• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.143-151
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• 1997

The present study was designed to investigate if antithyroid antibodies (ATA) could affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization and embryo transfer (IVF-ET). From October 1995 to September 1996, 28 euthyroid women with ATA who underwent IVF-ET were studied. Fifty-one euthyroid women without ATA who underwent IVF-ET served as control. Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were assayed using radio ligand assay kits as ATA. All patients included in study and control groups had only tubal factor in infertility. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. There were no significant differences between study and control groups in patient characteristics such as age, infertility duration and hormonal profile. There were also no significant differences between two groups with respect to the clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transfered. There were no correlations between ATA (TPOA and TGA) titers and fertilization rate. The clinical pregnancy rate per cycle seemed to be lower in the study group than in the control group (26.3% vs 39.3%), but the difference was not statistically significant. The biochemical pregnancy rate per cycle and miscarriage rate were significantly higher in the study group at 18.4% (7/38) and 40.0% (4/10) compared with 5.6% (5/89) and 11.4% (4/35) in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or non-pregnancy group. In 10 women with ATA who achieved pregnancy following IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing or delivery group. In conclusion, euthyroid women with ATA appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.

• 한국발생생물학회지:발생과생식
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• 제17권3호
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• pp.207-213
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• 2013

This study was performed to investigate the effect of peroxisome proliferators activated receptor-${\gamma}$ (PPAR-${\gamma}$) ligand, pioglitazone, on production of regulated upon activation normal T-cell expressed and secreted (RANTES) and in vitro fertilization (IVF) outcome in infertile patients with endometriosis. Sixty-four infertile patients with stage III or IV endometriosis undergoing IVF were randomly allocated to the study or the control group. The long protocol of GnRH agonist (GnRH-a) was used for controlled ovarian stimulation (COS) in all patients. Patients in the study group were treated with pioglitazone at a dose of 15 mg/day orally from the starting day of GnRH-a treatment to the day of hCG injection. Blood samples were drawn for serologic assay of RANTES on the first day of GnRH-a treatment and the day of hCG injection. There were no differences between the study and control groups in patient characteristics. There were also no differences between the two groups in COS duration, and the numbers of retrieved oocytes, fertilized oocytes and embryos transferred. The clinical pregnancy rate per cycle was higher in the study group, but this difference was not statistically significant. However, embryo implantation rate was significantly higher in the study group of 12.5% compared with 8.6% in the control group (P<0.05). The serum RANTES levels after pioglitazone treatment were significantly lower than those before pioglitazone treatmen in the study group (P<0.05). Our data suggest that pioglitazone treatment can suppress RANTES production and improve the embryo implantation rate in patients with endometriosis undergoing IVF.

• 한국발생생물학회:학술대회논문집
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• 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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• pp.60-60
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• 2003

Embryonic stem (ES) cells have property of self-renewal and can differentiate into the cells of all three primary germ layers. Recently, many growth factors, alteration of culture condition and gene modifications have been used to differentiate mouse and human ES cells into specific cell types. This study was performed to evaluate the differentiation protocol for human ES cells to the endodermal lineage cells. Human ES cells (Miz-hESl ) were cultured on STO feeder layer mitotically inactivated with mitemycin C, and embryoid bodies (EBs) were formed by suspension culture. Differentiation protocol of EBs consisted of three steps: stage I, culture of EBs for 6 days with ITSFn medium; stage II, culture of stage I cells for 8 days with N2 medium ; stage III, culture of stage II cells for 22 days with N2 medium. mRNA levels of the endodermal lineage differentiation genes were analyzed by semi- quantitative RT-PCR. The Oct-4 expression, a marker of the pluripotent state, was detected in undifferentiated human ES cells but progressively decreased after EBs formation. Differentiating human ES cells expressed marker genes of endodermal differentiation and pancreatic islet cells. GATA4, a-fetoprotein, Glut-2, and Ngn3 were expressed in all stages. However, albumin and insulin were expressed in only stage III cells. The human ES cells can be differentiated into endodermal lineage cells by multiple step culture system using various supplements. We are developing the more effective protocols for guided differentiation of human ES cells.

• Clinical and Experimental Reproductive Medicine
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• 제47권1호
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• pp.1-11
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• 2020

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

• Clinical and Experimental Reproductive Medicine
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• 제29권1호
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• pp.45-56
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• 2002

Objectives: Recently, recombinant FSH (rFSH) has been manufactured using a Chinese hamster ovary cell line transfected with the gene encoding human FSH. Both rFSH and urinary gonadotropin (uFSH) could be used for controlled ovarian hyperstimulation (COH). However, uFSH implies a number of disadvantages, such as batch-to-batch inconsistency, no absolute source control, dependence on large amounts of urine, low specific activity, and low purity. The purpose of this study was to evaluate the efficacy of rFSH in human IVF-ET program. Materials and Methods: A total of 508 infertile women was enrolled in this study. They are classified into rFSH group (n=177) or uFSH group (n=331), and all of them were matched by age and cause of infertility in same period. The $Puregon^{(R)}$ (Organon, Holland) was used as rFSH, and the Metrodin-$HP^{(R)}$ (Serono, Switzeland) and $Humegon^{(R)}$ (Organon, Holland) was used as uFSH. We subdivided the patients into three age groups. The outcomes of IVF-ET program were analyzed using the statistical package for social sciences (SPSS). Results: There was no significant differences in the level of estradiol on hCG injection day, the numbers of retrieved oocytes, matured oocytes, fertilized oocytes, transferred embryos, frozen embryos between the two groups. The total dose (IU) of gonadotropin for COH was significantly lower in the rFSH group compared to uFSH group ($1339{\pm}5491.1$ vs $2527.8{\pm}1075.2$ IU, p<0.001). Clinical pregnancy rate per embryo transfer in the rFSH group showed increasing tendency, compared to the uFSH group, but there was no statistical significance (35.2% vs 29.3%). Our results demonstrated that the relative efficiency of rFSH compared with uFSH is higher in older patients. Conclusions: The ovarian stimulatory effect and clinical outcome of recombinant FSH was similar to that of the urinary gonadotropin. The IVF-ET cycles with significantly lower dose of gonadotropin in rFSH group showed comparable results. Therefore, we suggest that recombinant FSH is more potent and effective than urinary gonadotropin.

• Clinical and Experimental Reproductive Medicine
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• 제22권2호
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• pp.203-210
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• 1995

Many oocytes fail to fertilize and cleave in vitro and many embryos transferred back to uterus fail to implant or maintain implantation. Chromosomal abnormalities in the male and female gametes may contribute to this loss. The higher incidence of meiotic chromosomal abnormalities bas been found in oocytes than in sperm. The wide range of incidence of chromosomal abnormalities in unfertilized oocytes has been reported in human IVF program (26-63%). However, factors affecting chromosomal abnormalities are not well understood. The present study has been conducted to investigate effects of the method for ovarian hyperstimulation, women's age, and the number of oocytes retrieved per patients on the incidence of numerical chromosomal abnormalities. Five hundred eighty four unfertilized metaphase II oocytes were subjected to chromosomal analysis. Included unfertilized oocytes were from 220 patients (mean $age=32.7{\pm}3.0$) and three hundred thirty oocytes were legible for analysis. Two hundred fourty five oocytes out of 330 (73.3%) were normal, while 38 (11.5%) were hyperploidy, 35 (10.6%) were hypoploidy, and 12 (3.6%) were diploidy. Significant difference in chromosomal abnormalities was not found between two patient groups stimulated by follicular stimulating hormone/human menopausal gonadotrophin (FSH/HMG) (25.9%) and gonadotrophin-releasing hormone agonist/follicular stimulating hormone/human menopausal gonadotrophin (GnRHa/FSH/HMG) (28%). There was a tendency of increasing chromosomal abnormalities in unfertilized oocytes from older patients (<30 yrs: 20.3%, 30-34yrs: 26.9%, >34 yrs: 35.3%). The number of oocytes retrieved per patient had no effect the incidence of chromosomal abnormalities (1-5: 31. 4%, 6-10: 29.8%, 11-15: 28.6%, > 15: 16.5%). These results from the present study suggest that the chromosomal abnormalities observed in the unfertilized oocytes has not affected by the stimulation methods, patient's age, and the number of oocytes retrieved per patients.

• 대한한방부인과학회지
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• 제31권4호
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• pp.147-164
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• 2018

Objectives: This study was performed to analyze the pattern identification in infertile women who participated in infertility support program of Cheongju-city. Methods: The project proceeded from October, 2016 to June 2017. Participants filled in the questionnaire which is composed of 33 symptoms before korean medical treatments. Data were collected from 17 participants. We classified symptoms into six pattern identifications based on previous research and rated each answer to score. Results: Throughout the study, the average age of 26 patients was $34.88{\pm}3.19$ years old, the average height was $162.51{\pm}4.99cm$, and average weight was $58.41{\pm}7.88kg$. The average duration of acupuncture treatment was $121.03{\pm}52.73$ days and the average times of acupuncture treatment was $27.42{\pm}10.77$ times. The average number of herbal medicine treatment was $2.65{\pm}0.69$, the majority of it was Chokyungjongok-tang. After the treatment, 3 patients of infertility became pregnant (11.54%) in twenty six patients. By analyzing pattern identification survey papers, We can classify infertile women into 6 pattern identification based on previous research. The majority of participants was identified as Blood deficiency and the other participants were identified as Kidney deficiency, Liver depression, Dampness-phlegm, Qi deficiency and Static blood in order of priority. Most of patients' pattern identification were combined with two kind of pattern identification. In terms of priority, Liver depression combined with Kidney deficiency, Blood deficiency combined with Kidney deficiency, Liver depression combined with Qi deficiency, Liver depression combined with Dampness-phlegm. Conclusions: After the study we confirmed that Korean traditional medicine is a safe treatment for infertile women. Further clinical study about herbal medicines of patients who have combined pattern identification is needed.

• 한국가축번식학회지
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• 제15권3호
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• pp.225-231
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• 1991

These experiments were carried out ot detect autoantiboies to zona pellucida in sera from infertile women using indirect ELISA and IFA and to investigate their effect on in vitro fertilization of mouse ova. In inidirect ELISA test, 12 of 116(10.3%) serum samples form infertile women gave positive reaction whereas all of 16 samples from fertile women and men were negative. Furthermore, in indirect IFA test, 17 of 116 (14.7%) serum samples from infertile women gave positive fluorescence whereas all of control sera were negative fluorescence. The fertilization rates(15.9%) of mouse eggs treated with positive sera were significantly lower than those(51.9%＋71.2%) autoantibodies to zonapellucida are responsible for infertility in unexplained infertile women, presumably by perventing sperm attachment and penetration.

• 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

• Clinical and Experimental Reproductive Medicine
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• 제27권2호
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• pp.159-164
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• 2000

연구목적:인간의 체외수정 및 배아이식술에서 난관수종을 갖는 환자에서 임신율과 착상률이 감소된다는 보고들이 있지만 이에 대한 명확한 기작은 밝혀지지 않았다. 본 연구에서는 생쥐 배아를 이용한 체외 착상모델에서 인간의 난관수종액(HSF)이 착상과정에 미치는 영향을 알아보고자 하였다. 연구재료 및 방법 난관수종액은 난관수종으로 수술을 받은 8명의 환자로부터 채취하였으며, 실험에 사용하기 전까지 냉동고에 보관하였다. 생쥐의 포배기 배아는 2-세포기배아를 3일 동안 배양하여 그 중 상태가 양호한 포배기 배아만을 선별하여 투명대를 제거한 후 사용하였다. 기본 배양액으로는 Ham's F-10을 사용하였으며, 배양 시 기본 배양액만을 사용한 경우를 group Ⅰ으로 하였고, 기본 배양액에 0.5% FBS를 첨가한 경우를 group Ⅱ, 0.5% FBS와 50% HSF를 첨가한 경우를 group Ⅲ , 100% HSF에 0.5% FBS를 첨가한 경우를 group Ⅳ,100% HSF만을 사용한 경우를 group Ⅴ로 하였다. 투명대를 제거한 포배기 배아를 각각의 HSF에 대한 5종류의 배양액에서 48시간 동안 배양하였다. 체외 착상 유무는 부착 부위에서 크기가 커진 영양세포들을 관찰하여 판정하였으며, 착상 부위의 표면적은 화상분석기를 이용하여 산출하였다. 결 과: 생쥐 배아의 체외 착상률은 group Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ에서 각각 0%, 98.9%, 77.5%, 40.4%, 10.0%로 나타났으며, 착상 부위의 평균 표면적은 group Ⅱ, Ⅲ, Ⅳ, Ⅴ에서 각각 $74,675{\pm}25,201{\mu}m^2$, $59,024{\pm}25,877{\mu}m^2$, $45,156{\pm}22,654{\mu}m^2$, $38,254{\pm}17,115{\mu}m^2$이었다. 체외 착상률과 부위의 표면적은 HSF의 농도가 증가함에 따라 통계적으로 유의하게 감소하였다(p<0.001). 결론:인간의 난관수종액(HSF)은 생쥐 배아의 체외 착상과 영양배엽세포의 증식을 억제하는 것으로 확인되었으며, 이러한 원인이 난관수종을 갖는 환자에서 임신율이 낮은 것과 밀접한 관련이 있을 것으로 생각된다.