OBJECTIVE: To compare the clinical efficacy of double intrauterine insemination with single intrauterine insemination in GnRH antagonist combined ovarian hyperstimulation (Mild ovarian hyperstimulation) MATERIALS AND METHODS: From Jan. 2001 to Jul. 2004, a retrospective clinical analysis was done of a total of 295 cycles in 170 patients who underwent ovarian hyperstimulation for ART (assisted reproductive technique). Subjects were divided into three groups; only clomiphene citrate ovarian hyperstimulation (n=55, 95cycles), GnRH antagonist combined ovarian hyperstimulation (soft ovarian hyperstimulation) (n=66 99cycles), and GnRH agonist combined ovarian hyperstimulation (short protocol) (n=49, 101cycles) Each group were randomly devided into two subgroups. One group underwent single IUI and the other group underwent double IUI. RESULTS: GnRH antagonist group and GnRH agonist group had similar pregnancy rate. In GnRH antagonist Group, pregnancy rate was 36.1% in single IUI subgroup and was 36.6% in double IUI subgroup. These finding were not statistically significant. And Pregnancy rate was 20.8% in single IUI subgroup and was 19.3% in double IUI subgroup in single clomiphene citrate group, and 36.3% in single IUI subgroup and was 33.3% in double IUI subgroup in GnRH agonist group. These finding were not statistically significant, too. CONCLUSION: Pregnancy rate of GnRH antagonist was high and complication rate such as OHSS and multiple pregnancy was lower. In GnRH antagonist group, to compare with single IUI and double IUI, the result do not statistically differ. So GnRH antagonist single injection with single IUI was relatively comparable ART in infertiliry patient.
Clomiphene ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Infertility* ; Insemination* ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Retrospective Studies

It has been well known that infertile women experience not only emotional disturbance but also stress. But there is no concern about male infertility patients. So phychiat.ic symptoms were studied with SCL-90 (Symptom Check List-90) in 30 infertile men who was operated testicular sperm extraction (TESE) in Samsung Cheil Hospital and in age matched 31 fertile men from Jan. 1998 to Aug. 1998. In 5 symptom dimensions (Obcessive-Compulsive, Interpersonal Sensitivity, Depression, Phobic anxiety, Psychoticisim) scores. The Infertile group scored significantly higher than the control group. The result revealed that infertile men also experienced substantially more psychiatric symptoms than fertile men. Considering this results, psychiatric evaluation and tender care by infertility specialist are necessary for infertile men during and after evaluation and treatment.
Affective Symptoms ; Anxiety ; Depression ; Female ; Humans ; Infertility ; Infertility, Male* ; Male ; Male* ; Specialization ; Spermatozoa

OBJECTIVE: To determine the reproductive outcomes of women undergoing microsurgical reversal of tubal sterilization at age 36 years or older. MATERIALS AND METHODS: A series of 133 patients who received microsurgical reversal of the previously sterilized fallopian tubes at Seoul National University Hospital from July, 1980 to January, 1992 was reviewed and evaluated for clinical characteristics, pregnancy rates, and factors influencing the outcome of tubal reversal. RESULTS: Of 133 patients, 78 (58.6%) had been sterilized by laparoscopic cautery. Loss of children was a leading cause for tubal reversal. The mean interval from tubal sterilization to tubal reversal was 65.0 months. The overall pregnancy rate was 52.6% (70/133), and the mean interval was 9.4 months from tubal reversal to pregnancy. Excluding 7 patients who were lost to follow-up, 76 pregnancies were confirmed in 63 patients with the delivery rate per patient of 66.7% (42/63). There were no significant differences in age, duration of tubal sterilization, postoperative tubal length between pregnant and non-pregnant groups. CONCLUSIONS: Microsurgical reversal of tubal sterilization could be a justifiable method in women 36 years age or older.
Cautery ; Child ; Fallopian Tubes ; Female ; Humans ; Lost to Follow-Up ; Pregnancy ; Pregnancy Rate ; Seoul ; Sterilization, Tubal*

The safety of ICSl as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestaional age (+/-SEM) and birth weight in singleton pregnancy were 38.8+/-1.9 weeks and 3209.7+/-501.9gm in IVF group, 39.0+/-2.2 weeks and 3289.9+/-479.5gm in ICSI group, respectively. Mean gestational age and birth weight in twins were 36.8+/-2.1 weeks and 2512.8+/-468.0gm in IVF group, 36.5+/-2.8 weeks and 2492.7+/-537.1gm in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twinst for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.
Birth Weight ; Fertilization* ; Gestational Age ; Holoprosencephaly ; Humans ; Incidence ; Perinatal Mortality ; Pregnancy ; Pulmonary Artery ; Sperm Injections, Intracytoplasmic* ; Telephone ; Twins

OBJECTIVE: The aim of this study was to evaluate the effect of Pentoxifylline(PF) on the conventional ICSI program undergone in severe asthenozoospermia. METHOD: Total 348 cycles of ICSI programs undertaken at CHA General Hospital from January, 1996 to September, 2000, were divided into two groups - injected with pentoxifylline-treated sperm(PFT, 204 cycles) or non-treated sperm(NPFT, 144 cycles) and the clinical results of PFT group were compared with those of NPFT. RESULTS: PF-treatment on sperm increased their motility of normozoospermia and severe asthenozoospermia. Fertilization rate of PFT group was higher than those of ICSI programs undertaken using sperm of NPFT(70.6% vs. 62.9%, p<0.01). And, ET and clinical pregnancy rates of PFT were slightly higher than those of NPFT(93.1%, 44.2% vs. 90.3%, 36.2%). CONCLUSION: These results showed that treatment of pentoxifylline has a beneficial role on selection of viable sperm in severe asthenozoospermia.
Asthenozoospermia* ; Fertilization ; Hospitals, General ; Pentoxifylline* ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

OBJECTIVE: To evaluate luteinizing hormone(LH) in patients with infertility and recurrent spontaneous abortion. MATERIAL AND METHOD: LH was tested by solid phase immunoradiometric assay based on monoclonal and polyclonal anti-LH antibodies. RESULTS: Of 100 infertile patients, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 67(67%), 22(22%), 11(11%), respectively. Of 100 patients with recurrent spontaneous abortion, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 79(79%), 18(18%), 3(3%), respectively. There was a significant difference between patients with infertility and recurrent spontaneous abortion only in the group with LH level greater than 10 mIU/ml(p=0.325). CONCLUSIONS: High LH in the follicular phase is known to decrease pregnancy rate and increase abortion rate. But in this study the incidence of high LH in patients with recurrent spontaneous abortion was low. On the contrary, there was a significant increase of LH in infertile patients. So recurrent spontaneous abortion does not seem to be related to high LH level.
Abortion, Induced ; Abortion, Spontaneous* ; Antibodies ; Female ; Follicular Phase ; Humans ; Immunoradiometric Assay ; Incidence ; Infertility* ; Lutein* ; Luteinizing Hormone* ; Pregnancy ; Pregnancy Rate

OBJECTIVE: The purpose of the current series of experiments were to assess the effect of GM-CSF, as a medium supplement, on the development of mouse embryos and the expression of LIF and IL-1beta mRNA. MATERIALS AND METHODS: Mouse 2-cell embryos were collected from the oviducts of 6 weeks old ICR mice at 48 hours after hCG injection. Embryos were cultured in P-1 medium supplemented with mouse GM-CSF(0,1,5,10 ng/ml). The embryo development to blastocysts and hatching blastocysts was assessed and the cell number in blastocyst was also examined. Using RT-PCR, the expressions of LIF and IL-1beta mRNA in blastocyst were evaluated in the GM-CSF supplemented group and control group. RESULTS: In mouse, the addition of GM-CSF increased the percentage of blastocysts(65.5%, 68.6%, 73.0% and 76.1% for control and 1, 5 and 10 ng/ml, respectively), and increased the proportion of hatching blastocysts(35.2%, 36.4%, 43.2% and 53.0% for control and 1, 5 and 10 ng/ml, respectively). The mean cell numbers in blastocyst were significantly increased in GM-CSF supplemented groups compared to control group. LIF and IL-1beta expression in blastocysts were significantly higher in GM-CSF supplemented group than in control group. CONCLUSION: The results of experiment by mouse embryos showed beneficial effects of GM-CSF as a medium supplement. Furthermore, the addition of GM-CSF significantly increased the expression of LIF and IL-1beta in mouse embryos. These results suggest that GM-CSF might be a important molecule in embryo implantation.
Animals ; Blastocyst ; Cell Count ; Embryo Implantation ; Embryonic Development* ; Embryonic Structures* ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Mice* ; Mice, Inbred ICR ; Oviducts ; Pregnancy ; RNA, Messenger

OBJECTIVE: This study is to evaluate the efficacy of Intracytoplasmic Sperm Injection(ICSI) for previous fertilization failure with conventional in vitro fertilization(IVF), compared with ICSI for male factor. METHOD: The author analyzed the 3 years of clinical experience with ICSI retrospectively, between the conventional IVF failure group (IVF failure) and male factor group (male factor). Surgically retrieved epididymal or testicular spermatozoa for ICSI were excluded. The IVF failure group was 13 cycles of 6 patients and male factor group was 30 cycles of 15 patients. RESULTS: The fertilization rates of the IVF failure group and male factor group were 63% and 66% respectively (p=0.635). The clinical pregnancy rates of the both group were 23.1% and 26.7% (p=0.804), and that of live birth rates were 15.4% and 13.3% (p=0.858). There were no significant difference between the two groups. CONCLUSION: The author concluded that ICSI can overcome previous fertilization failure, with the same fertilization and clinical pregnancy rates seen in patients with male factor.
Fertilization in Vitro* ; Fertilization* ; Humans ; Live Birth ; Male ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(ADD), dehydroepiandrosterone-sulfate(DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and E2 in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thermal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH follicular development and dominant follicle selection resulted in ovulatory disturbance.
Diagnosis ; Estrogens ; Female ; Follicular Atresia ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Granulosa Cells ; Humans ; Hypertrophy ; Inhibins* ; Lutein ; Menstrual Cycle ; Ovary* ; Peptides ; Prolactin ; Prospective Studies ; Receptors, LH ; Ultrasonography

The uptake of glucose for metabolism and growth is essential to most animal cells and is mediated by glucose-transporter (GLUT) proteins. The aim of this study was to determine which class of glucose transporter molecules was responsible for uptake of glucose in the mouse early embryo and at which stage the corresponding genes were expressed. In addition, co-culture system with vero cell was used to investigate the effect of the system on GLUT expression. Two-cell stage embryos were collected from the superovulated ICR female and divided into 3 groups. As a control, embryos were cultured in 0.4% BSA-T6 medium which includes glucose. For the experimental groups, embryos were cultured in either co-culture system with vero cells or glucose-free 76 medium supplemented with 0.4% BSA and pyruvate as an energy substrate. 2-cell to blastocyst stage embryos in those groups were respectively collected into microtubes (50 embryos/tube). Total RNA was extracted and RT-PCR was performed. The products were analysed after staining ethidium bromide by 2% agarose gel electrophoresis. Blastocysts were collected from each group at 120hr after hCG injection. They were fixed in 2.5% glutaraldehyde, stained with hoechst, and mounted for observation. In control, GLUT1 was expressed from 4-cell to blastocyst. GLUT2 and GLUT3 were expressed in morula and blastocyst. GLUT4 was expressed in all stages. When embryos were cultured in glucose-free medium, no significant difference was shown in the expression of GLUTI1, 2 and 3, compared to control. However GLUT4 was not expressed until morular stage. When embryos were co-cultured with vero cell, there was no significant difference in the expression of GLUT1, 2, 3 and 4 compared to control. To determine cell growth of embryos, the average cell number of blastocyst was counted. The cell number of co-culture (93.8+/-3.1, n=35) is significantly higher than that of control and glucose-free group (76.6 +/- 3.8, n=35 and 68.2+/-4.3, n=30). This study shows that the GLUT genes are expressed differently according to embryo stage. GLUTs were detectable throughout mouse preimplantation development in control and co-culture groups. However, GLUT4 was not detected from 2- to 8-cell stage but detected from morula stage in glucose-free medium, suggested that GLUT genes are expressed autocrinally in the embryo regardless of the presence of glucose as an energy substrate. In addition, co-culture system can increase the cell count of blastocyst but not improve the expression of GLUT. In conclusion, expression of GLUT is dependent on embryo stage in preimplantation embryo development.
Animals ; Blastocyst ; Cell Count ; Coculture Techniques ; Electrophoresis, Agar Gel ; Embryonic Development ; Embryonic Structures* ; Ethidium ; Female ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Glutaral ; Humans ; Metabolism ; Mice* ; Morula ; Pregnancy ; Pyruvic Acid ; RNA ; Vero Cells