Obstetric Outcomes and Congenital Malformations of Children born after Intracytoplasmic Sperm Injection According to the Origin of Sperm / 대한산부인과학회지

OBJECTIVE: To analyze the obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies of neonates born after intracytoplasmic sperm injection (ICSI) according to the origin of sperm. METHODS: A total of 103 neonates born from ICSI between January 1995 and January 2004 was included. They were divided into three groups: ejaculated (n=73), epididymal (n=17) and testicular (n=13) groups. We compared obstetric outcomes such as pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth, birth-weight, and the incidence of congenital malformations and chromosomal anomalies. RESULTS: There were no differences among the three groups in terms of pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth and birth-weight. There were no differences in the incidence of low birth-weight babies and very low birth-weight babies. Major malformations were observed in two cases of ejaculatory group (2.7%) and one of testicular group (7.7%). Major malformations included two gastrointestinal malformations and one cleft lip. Minor malformations were observed in three cases of ejaculatory group (4.1%) and one of testicular group (7.7%). Chromosomal anomalies were observed in 6 cases of 105 pregnancies (5.7%), and all of them were from the ejaculatory group. Two cases had autosomal numerical anomalies and 4 cases autosomal structural anomalies. However, sex chromosomal anomalies were not detected in this study. CONCLUSION: The obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies in ICSI babies were not different according to the origin of sperm. These findings should be further investigated in larger long-term studies.

Clinical Study of Microinvasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: With the use of regular cervical cytologic screening, an increasing percent of patients with invasive cervical cancer are being diagnosed with early-stage disease. During the past two decades, there has been considerable interest in identifying a group of patients with early invasive cancer who have a minimal risk for extracervical spread. Method: From January 1993 to June 2000, we have experienced 26 cases with microinvasive cervical cancer. The data were collected retrospectively and all charts were reviewed. Result: The age ranged from 29 to 69 years and median age was 44.3 years. 18 cases incidentally found through the routine Pap smear, in symptomatic group most frequent initiating symptom was postcoital bleeding. The corresponding rate of Pap smear to histologic diagnosis was approximately 26.9%. However, corresponding rate within one histologic grade was about 69.2%. The modified radical abdominal hysterectomy was performed in 21 cases and modified radical abdominal hysterectomy with pelvic lymph node biopsy was performed in 4 cases and radical abdominal hysterectomy with pelvic node biopsy was done in 1 case with greater than 3 mm and no greater than 5 mm stromal invasion. There was no surgery-related deaths and recurrent cases in this study. CONCLUSION: The prognosis of stage Ia cervical cancer is relatively good and less radical therapeutic approach may be beneficial. But, further prospective study based on large numbers of cases with multi-institutional cooperation and designed protocol will be necessary.

Analysis of Serum Triple-Marker Screening in In Vitro Fertilization and Naturally Conceived Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To compare and analysis the result of second trimester maternal serum triple marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived by conventional in vitro fertilization- embryo transfer (IVF-ET) with that of the naturally conceived pregnancies. METHODS: Maternal serum screening tests during the second trimester in 49 singleton pregnancies conceived by IVF-ET and 813 singleton pregnancies conceived naturally of whom delivery outcome was normal in each other were analyzed from April 1997 to June 2000. RESULTS: 4 (8.2%) out of 49 cases of IVF-ET singleton pregnancies compared with 62 (7.6%) out of 813 cases of naturally conceived pregnancies had a positive RESULTS: for Down syndrome or open neural tube defects. The median level of the triple markers were 1.03 0.47 multiples of the median (MoM) in IVF-ET pregnancies vs 1.05+/-0.39 MoM in natural pregnancies for alpha-fetoprotein (AFP), 1.11+/-0.64 vs 1.19+/-1.13 MoM for unconjugated estriol (uE3) and 1.21+/-0.56 vs 1.11+/-0.59 MoM for human chorionic gonadotropin (hCG). CONCLUSION: The positive rate of triple test and the median values of triple markers for Down syndrome and open neural tube defect between two groups were not different in terms of statistical significance. To provide an objective assessment of an individual patient's risk of fetal abnormality, the impact of IVF-ET on triple marker biochemistry should be studied further in larger samples and adjustments made if appropriate.