Association between serum anti-Mullerian hormone level and ovarian response to mild stimulation in normoovulatory women and anovulatory women with polycystic ovary syndrome / 대한생식의학회지

OBJECTIVE: To evaluate the correlation between serum levels of anti-Mullerian hormone (AMH) and ovarian response to mild stimulation in normoovulatory women and anovulatory women with polycystic ovary syndrome (PCOS). METHODS: Seventy-four cycles of mild stimulation (clomiphene citrate+gonadotropin followed by timed intercourse or intrauterine insemination) performed in normoovulatory women (57 cycles) and anovulatory women with PCOS (17 cycles). Ovarian sensitivity was defined by the number of mature follicles (> or =14 mm) on triggering day per 100 IU of gonadotropin. A correlation between ovarian sensitivity and the baseline serum AMH level (absolute or multiples of the median [MoM] value for each corresponding age) was calculated. Correlation between ovarian response and serum AMH level was evaluated. RESULTS: Ovarian sensitivity to mild stimulation was positively correlated with absolute serum AMH (r=0.535, p0.05, r=-0.265, p>0.05, respectively). CONCLUSION: Ovarian response to mild stimulation is possibly predicted by the serum AMH level in normoovulatory women, but not in anovulatory women with PCOS.

Serum biomarkers for predicting pregnancy outcome in women undergoing IVF: human chorionic gonadotropin, progesterone, and inhibin A level at 11 days post-ET / 대한생식의학회지

OBJECTIVE: This study was performed to assess the prognostic value of serum hCG, progesterone, and inhibin A levels measured at 11 days post-ET for predicting pregnancy outcome in women participating in IVF. METHODS: Between May 2005 and April 2008, sera were obtained from 70 infertile women who underwent IVF-ET at 11 days post-ET and stored. HCG, progesterone, and inhibin A levels were measured by commercial enzyme-linked immunosorbent assay kits. The predictive accuracy of hCG, progesterone, and inhibin A levels for establishment of intrauterine pregnancy and ongoing pregnancy was calculated by receiver-operating characteristic curve analysis. RESULTS: For the prediction of intrauterine and ongoing pregnancy, serum hCG was better than progesterone and inhibin A. The predictive performance of progesterone and inhibin A was similar. The serum progesterone and inhibin A levels were significantly correlated each other (r=0.915, p=0.010). CONCLUSION: A single measurement of the serum hCG level is sufficient to predict pregnancy outcome in IVF-ET patients.

Stimulated intrauterine insemination in women with unilateral tubal occlusion / 대한생식의학회지

OBJECTIVE: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. METHODS: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. RESULTS: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. CONCLUSION: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

A Case of Krukenberg Tumor arising from Appendix / 대한산부인과학회잡지

Krukenberg tumor arising from an appendiceal neoplasm is rare. The 30 cases of appendiceal Krukenberg tumor have been reported since 1970 currently. The tumors can be easily overlooked because appendiceal tumors are rare and its size is very small so that they can be seen normally to the naked eye. The proper treatment of tumors which spreads from the appendix to the ovary does not exist as of yet, so the mean survival time is only 7-9 months and the prognosis is not good. Therefore, when the ovarian tumor that secrete the mucus substance is found and primary origin cannot be found, diagnostic appendectomy is recommended. Authors report a case of the 46-year-old woman who admitted with chief complaints of palpable abdominal mass which reveals Krukenberg tumor from appendix.