Despite the rapid development of assisted reproductive technologies (ART) in recent years, implantation rates after replacement of embryos into the uterine cavity remains low. Several techniques such as culture conditions based on formulations of human tubal fluid and various ART techniques as GIFT, ZIFT, TET have been adopted in recent years to improve embryo viability in vitro and implantation rates. Also, coculture of human IVF-derived embryos have been used in an effort to increase the number of viable embryos following IVF and to improve synchrony between the developing embryo and the uterine environment. The aim of this study was to evaluate whether the use of coculture with autologous cumulus cells has a significant beneficial effect on the development of embryos in vitro and its relation to the pregnancy rates in 120 patients with previous failed IVF-ET from September, 1995 to January 1998. We obtained the results from which significant improvement in the quality of viable embryos were observed using a coculture system with autologous cumulus cells, but pregnancy rates in this group of patients did not differ from the rate in the standard IVF group during the same period. Our study shows that a simplified short-term coculture system with autologous cumulus cells may help rescue moderate quality embryos to cleave regularly.
Coculture Techniques* ; Cumulus Cells* ; Embryonic Structures* ; Humans ; Pregnancy Rate* ; Pregnancy* ; Reproductive Techniques, Assisted ; Zygote Intrafallopian Transfer

No abstract available.
Contraceptives, Oral* ; Fertilization in Vitro* ; Gonadotropins*

No abstract available.
Female ; Follicle Stimulating Hormone* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Ovarian Diseases*

No abstract available.
Female ; Methotrexate* ; Pregnancy ; Pregnancy, Tubal*

Cervical pregnancy is a rare form of ectopic pregnancy and it can cause life-threatening bleeding. Until recently abdominal hysterectomy has been considered the standard therapy for fear of profuse hemorrhage. Methotrexate, however, can be useful agent to conserve further fertility and it is used in various routes of administration. We report a case of cervical pregnancy that was successfully treated by intraamniotic methotrexate injection under the guidance of transvaginal ultrasonography and subsequent four systemic doses thereafter.
Female ; Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate* ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography

OBJECTIVE: To analyze the relationship between the degree of expression of E-cadherin and presence of high risk prognostic factors (lymph node metastasis or parametrium involvement), clinical stages and pathologic types in invasive cervical cancer. METHODS: An immunohistochemical technique has been applied to formalin-fixed, paraffin- embedded samples from 20 radical hysterectomy without risk factors and 16 radical hysterectomy with risk factors. The degree of expressions of E-cadherin immunostaining was compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, presence of high risk prognostic factors, and pathologic types. RESULTS: The difference of the degree of expression of E-cadherin was not statistically significant between high-risk group (lymph node metastasis or parametrium invasion) and non-risk group. The difference of the degree of expression of E-cadherin was not statistically significant according to clinical stages and variable pathologic types either. CONCLUSIONS: These results suggest that the degree of the expression of E-cadherin has no relationship with known high risk prognostic factors, clinical stages and pathologic types in invasive cervical cancer.
Cadherins* ; Gynecology ; Humans ; Hysterectomy* ; Neoplasm Metastasis ; Obstetrics ; Risk Factors ; Uterine Cervical Neoplasms*

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginally administered misoprostol(PGE1) versus dinoprostone(PGE2) for labor induction in a prospective controlled trial. METHOD: One hundred eleven patients for labor induction (including preterm rupture of membranes) were randomly assigned to receive either misoprostol 50microgram or dinoprostone 3mg intravaginally. The interval of doses was 8 hours after first dose, with a potential maximum of six dose until active labor pain was achieved. RESULTS: Among 111 patients enrolled, 55 were randomized to receive misoprostol 50microgram and 56 to receive dinoprostone 3mg with every 8 hours interval intravaginally. There were no significant differences in demographic characteristics except in Bishop score(3.81+/-1.52 vs 4.38+/-1.29, P<0.05). There were no significant differences in indications for labor induction. The interval of induction to delivery was shorter in the misoprostol group(750.8+/-518.8min) than in the dinoprostone group(1264.1+/-730.7min). Delivery within 24 hours after administration occurred more often in the misoprostol group than in the dinoprostone group (86.3% vs 65.2%, P<0.05). More than two doses for completion of delivery were frequent in dinoprostone group(36.96% vs 9.8% in misoprostol group, P<0.05). Additional Oxytocin augmentation was needed more commonly in the misoprostol group(3.64%) than in the dinoprostone group(14.29%)(P<0.05), but no significant differences were noted between two groups in total oxytocin doses and indications. Tachysystole occurred more often in the misoprostol group (12.73% vs 1.79% in the dinoprostone, P<0.05) Precipitating delivery occurred more commonly in the misoprostol group(21.82% vs 7.14% in the dinoprostone group, P<0.05). No differences in the cesarean section rate, fetal heart rate abnormalities, hyperstimulation syndrome, meconium staining, fetal outcome (Apgar score at 1 and 5 minutes, birth weight), and marternal outcome (nausea and vomitting, postpartum bleeding) were noted. The cost of misoprosl is one hundredth cheaper than dinoprostone. There was no significant differences in the fetal outcome and maternal outcome. CONCLUSION: These results suggest that intravaginal misoprostol(PGE1) is a safe drug for labor induction which is more effective and cheaper compare to intravaginal dinoprostone(PGE2).
Alprostadil* ; Cesarean Section ; Dinoprostone* ; Female ; Heart Rate, Fetal ; Humans ; Labor Pain ; Meconium ; Misoprostol* ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Prospective Studies ; Rupture

Disorders derived from abnormal prolactin(PRL) production are relatively common ingynecological practice. Infertility, menstrual disorders, and galactorrhea are the most frequentmanifestations encountered in women. And, although frequently benign, the disordersoccasionally may have severe consequences.We studied 341 infertile women with normal menstruation(N group) and 105 womenwith oligomenorrhea(O group) and 70 women with secondary amenorrhea(A group), first; to investigate the prevalence of hyperprolactinemia(hPRL) and its clinical etiologies in 3groups, second; to estimate the effect of the bromocriptine(BRMC) treatment in N group,and finally; to obtain an understanding of the underlying physiology and pathoghysiologycoupled with the awareness of the hetrogeneous presentation of hPRL from June, 1994 toDecember, 1996.The results of this study were as follows;1. There were no significant correlations of serum PRL levels by ages in 3 groups.2. The prevalence rates of conventional hPRL(PRL>25ng/mL) were 18.2% in N group,22.9% in O group, 28.6% in A group and were not different among 3 groups(P=0.12).But the rates of PRL>50 ng/mL were 4.7%, 7.6%, 20.0%, respectively and were different(p < 0.01).3. The most common causes of hPRL were prolactinomas(9.3%) and thyroid disorders(4.7%) except the undiagnosed(72.1%).4. The cumulative pregnancy rates of 6~24 months duration were not different betweenBRMC-treated women(33.3%) and BRMC-untreated women(38.9%) in N group(p=0.92).
Female ; Galactorrhea ; Humans ; Hyperprolactinemia* ; Infertility ; Physiology ; Pregnancy ; Pregnancy Rate ; Prevalence ; Thyroid Gland

OBJECTIVE: The purpose of the study was to determine the effects of co-culture with oviductal epithelial cells and Vero cells on mouse embryo. METHOD: For the control group, mouse embryos were cultured alone in Ham's F-10 with 10% FBS. Subcultured oviductal epithelial cell and Vero cell were cocultured in Ham's F-10 with 10% FBS with the mouse embryo and used as the treatment group. Development of mouse embryos were observed. Result: The development rate and hatching rate of embryos that cocultured with oviductal epithelial cell and Vero cell was significantly higher (p<0.05) than control group. When subcultured oviductal epithelial cells were co-cultured with mouse embryo, there was no significant difference in development rate and hatching rate among subculture step. When oviductal epithelial cells that have been frozen-thawed were co-cultured with mouse embryo, there was no significant difference in development rate and hatching rate among subculture step. No statistical significance was seen in the development rate and hatching rate between subcultured oviductal epithelial cells and frozen-thawed oviductal epithelial cells when cocultured with mouse embryo, Vero cells and frozen-thawed when cocultured with mouse embryo, and Vero cells and oviductal epithelial cells when cocultured with mouse embryo. CONCLUSION: Oviductal epithelial cells and Vero cell may have a stimulatory role in early mouse embryonal development compared to control in vitro. As well, there is no significant difference in development rate and hatching rate among subculture step, when early mouse embryo was cocultured with cells that subcultured and frozen-thawed.
Animals ; Coculture Techniques ; Embryonic Structures ; Epithelial Cells* ; Humans* ; Mice* ; Oviducts* ; Vero Cells*

OBJECTIVE: This study was performed to evaluate the efficacy of treating of unruptured ectopic pregnancy by systemic and transvaginal local administration of methotrexate. METHODS: We reviewed the medical records of 32 patients who were treated with methotrexate from June 1995 to October 1999. Among the patients, 14 were treated by ultrasound-guided transvaginal local injection and 18 were treated by systemic intramuscular administration. Success rate of the treatment was examined for each group, and the cases of methotrexate failure were characterized and compared with the success group. RESULTS: The success rate was similar between the transvaginal (85.7%) and the systemic (77.8%) groups. There were no differences in initial serum hCG levels, size of gestational sac, fetal cardiac activity between the success group and failure group. CONCLUSION: The results of this study suggest that there is no difference in efficacy between systemic and transvaginal local methotrexate administration, and there are no useful parameters in identifying the risk for the failure of methotrexate treatment.
Female ; Gestational Sac ; Humans ; Medical Records ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*