion rate due to a various side effects. The following features were the results of the study: 1. During the twelve months period, from January 1993 to December 1993, the largest number of IUD insertion per one physician is 740 cases and the smallest number 60 cases, the mean 195 cases. 2. After insertion of Copper T 380A, a total of 117 cases were removed the IUD;81 cases(0.8%) were due to extensive bleeding and 36 cases(O.36%) were due to pain. The pregnancy failure rate represented comparatively lower rate, 0.08% (8 cases) and the expulsion rate was 0.06%(6 cases). 3. The removal rate of Copper T 380A was different by physicians. The highest removal rate for bleeding was 3.13% and 13 physicians(25.5%) did not experience any bleeding cases. 4. For the removal rate for pain, 30 physicians(58.8%) did not experience any removal of IUD due to pain while 21 physicians(41.2%) removed IUD due to pain: 17 physiciansC33.4 %) had 0.1-1.5% of removal rate and 4 physiciansC7.0%) had 1.6-2.1% of removal rate. 5. A total of 43 physicians(84.3 %) did not experience any pregnancy failure case while 8 (15.7%) physicians was experienced pregnancy failure rate. Four physicians(7.8%) had 0.1-0.5% of pregnancy failure rate and 4 physicians had 0.6-1.0% of pregnancy failure rate. 6. Expulsion rate showed comparatively lower, 0.06% in this study. A total of 45 physicians (88.2%) did not experience any expulsion cases while 6 physicians(11.7%) had expulsion rate with the highest expulsion rate of 2.0%.
Journal of agricultural medicine and community health
/
v.7
no.1
/
pp.74-79
/
1982
Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.
Objective: This study was carried out to establish the effectiveness of the vitrification method and the optimal cryoprotectants in the cryopreservation of human embryonic stem cells (ESC). Materials and Methods: Human ESC clumps established at Seoul National University Hospital (SNUhES 1) were cryopreserved with the vitrification method using the EM grid. EDS and EFS40 were used as vitrification solutions. Results: Between the EDS and EFS40 groups, there was no significant difference in the recovery rate after cryopreservation of human ESC. The formation rates of ESC colonies in the vitrified groups were significantly lower than those in the control ESC group (p<0.05, p<0.05). In addition, the formation rate of ESC colonies in the EDS group was significantly higher than that in the EFS40 group (p<0.05). The ESC colonies in the vitrified groups were significantly smaller after culture duration of 2 and 4 days, respectively, compared with the control ESC group (p<0.1, p<0.05). However, these effects could be reduced to nonsignificant level by the additional culture of ESC colonies. The vitrified human ESC retained the properties of pluripotent cells, including the expression of cell surface. markers for the undifferentiated cells such as alkaline phosphatase and SSEA-4 (stage-specific embryonic antigen-4), and the expression of transcription factor Oct-4 (octamer-binding transcription factor-4), and the normal karyotype. Conclusion: The vitrification method using the EM grid and EDS solution was confirmed to be very effective for the cryopreservation of human ESC.
Lee, Sun-Hee;Lee, Hyoung-Song;Lim, Chun Kyu;Park, Yong-Seog;Yang, Kwang Moon;Park, Dong Wook
Clinical and Experimental Reproductive Medicine
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v.40
no.3
/
pp.122-125
/
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.
Objective: Human embryonic stem cells (hESCs) have the capacity to differentiate into all of the cell types and therefore hold promise for cell therapeutic applications. In order to utilize this important potential of hESCs, enhancement of currently used technologies for handling and manipulating the cells is required. The cryopreservation of hESC colonies was successfully performed using the vitrification and slow freezing-rapid thawing method. However, most of the hESC colonies were showed extremely spontaneous differentiation after freezing and thawing. In this study, we were performed to rapidly collect of early passage hESCs, which was thawed and had high rate of spontaneously differentiation of SNUhES11 cell line. Methods: Four days after plating, partially spontaneously differentiated parts of hESC colony were cut off using finely drawn-out dissecting pipette, which is mechanical separation method. Results: After separating of spontaneously differentiated cells, we observed that removed parts were recovered by undifferentiated cells. Furthermore, mechanical separation method was more efficient for hESCs expansion after thawing when we repeated this method. The recovery rate after removing differentiated parts of hESC colonies were 55.0%, 74.5%, and 71.1% when we have applied this method to three passages. Conclusion: Mechanical separation method is highly effective for rapidly collecting and large volumes of undifferentiated cells after thawing of cryopreserved early passage hESCs.
This survey was carried out to investigate the occurrence of reproductive disorders in Korean native cattle (Hanwoo). The general management status such as barn type, feed intake, parity and type of reproductive disorders were examined in the Hanwoo farms. In this survey, the total incidence of reproductive disorders that was assessed from 54 Hanwoo farms was 11.6% (73/ 631). We first examined the incidence of reproductive disorders following herd size per farm. The rates of reproductive disorders in under 10 heads, 10 to 20 heads and over 20 heads were 25.2%, 9.4% and 8.3%, respectively (P<0.05). The rate of reproductive disorders in tie stall barn was significantly (P<0.05) higher than that in free stall barn (14.9% vs. 8.1%). The major types of reproductive disorders were follicular cysts (21.8%), fat necrosis (21.8%), and repeat breeding (17.8%). The rate of reproductive disorders assessed by the parity tended to decrease as the parity increased. The relationship between incidence of reproductive disorders and body condition score (BCS) was investigated in 203 Hanwoo. The incidence of reproductive disorder was 80.0%, 8.8%, 9.4%, 10.0%, 33.3% and 57.1% at 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0 of BCS, respectively. These data show that the increase of herd size, barn type and BCS affect the incidence of reproductive disorders such as follicular cysts, fat necrosis and repeat breeding in Hanwoo.
A field survey was conducted to obtain the data on reproductive performation of Korean native cattle. The data for this study were taken from 6,461 breeding records of cows raising at general farms in 8 Hanwoo(native cattle) pure breeding areas from June, 1984 through November, 1985. The recycling rate within 30 days, 31 to 60 days, and 61 to 90 days postpartum was 7.5%, 40.0%, and 32.8%, and it amounted to 80.3%, while the non-recyling rate up to 120days postcalving was 8.4%. Conception rate according to insemination(AI) frequencies was 65.7% at 1st AI, 21.3% at 2nd AI, and 8.4% at 3rd AI, respectively. It amounted to 95.4% up to 3rd AI. Clving rate during the spring time was the highest, 39.6%, and tended to be reduced according to summer(31.6%), autumn (16.3%), and winter (12.5%). Spring and summer were the highest seasons for pregnancy and their gestation rates are 33.7% in spring and 39.2% in winter, respectively. The days from calving to estrus and conception, and calving interval of the cows, which calved two or three times, tended to be reduced. However, the more parities, the more they are extended. According to parities, gestation length and services per conception showed irregular tendencies.
Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.
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.
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