Significance of Combined Use of Kamishoyosan and Tokishakuyakusan for General Infertility Treatment / 日本東洋医学雑誌

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.

Role of Diagnostic Laparoscopy in Evaluation of Infertile Women

Objective: To find out the magnitude of different types ofpelvic pathologies female infertility by laparoscopy.Methods: Seventy five infertile women who had undergoneinfertility evaluation by laparoscopy to see the pelvic pathologyor evaluation of pelvic organs at infertility department of BangoBandhu Sheikh Mujib medical university between July 2016 toJune 2017, were studied. Assessment of these patients wascarried out carefully before starting the endoscopic procedures.A full history was taken which was followed by thoroughgeneral, abdominal and pelvic examination than laparoscopywas performed under G/A.Results: The mean age ranged from 18 to 42 years. Amongthem 51(68%) patients were aged between 21 to 30 years. 51(68%) patients had primary infertility and 24 patients (32%) hadsecondary infertility.44 (58%) had normal tubes, 08 (10.67%)had some form of peritubal adhesion and 14 (18.67%) hadtubal block, either unilateral or bilateral. 52 (69.33%) patientshad normal pelvic peritoneum, 16 (21.33%) had pelvicadhesion probably from pelvic inflammatory diseases and07 (9.33%) had frank endometriosis. 23 (30.66%) had normalovaries, 32 (42.66%) had polycystic ovaries (pcos), 06 (08%)had periovarian adhesions, 04 (5.33%) patients had simpleovarian cysts, while 02 (2.66%) had endometriotic (chocolate)cysts.Conclusion: Ovarian pathology was the highest pelvicabnormality (69%) followed by tubal pathology (38%) anduterine pathology (29%)

Intrafollicular Soluble RAGE Benefits Embryo Development and Predicts Clinical Pregnancy in Infertile Patients of Advanced Maternal Age Undergoing In Vitro Fertilization / 华中科技大学学报（医学）（英德文版）

Soluble receptor for advanced glycation end products (sRAGE) can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular sRAGE levels and clinical outcomes in infertile women of young or advanced maternal age (AMA) undergoing in vitro fertilization (IVF).A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular sRAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sRAGE and age or follicle-stimulating hormone (FSH) were examined.We found that the intrafollicular sRAGE levels were higher in young patients than those in AMA patients,suggesting that the sRAGE levels were inversely correlated with age.In young patients,sRAGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sRAGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the sRAGE levels decrease with age.Elevated intrafollicular sRAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of sRAGE may not be so predominant.

Profile of MicroRNA Expression in Endometrial Cell during In Vitro Culture According to Progesterone Concentration

Artificial uterus using endometrium implant can be a novel treatment strategy for infertile women with refractory endometrial dysfunction. At early pregnancy, the function of uterine endometrial cells for the communication between the conceptus of pre-implantation period and maternal reproductive system is essential. MicroRNA (miR) expression profile of endometrial cells according to progesterone, a crucial pregnancy-maintaining hormone, provides important data for in vitro endometrial cell culture strategy that is useful for engineering artificial uteri using endometrial implants. The present study aimed to evaluate the miR expression profile of in vitro cultured endometrial cells under hormonal milieu mimicking early pregnancy period in terms of progesterone concentration. We cultured murine uterine endometrial cells, human uterine endometrial carcinoma cells, and immortalized human uterine endometrial cells using different progesterone concentrations, and analyzed the expression of miRs critical for early pregnancy. The expression of miR-20a, -21, -196a, -199a, and -200a was differently regulated according to progesterone concentration in different endometrial cell lines. The analysis of candidate target genes showed that the expression of phosphatase and tensin homolog, mucin 1 (MUC1), progesterone receptor, transforming growth factor β receptor II, matrix metallopeptidase-9 was up-regulated by progesterone treatment in mouse and human endometrial cell lines. These results indicate that physiological concentration range (10⁻⁷ and 10⁻⁹ M) of progesterone affect the survival and target gene expression via modulating miR expression. Taken together, progesterone can be a crucial factor in regulating miR expression on in vitro cultured endometrial cells.

Relationship between Infertility Stress and Quality of Life of Infertile Women: Based on the Moderating and Mediating Effects of Sexual Satisfaction

PURPOSE: We aim to assess the moderating and mediating effects of sexual satisfaction in the relationship between infertility stress and quality of life of infertile women, and contribute to alleviate the infertility stress and promote the quality of life of infertile women. METHODS: As a descriptive study, we surveyed 151 infertile women in G. and B in Korea. cities from November 2014 to January 2015. The data was analyzed in SPSS WIN 18.0 program. RESULTS: Infertility stress, sexual satisfaction, and quality of life averaged 3.82±.56 (range of scale 1~6), 3.42±.44 (range of scale 1~5), and 3.52±.50 (range of scale 1~5), respectively. Infertility stress had a negative correlation with quality of life (r=-.709, p<.001). Sexual satisfaction had a negative correlation with infertility stress (r=-.332, p<.001), and positive correlation with quality of life (r=.543, p<.001). Sexual satisfaction did not have moderating effects on the relationship between infertility stress and quality of life. However, sexual satisfaction showed mediating effects between infertility stress and quality of life. CONCLUSION: Therefore, it is necessary to provide infertile women with the counseling on their sexual problems, and the intervention programs for infertile women is expected to help them cope and adapt with their personal and marital problems, reduce their stress, and thus promote their quality of life.

Effect of Abdominal Massage before In Vitro Fertilization Injection on Alleviating Pain among Infertile Women

PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.

Factors Associated with Marital Satisfaction of Women Under Infertility Treatments

PURPOSE: The purpose of this study is to determine the infertility stress, marital intimacy, and marital satisfaction of women under infertility treatment, and to reveal associated factors of marital satisfaction. METHODS: As a descriptive correlation study, data was collected from 174 women under infertility treatment. Data was analysed using χ2-test, t-test, ANOVA, pearson's correlation coefficients, and stepwise multiple regression. RESULTS: Infertility stress, marital intimacy, and marital satisfaction averaged 3.20±.3 (range of scale 1~5), 3.53±.5, and 3.74±.6, respectively. The marital satisfaction varied with a statistical significance by the spouse's attitude about infertility treatment and financial burden on infertility treatments. Marital satisfaction had a positive correlation with infertility stress (r=.526, p<.001) and marital intimacy (r=.637, p<.001). We also identified the marital intimacy as the most influencing factor and the infertility stress as the second most influencing factor on the infertile women's marital satisfaction. CONCLUSION: This research provided a valuable opportunity to recognize infertility as a marital, family, and societal problem, which calls for relational support as well as personal support. The infertility experts need to recognize both the personal and relational aspects of the infertility problem, and make various efforts to promote the reproductive health of the infertile patients.

A Structural Model for Quality of Life of Infertile Women

PURPOSE: The purpose of this study was to test a model for quality of life among infertile women. This model was based primarily on the concept of the Fertility Quality of Life by Boivin et al. (2011) and the Infertility Resilience Model by Rindenour (2009). METHODS: Fifteen measurable variables were used to estimate quality of life. They included endogenous variables such as fertility quality of life and resilience, and exogenous variables such as infertility related stress, depression, marital adjustment, and family support. Data sets (n=203) used for analysis were collected in a general hospital which had, on average, 400 assisted reproductive technologies per month. RESULTS: The assessment of the modified model indicated acceptable fit, with chi2/d.f=2.07, GFI=.90, AGFI=.89, NFI=.89, CFI=.91, RMSEA=.07. Depression, infertility related stress, marital adjustment, resilience, and family support had direct influences on quality of life. CONCLUSION: The results of this study should contribute to the development of nursing intervention programs to enhance quality of life using factors that affect fertiQol (fertility quality of life) of infertile women.

Sero prevalence of Hepatitis B virus among infertile women recruited for Assisted Reproduction Technology (ART)

Aim: Sexually transmissible diseases such as Hepatitis B virus (HBV) causes or induces incurable often fatal infections have been transmitted through Assisted Reproduction Technology (ART). This study is to determine the seroprevalence of HBV among infertile women recruited for intrauterine insemination (I.U.I). Methodology and Results: A 5mL of blood was collected and serum aspirated. The detection of HBV was carried out using global one-step rapid test kit relative sensitivity of 99% and specific of 97%. Age range of infertile women was 20 – 49 years. Approximately 30 (5.9%) out of the 512 recruited women were seropositive for HBV with increase in prevalence rate among age group of (25 – 29 years) and (30 – 34 years). The rate of infection of HBV was found to be insignificant in this study using chi-square statistical analysis (p > 0.0001). Conclusion, Significance and Impact of Study: Though the rate of the virus infection were statistically insignificant but the screening should be a continuous exercise and be carried out by all fertility center.

Development of an Uncertainty Scale for Infertile Women / 여성건강간호학회지

PURPOSE: The purpose of this study was to develop an uncertainty scale for infertile women. METHODS: The process included construction of a conceptual framework, generation of 12items, verification of content validity, selection of secondary items, verification of construct validity and extraction of final items. In order to verify the reliability and validity of the preliminary instrument, data were collected from 50 infertile women in an In Vitro Fertilization (IVF) clinic. Data were analyzed by item analysis, Varimax factor analysis and Cronbach's alpha. RESULTS: There were 10 items in the final instrument categorized into 2 factors labeled as "personal (6 items)" and "relational (4 items)" The total variance explained was 73.36%. The instrument was shown to have good reliability with a Cronbach's alpha of .899. CONCLUSION: Validity and reliability of the scale were confirmed in this study showing its utility to measure uncertainty for infertile women. The instrument can help understand sterility and accurately measure uncertainty for infertile women. The instrument can also be used to evaluate nursing interventions designed for mitigating uncertainty for infertile women.

Effect of Folic Acid Supplementation on Serum Homocysteine and B Vitamins in Infertile Women

Elevated homocysteine concentration is known to be related to placental abruption, spontaneous abortion, and many adverse pregnancy outcomes. The purpose of this study was to investigate the effects of folic acid supplementation (1000 microgram per day) and 5, 10 methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism genotype on serum homocysteine and B vitamin levels in 50 infertile women (aged 31.2 +/- 3.2 years). Blood sampling was performed at baseline and at the end of folic acid supplementation period. In infertile women, serum folate and vitamin B12 concentrations were significantly higher in post-supplementation than those in pre-supplementation. Serum homocysteine concentration was significantly lower in post-supplementation than that in pre-supplementation. However, serum homocysteine levels were still higher in the T/T genotype than those in the C/C or C/T even after folic acid supplementation. Serum homocysteine was inversely related to serum folate in T/T homozygotes at baseline and at the end of folic acid supplementation. These results suggest that folic acid supplementation is needed for infertile women to improve their vitamin status and also to reduce the risk of hyperhomocysteinemia. These effects were different according to their MTHFR C677T genotypes. Therefore, further studies are necessary to determine the optimal level of supplementation of folic acid by MTHFR genotypes.

Vitamin B Status and Serum Homocysteine Levels in Infertile Women

Adequate vitamin B(2), vitamin B(6), folate and vitamin B(12) nutrition is known to be important for reproductive function in women of childbearing age. The purpose of this study was to evaluate serum vitamin B(2), vitamin B(6), folate and vitamin B(12) status and serum homocysteine levels in 115 women aged 33.2 +/- 4.0 years, who had been diagnosed with infertility, and 49 women aged 34.5 +/- 3.8 years having at least one born child. Total vitamin B(2) and vitamin B(6) intakes in infertile women were significantly lower than those in control. Serum vitamin B(2), vitamin B(6), folate and vitamin B(12) concentrations were significantly lower in infertile women than those in control and serum homocysteine levels were significantly higher in infertile women than those in control. Thirteen percent in infertile women and zero percent in control were assessed as hyperhomocysteinemic and there was a significant difference in the prevalence of hyperhomocysteinemia between infertile women and control. 41% infertile women were assessed as folate deficiency. Serum folate concentrations was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B2 intakes was negatively correlated with serum homocysteine of the infertile women and control. Total vitamin B6, folate intakes were negatively correlated with homocysteine of infertile women only. In conclusion, infertile women are needed to intake more B vitamins intakes. Furthermore researches are needed to estimate adequate B vitamin supplementation in infertile women.

Stress Perception, Coping Behavior, Depression and Anxiety in Infertile Women / 신경정신의학

OBJECTIVE: The purpose of this study was to investigate psychological impacts of infertility-related stress in Korean infertile women. METHODS: Both the 34 infertile women group and the control group(34 married women) were evaluated by using Semistructured Questionnaire, Stress Perception Scale, Coping Behavior checklist, Beck Depression Inventory(BDI), Hamilton Anxiety Scale(HAS), Hamilton Rating Scale for Depression(HRSD), SCL-90-R and State Trait Anxiety Inventory(STAI). RESULTS: Perceived financial stress, frequency of negative and neutral life events and frequency of passive coping(especially, emotion-focused coping) were significantly higher in infertile women than control group. In infertile women, totally perceived stress was positively correlated with BDI, SCL-90-R(depression) and STAI. Passive coping behavior was positively correlated with BDI, HAS and STAI. CONCLUSION: Above results suggest that infertile women would have a tendency to passive coping and high level of depression and anxiety, and should be considered for psychiatric intervention.