2.Fertility Outcome after Treatment of Ectopic Pregnancy.
Korean Journal of Obstetrics and Gynecology 1999;42(3):525-531
OBJECTIVE: It is generally accepted that ectopic pregnancy (EP) may adversely affected on the female fertility. However, it is not fully understood how it influences on the future fertility after treatment of an EP, so we intended to evaluate its effects, METHODS: This study was undertaken on 473 patients with clinically and pathologically proven diagnosis of ectopic pregnancies at the Department of Obstetrics and Gynecology, Anam Hospital, Kroea University Medical College hom Jan. 1, 1989 to Aug. 31, 1996. RESULTS: The incidence of ectopic pregnancy was 1 in 19.6 deliveries (5.1%). The overall spontaneous conception rate after treatment of ectopic pregnancy was 67.4%, and among them, the rate of intrauterine pregnancy (IUP) and repeat ectopic pregnancy (rEP) was 56.3% and 11.1% respectively. The occurrance rate of infertiity after treatment of EP was 32.6%. The mean time to IUP after treatment of EP was 16.5 months, and 79.0% of all IUP were conceived within 2 years after treatment. The mean time to repeat ectopic pregnancy was 15.9 months. With increasing maternal age, IUP rate was decreased and rEP rate was increased but they were statistically not signiTicant. Repeat EP rate was also increased in multiparous women but it was also statistically not significant. Overall PR (IUP and rEP) was decreased in women who have organic lesions (adhesions, endometriosis, PID etc.) in pelvic cavity(p=0.003). Patients who were treated with conservative surgery achieved a lower conception rate without statistical significance and it may be due to low cases. CONCLUSION: Future fertility rate was not significantly altered by EP itself, but rather affected by patient's age, organic lesions and previous history of pelvic surgery. Recently, the advent of assisted reproductive technology and its associated techniques improved the female fertility in women with such a problem.
Birth Rate
;
Diagnosis
;
Endometriosis
;
Female
;
Fertility*
;
Fertilization
;
Gynecology
;
Humans
;
Incidence
;
Maternal Age
;
Obstetrics
;
Pregnancy
;
Pregnancy, Ectopic*
;
Reproductive Techniques, Assisted
3.Transvaginal Selective Fetal Reduction in Multifetal Pregnancy induced by Assisted Reproductive Technology.
Korean Journal of Obstetrics and Gynecology 1999;42(3):517-524
OBJECTIVE: The prevalence of multifetal pregnancies has increased up to 30% as a result of the introduction of ovulation inducing agents for assisted reproductive teclmology(ART). An exttemely poor pognosis could be expected for viable pregnancies in multifetal gestation. So, to decrease the consequence of multiple pregnancies and prevent complications, especially premature baby irreversibly damaged, selective fetal reduction to the smaller number of fetuses should be considered in an early gestational period. METHODS: From May 1994 to Apr 1998, transvaginal selective fetal reduction in 13 pati including 9 triplet, 3 quadruplet and 1 quintuplet. Of the 13 patients, 4 were obtained by controlled ovarian hyperstimulation with intrauterine insemination (COH with IUI), 6 were by IVF-ET, 2 wae by controlled ovarian hyperstimulation with natural contact and 1 was by natural conception. Selective fetal reduction using intracardiac KC1 injection and aspiration of amniotic fluid carried out in 8-11 weeks of gestation. RESULTS: After procedures, 8 patients were remained as twin pregnancies, 5 patients as singleton pregnancies and 1 of the remaining twin embryos vanished after procedure. There have been 7 sets of twin delivery including 1 stillbirth and 3 singleton delivery. 1 cases are ongoing state. All of the singleton delivery were completed after 37 weeks of gestation. Of the twin delivery, 2 cases were delivered after 37 weeks of gestation, 2 cases in 35-37 weeks, and 3 cases before 35 weeks of gestation. Unfortunately, 1 stillbirth occurred in 20 weeks of gestation and 2 cases of singleton were aborted. As 3 losses(2 singleton, 1 twin) occurred, the delayed fetal loss rate in this selective fetal reduction was 25.0%(3/12). There was no fetal anomaly related to the procedure. CONCLUSION: Selective fetal reduction in multifetal pregnancies is a rather safe procedure and it may improve the outcome of multiple pregnancies.
Amniotic Fluid
;
Embryonic Structures
;
Female
;
Fertilization
;
Fetus
;
Humans
;
Insemination
;
Ovulation
;
Pregnancy Reduction, Multifetal*
;
Pregnancy*
;
Pregnancy, Multiple
;
Pregnancy, Twin
;
Prevalence
;
Quadruplets
;
Quintuplets
;
Reproductive Techniques, Assisted*
;
Stillbirth
;
Triplets
4.Comparison of three methods for semen preparation for IVF.
Sun Haeng KIM ; Young Tae KIM ; Pyong Sam KU
Korean Journal of Obstetrics and Gynecology 1992;35(3):393-398
No abstract available.
Semen*
5.A study on fertilization & cleavage of human oocytes following reinsemination in vitro.
Tak KIM ; Sun Haeng KIM ; Pyong Sham KU
Korean Journal of Obstetrics and Gynecology 1992;35(8):1202-1209
No abstract available.
Fertilization*
;
Humans*
;
Oocytes*
6.GnRH analogue in controlled ovarian hyperstimulation for gonadotropin poor responder.
Sun Haeng KIM ; Hee Kyung LEE ; Pyong Sahm KU
Korean Journal of Fertility and Sterility 1993;20(1):37-43
No abstract available.
Gonadotropin-Releasing Hormone*
;
Gonadotropins*
7.Male factor infertility and in vitro fertilization-embryo transfer.
Sun Haeng KIM ; Rae Hwan JUNG ; Pyong Sahm KU
Korean Journal of Fertility and Sterility 1992;19(1):71-79
No abstract available.
Humans
;
Infertility*
;
Male*
8.Artificial abortion status and the recognition of its complication for married women.
Sun Hee KIM ; Bo Young KIM ; Yeo Jung KIM ; Jung Ah LEE ; Jing Haeng CHO
Journal of the Korean Academy of Family Medicine 1997;18(9):953-962
BACKGROUND: Many women have experienced artificial abortion, but artificial abortion itself may take a life away from a fetus and also influence serious effect on operated womens health condition. So this study was attempted to offer basic information for improving maternity health condition by knowing womens artificial abortion performance status and recognition about its complication. METHODS: The 215 married women who visited in OPD of certain hospital in Pusan from november 1994 to January 1995, answered the question about experience of artifial abortion the recognition about its complication, and artificial abortioned group answered the reason of artificial abortion and the experience of complication. RESULTS: The number of women who experienced artificial abortion was 107 persons(49.8%). More educated women have experienced less artificial abortion. The causes of artificial abortion were birth control as of 40.6%, continuation of occupation or study as of 20.6%, for preserving health condition as of 14.2%, impossible marriage as of 14.2%. 115 persons out of 215 persons (53.4% ) answered they heard about, its complicatons. In relation to health, 66 persons(30.7% ) answered that the abortion had no relation with health condition or they answered they have no idea about the issue, 68 persons(31.6%) answered that the abortion had relation with but its complication would be soon recovered. Higher understanding was obtained in higher educated group(P<0.05). If unwanted pregnancy occur to them in the future, 32 persons(27.8%) in recognized group and 38 persons(38%) in unrecognized group answered they would perform artificial abortion. So understanding about complicaton of artificial abortion has little effect on their artificial abortion rate. CONCLUSIONS: Recognition of complications of married women is low, and recognition degree doesnt affect artificial abortion. So, not only education about complications of artificial abortion and contraception but also social performance of sharing womens responsibility for birth control or bringing up infants is necessary.
Abortion, Induced
;
Busan
;
Contraception
;
Education
;
Female
;
Fetus
;
Humans
;
Infant
;
Marriage
;
Occupations
;
Pregnancy
;
Pregnancy, Unwanted
;
Women's Health
9.Hyperstimulation syndrome in superovulatory cycle for IVF.
Hae Joong KIM ; Young Tae KIM ; Sun Haeng KIM ; Byung Sam KU
Korean Journal of Obstetrics and Gynecology 1991;34(3):415-420
No abstract available.
10.Blastulation and the clinical outcome of the blastocyst transfer in the COH cycles with premature progesterone elevation.
Sun Haeng KIM ; Yong Ho LEE ; Nak Woo LEE ; Tak KIM
Korean Journal of Obstetrics and Gynecology 2000;43(2):281-285
OBJECTIVES: To determine the effect of increased plasma Progesterone(P) level on the day of hCG administration on oocyte /embryo development and implantation after blastocyst transfer in controlled ovarian hyperstimulation (COH) cycle with premature progesterone elevation for IVF-ET. METHODS: Seventy controlled ovarian hyperstimulation cycles for IVF-ET were underwent with GnRH agonist and hMG/FSH in 70 women. Embryos were cocultured up to the blastocyst stage and transferred into the uterine cavity. The cycles were devided into two groups depending on the levels of plasma P on the day of hCG administration, and the clinical results in both groups were analysed and compared each other. High P group was defined when the level of plasma P was higher than 0.9 ng/mL. RESULTS: Fertilization rates, cleavage rates and blastulation rates were similar in the low and high P groups. Blastulation rates were increased in high quality (morphological characteristics) D 2-3 preembryo regardless of the P levels during the late follicular phase(p <0.001). However, clinical pregnancy rate, ongoing pregnancy rate and implantation rate were higher in low P group compared with high P group(p <0.01). CONCLUSIONS: Premature P elevation did not deteriorate the developmental potential of oocyte, but had a harmful effect on pregnancy rate and implantation rate. So we suggest that early ET on the day 2-3 (after ovum pick-up) without delaying another several days to avoid the advanced maturation of secretory endometrium might be better than blastocyst transfer in patients with premature P elevation.
Blastocyst*
;
Embryo Transfer*
;
Embryonic Structures
;
Endometrium
;
Female
;
Fertilization
;
Gonadotropin-Releasing Hormone
;
Humans
;
Oocytes
;
Ovum
;
Plasma
;
Pregnancy Rate
;
Progesterone*