• Clinical and Experimental Reproductive Medicine
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• 제41권2호
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• pp.75-79
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• 2014

Objective: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. Methods: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. Results: Body fat mass was significantly lower in pregnant women than in non-pregnant women ($15.61{\pm}3.65$ vs. $18.78{\pm}5.97$, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient${\geq}0.277$, t-value ${\geq}2.537$; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. Conclusion: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.80-84
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• 2021

Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas. Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups. Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all). Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.

• Clinical and Experimental Reproductive Medicine
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• 제38권3호
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• pp.168-173
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• 2011

Objective: To examine the association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and hyperhomocysteinemia in women with unexplained recurrent miscarriages (RM) and to investigate the association between MTHFR genotype variants and alloimmune activation, proportion of peripheral blood natural killer (pbNK) cells. Methods: A total of 39 patients with a history of two or more unexplained miscarriages were recruited to this study. The controls were women who had a live birth without a history of RM (n=50). The proportion of pbNK cells was measured by flow cytometry. Plasma homocysteine levels and the incidence of the MTHFR variant of the RM and control groups were compared. The proportion of pbNK cells was compared to the MTHFR variants in the RM group. Results: No differences were found between the two groups' mean plasma homocysteine levels ($7.6{\pm}1.5{\mu}mol$/L vs. $7.1{\pm}2.1{\mu}mol$/L) or incidence of the MTHFR genotype variant (CC, 35% vs. 33%; CT, 40% vs. 53%; and TT, 25% vs. 14%). In the RM group, individuals with the TT variant ($7.7{\pm}1.1{\mu}mol$/L) had higher homocysteine levels than those with the CC and CT variants ($7.4{\pm}1.9{\mu}mol$/L and $7.4{\pm}1.2{\mu}mol$/L) and those with the CT variant ($19.2{\pm}8.1%$) had a higher proportion of CD3-/CD56+ pbNK cells than those with the CC and TT variants ($17.7{\pm}6.6%$ and $17.9{\pm}7.0%$), but the results of both comparisons were statistically insignificant. Conclusion: These preliminary results show no difference in plasma homocysteine levels between the RM and control groups or among MTHFR genotype variants in the RM group, which may suggest that the plasma homocysteine level is difficult to use as a predictive marker of RM in the Korean population. A study of a larger number of patients is needed.

• Clinical and Experimental Reproductive Medicine
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• 제27권1호
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• pp.111-116
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• 2000

IVF-ET therapy was originally developed as a method for treating patients with absolute mechanical infertility for whom spontaneous conception is almost impossible. Objective: To report that the recent IVF-ET is now applied to couples not only untreatable tubal infertility but also peritubal periovarial adhesions, endometriosis, male-related or unexplained infertility. Material and Method: Case report. Result: We experienced 5 Pregnancies after unsuccessful IVF-ET attempt with additional non IVF-ET therapy or without therapy. Conclusions: The follicular puncture and ovarian enlargement may result in restoration of pituitary-ovarian axis and peritoneal environment in infertility patients.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 1997년도 제34차 추계 학술대회
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• pp.66-67
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• 1997

• Journal of Medicine and Life Science
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• 제20권4호
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• pp.158-165
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• 2023

This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

• 대한한의학회지
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• 제27권2호
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• pp.44-56
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• 2006

Objectives : This study was to analyze the status of patients with infertility in the department of oriental gynecology in an oriental medical hospital and propose infertility treatment in oriental medicine. Methods : This study was presented with 2,153 cases of infertile women who had visited the department of oriental gynecology in one oriental hospital in Seoul from 2002 to 2004. Results : The total number infertile patients has decreased year by year. The age range of patients was getting higher and the age group between 30 and 35 took up about one half of the total patients. The duration of infertility for less than 3 years held about 50-60% of the total patients, and the mean duration of infertility was $39.18{\pm}29.57$ months (2004). The most common occupations of females were professionals or administrative managers. The secondary infertility was increasing and unexplained infertility increased from 38.2% (in 2002) to 54.4% (in 2004). However the duration of treatment was shorter. This shows that the age range of the patients having oriental-medicine treatment is gradually getting higher and the number of the patients having oriental-medicine treatment and compliance is decreasing. Conclusions : More studies about objectification of oriental medicine need to precede any other studies. Then, it is thought to be necessary to rebuild cooperative relationships between oriental & western medicine through systematic research and political supports and to establish firm foundations of oriental medicine.

• Clinical and Experimental Reproductive Medicine
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• 제20권1호
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• pp.45-51
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• 1993

Micromanipulation procedures have been used to improve fertilization rates in patients with male factor or with unexplained infertility. Partial zona disseetion(PZD), a method using mechanical force to open the zona pellucida increase the chances of fertilization. The purpose of this study is to increase rates of fertilization and pregnacy in the ART program by using PZD. The influence of PZD on the fertilization rate was investigated in 57 couples with semen defects, antisperm antibodies(ASA), or unknown factors. PZD directly performed in 35 couples with a history of fertilization failure in previous cycle (Group 1), and PZD applied in 22 couples with the failure of initial fertilization in the same cycle (Group 2). The fertilization rates of the male facor, ASA positive factor and unknown factor in Group 1 were 37.6%, 20.0% and 59.2%, respectively. The rates of fertilization of male factor, ASA positive factor and unknown factor in Group 2 were 34.8%, 20.0% and 26.5%, respectively. The incidences of polyspermy in Group 1 and Group 2 were 5.9% and 9.0%, respectively. Among 35 patients of Group 1, one patient was pregnant and successfully delivered, whereas 1 of 22 patients of Group 2 became pregnant, but aborted at 7 weeks.

• Clinical and Experimental Reproductive Medicine
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• 제42권2호
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• pp.67-71
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• 2015

Objective: Elevated serum progesterone (P) levels on triggering day have been known to affect the pregnancy rate of in vitro fertilization (IVF). This study aimed to identify the possible factors influencing serum P levels on triggering day in stimulated IVF cycles. Methods: Three hundred and thirty consecutive fresh IVF cycles were included in the study. All cycles were first attempts and were performed in a single infertility center. The indications for IVF were male factor infertility (n=114), ovulatory infertility (n=84), endometriosis (n=61), tubal infertility (n=59), unexplained infertility (n=41), and uterine factor infertility (n=39). A luteal long protocol of a gonadotropin-releasing hormone (GnRH) agonist (n=184) or a GnRH antagonist protocol (n=146) was used for pituitary suppression. Ovarian sensitivity was defined as the serum estradiol level on triggering day per 500 IU of administered gonadotropins (OS[a]) or the retrieved oocyte number per 500 IU of administered gonadotropins (OS[b]). Results: Univariate analysis revealed that the serum P level on triggering day was associated with the serum estradiol level on triggering day (r=0.379, p<0.001), the number of follicles ${\geq}14mm$ (r=0.247, p<0.001), the number of retrieved oocytes (r=0.384, p<0.001), and ovarian sensitivity (OS[a]: r=0.245, p<0.001; OS[b]: r=0.170, p=0.002). The woman's age, body mass index, antral follicle count, and basal serum follicle stimulating hormone and estradiol levels were not associated with serum P level on triggering day. The serum P level on triggering day did not show significant variation depending on the type or cause of infertility, pituitary suppression protocol, or the type of gonadotropins used. Conclusion: The serum P level on triggering day was closely related to the response to ovarian stimulation.

• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.183-189
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• 1995

In human IVF-ET, the development and morphology of the embryo have been known to affect implantation and pregnancy rates(PRs). Recently, pregnancy has been reported to related to the embryos with thick zona-pellucida, high levels of fragmentation, poor blastomere development and zona hardening. Although the mechanism of implantation is unclear, it is thought that the hatching process precedes implantation and that the hatching is related to implantation and PRs. This study was carried out to investigate the effect of assisted hatching(AHA) on the improvement of PRs in human IVF-ET. The results were as follows; 1. The PRs of the AHA group (40.8%) was significantly higher than that of control group(27.2%)(P<0.01). 2. According to the age of patients, the PRs of control and AHA groups were 33.9%(20/59), 44,4%(12/27) in <30 yrs, 26.1%(30/115), 38.3%(18/47) in 31-35 yrs, 22.4%(13/58), 41.4%(12/29) in >36 yrs, respectively. 3. According to the factors of infertility in AHA group, unexplained(immunologic factor) (40.0%) and male factors(41.9%) were higher than female(tubal obstruction, endometriosis, adhesion) factor (28.9%). As a result, it is suggested that AHA technique improve the PRs in poor prognosis patients. It is concluded that AHA method can be used to improve the PRs in human lVF-ET.