Comparison of the clinical outcome of frozen-thawed embryo transfer with and without pretreatment with a gonadotropin-releasing hormone agonist

OBJECTIVE: To describe the clinical outcomes of frozen-thawed embryo transfer (FET) with artificial preparation of the endometrium, using a combination of estrogen (E2) and progesterone (P4) with or without a gonadotropin-releasing hormone agonist (GnRHa), and the modified natural cycle (MNC) with human chorionic gonadotropin (hCG) trigger. METHODS: In this retrospective study, we evaluated 187 patients during 3 years (February 2012–April 2015). The patients were allocated to the following treatment groups: group A, comprising 113 patients (181 cycles) who received GnRHa+E2+P4; group B, comprising 49 patients (88 cycles) who received E2+P4; and group C, comprising 25 patients (42 cycles) who received hCG+P4. The inclusion criteria were regular menstrual cycles (length 24–35 days) and age 21–45 years. RESULTS: The primary outcome of the study — implantation rate (IR) per embryo transferred — was not statistically different among the 3 groups. Similar results were found for the IRs with fetal heartbeat per embryo transferred (68/181 [37.6%] in group A vs. 22/88 [25.0%] in group B vs. 14/42 [33.3%] in group C) and for the live birth rates (LBRs) per embryo transferred (56/181 [30.9%] in group A vs. 18/88 [20.5%] in group B vs. 11/42 [26.2%] in group C). CONCLUSION: Although the pregnancy outcomes were better in the hormone therapy with GnRHa group, hormone therapy FET with GnRHa for pituitary suppression did not result in significantly improved IRs and LBRs when compared with hormone therapy FET without GnRHa or MNC FET.

The status of assisted reproductive technology in Korea in 2012 / 대한생식의학회지

OBJECTIVE: This study was designed to report the status of assisted reproductive technology (ART) therapy in South Korea between January 1, 2012 and December 31, 2012. METHODS: A localized online survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was first launched and provided to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized as standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI. Thawed embryo transfer (TET) and other related procedures, including surgical sperm retrieval, were surveyed. RESULTS: Data from 33,956 ovum pick-up procedures were provided by 75 clinics in 2012. Of the 33,088 cycles in which ovums were retrieved, a complete transfer was performed in 90.5% (29,932 cycles). In addition, 10,079 FET cycles were confirmed to have resulted in clinical pregnancy, representing a pregnancy rate of 30.5% per ovum pick-up and 33.7% per ET. The most common number of embryos transferred in FET was 2 (41.6%), followed by 3 (34.0%), and non-elective single ETs (10.0%). Of the 10,404 TET cycles in which transfer was completed, 3,760 clinical pregnancies (36.1%) were confirmed by ultrasonography. CONCLUSION: The overall clinical pregnancy rate for FET and TET cycles in 2012 was higher than in 2011 (33.7% vs. 33.2% and 36.1% vs. 31.1%, respectively). The most common number of embryos transferred in FET cycles was 2, unlike in 2011.

Anti-Proliferative and Apoptotic Activities of Mullerian Inhibiting Substance Combined with Calcitriol in Ovarian Cancer Cell Lines

PURPOSE: This study aimed to investigate whether Mullerian inhibiting substance (MIS) in combination with calcitriol modulates proliferation and apoptosis of human ovarian cancer (OCa) cell lines (SKOV3, OVCAR3, and OVCA433) and identify the signaling pathway by which MIS mediates apoptosis. MATERIALS AND METHODS: OCa cell lines were treated with MIS in the absence or presence of calcitriol. Cell viability and proliferation were evaluated using the Cell Counting Kit-8 assay and apoptosis was evaluated by DNA fragmentation assay. Western blot and enzyme-linked immunosorbent assay were used to determine the signaling pathway. RESULTS: The cells showed specific staining for the MIS type II receptor. Treatment of OCa cells with MIS and calcitriol led to dose- and time-dependent inhibition of cell growth and survival. The combination treatment significantly suppressed cell growth, down-regulated the expression of B-cell lymphoma 2 (Bcl-2), and up-regulated the expressions of Bcl-2 associated X protein, caspase-3, and caspase-9 through the extracellular signal-regulated kinase signaling pathway. CONCLUSION: These results, coupled with a much-needed decrease in the toxic side effects of currently employed therapeutic agents, provide a strong rationale for testing the therapeutic potential of MIS, alone or in combination with calcitriol, in the treatment of OCa.

Current status of assisted reproductive technology in Korea, 2009

Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical pregnancy rate per cycle with embryo transfer. When comparing with international registry data, clinical pregnancy rate per transfer from fresh IVF cycles including ICSI (34.1%,) was comparable to clinical pregnancy rate per transfer in European Society for Human Reproduction and Embryology report was 32.5% though lower than 45.0% for USA data. There was no remarkable difference in status of assisted reproductive technology in Korea between the current report and the data reported in 2008. The age of women trying to get pregnant was reconfirmed to be the most important factor that may have impact on success of ART treatment.

A Complex Chromosomal Rearrangement Involving 46,XX,t(1;7;16)(p32.1;q22;q13) in a Female with Recurrent Miscarriages After in vitro Fertilization

Balanced complex chromosomal rearrangements involving three or more chromosomes are often detected in phenotypically normal female patients with an adverse obstetric history. Here, we report a 32-yr-old phenotypically normal female with a history of multiple in vitro fertilization (IVF) failures and carrying a balanced complex chromosomal rearrangement involving chromosomes 1, 7, and 16. Cytogenetic analysis revealed the following complex karyotype: 46,XX,t(1;7;16)(p32.1;q22;q13). The patient achieved a twin pregnancy after IVF, although no heartbeat was detected during the sixth gestational week checkup. Tissues from intrauterine fetal demise were tested for chromosomal analysis and revealed 46,XX,t(1;7;16)(p32.1;q22;q13)mat and 46,XY,der(1)t(1;16)(p32.1;q13),der(7)t(1;7) (p32.1;q22)mat. This case illustrates the importance of chromosomal analysis in infertile females or infertile females with multiple IVF failures. Therefore, it would be beneficial for patients visiting infertility clinics to undergo cytogenetic screening for complex chromosome rearrangements before further counseling and prenatal investigations.

A case of primary ovarian leiomyoma / 부인종양

Ovarian leiomyoma is a rare type of tumor that only takes about 1% of benign ovarian tumor. It mostly does not induce any symptoms and is often found by chance during a surgical operation in abdominal cavity. It is microscopically observed that smooth muscle cells with an identical shape and a small nucleus grow in a bundle or in a storiform configuration, and they need to be distinguished from other tumors of the smooth-muscle origin that can occur in ovary such as fibroma/thecoma and extragastrointestinal stromal tumor. Using immunohistochemistry staining on desmin, smooth muscle actin (SMA), alpha-inhibin, c-kit, etc can help with distinguishing these tumors. Recently, the authors experienced in this hospital a primary ovarian leiomyoma of a 43-year-old female patient and hereby report the case with a review of literatures.

Patterns of Normal Change in Fetal Cerebral Artery Doppler by Fetal Gender / 대한산부인과학회지

OBJECTIVE: To establish the normal range of the fetal cerebral artery pulsatility index (PI) throughout pregnancy and to determine if there are any gender differences. METHODS: Doppler ultrasonographic examination was performed to measure the fetal middle cerebral artery (MCA) and anterior cerebral artery (ACA) PI in 71 normal pregnancies between 25 and 39 weeks gestation. Gender determination was possible in 44 fetuses by either a postnatal examination or genetic amniocentesis. The gestational weeks were grouped into 4-week sections. Group I ranged from 28 to 31 gestational weeks. Group II and III ranged from 32 to 35 and from 36 to 39 weeks, respectively. RESULTS: The ACA PI of the male fetuses decreased with increasing gestational time (group I, II and III: 1.79+/-0.35, 1.57+/-0.67 and 1.30+/-0.35; P<0.05). The ACA PI of the female fetuses also decreased significantly (group I, II and III: 1.97+/-0.59, 1.68+/-0.41 and 1.33+/-0.21; P<0.05). The MCA PI of the male fetuses decreased (group I, II and III: 2.02+/-0.58, 1.88+/-0.43 and 1.53+/-0.47; P<0.05). However, there was no significant decrease in the MCA PI of female fetuses (group I, II and III: 2.14+/-0.60, 1.87+/-0.56 and 1.88+/-0.40; P=0.83). CONCLUSION: These data demonstrate that female fetuses show a relatively constant middle cerebral artery PI regardless of the gestational time.

Clinical Evaluation of Ovarian Tumors in Pregnancy / 대한산부인과학회잡지

OBJECTIVE: We performed this study to evaluate the clinical appearance of ovarian timor in pregnancy. MATERIALS AND METHODS: From January 1995 to December 2000, a review was performed 51 cases of ovarian tumors in pregnancy. The diagnosis of ovarian tumor was confirmed by pathologist after operation. RESULTS: 1. The incidence of ovarian tumors in pregnancy was 51 in 11,056 deliveries (1:217). Five cases of borderline malignancy and one case of granulosal cell tumor were reported. 2. The ovarian tumors were the most common between 30 and 34 years of age pregnant women (35.5%) and more common in multiparous women than in nulliparous women. 3. As to the initial chief complaints, no symptoms and sign were in 36 cases (70.6%) low abdominal pain and discomfort were in 6 cases (11.8%) palpable mass were found in 2 cases (3.9%). 4. 53% of patients was diagnoses in the third trimester, 33.3% of patients in the first trimester, 13.7% of patients in the second trimester. 5. Excluding the 27 cases of incidental operation during cesarean section, operation was performed at first trimester in 4 cases (16.7%), at second trimester in 9 cases (37.5%), after conservative management operation during cesarean section was performed at third trimester in 11 cases (45.8%). 6. Complication resulting ovarian tumors occurred in one case of torsion. 7. According to histologic type, there were 15 cases (29.4%) of benign cystic teratoma, 13 cases (23.5%) of mucinous cystadenoma, 8 cases (15.7%) of serous cystadenoma, 4 cases (7.7%) of corpus luteal cyst, 5 cases (9.8%) of mucinous cystic tumor borderline malignancy, 1 case (2%) of granulosal cell tumor. 8. According to effects on pregnancy, among 13 cases in which the ovarian tumor was removed, vaginal delivery occurred at term in 6 cases (46.1%), cesarean section at term in 4 case (30.8%), missed abortion in 1 case (7.7%), preterm delivery in 2 cases (15.4%). 11 cases in which was performed conservative management were done cesarean section at term. CONCLUSION: The incidence of benign and malignant ovarian tumor in pregnancy and is being increased. Considering effects on pregnancy and pregnant women of treatment method, appropriate timing and treatment method should be chosen.

Comparison of Vitrification and Slow Freezing-thawing Method on 1-cell Zygotes / 대한불임학회지

OBJECTIVE: This study was conducted to examine the effect of vitrification on the survival and in vitro development of mice 1-cell zygotes. METHOD: Effects of exposure to vitrification solution and vitrification, with different concentrations of the cryoprotectant solution, were examined. The 1-cell zygotes were also subjected to a slow freezing- thawing method to compare with vitrification method. Solution composed of ethylene glycol (6.0 M, 5.0 M, 4.0 M) and sucrose (1.0 M) were used as cryopropectant. The experiments employed the method loading the embryos on electron microscope grids. RESULTS: I. The effects of exposure in vitrification solution 1-cell zygotes were non-toxic at all concentrations of the vitrification solution showing the survival rate between 88.1% and 97.5%. Development into 2-cell was more successful in the higher concentrations of the vitrification solution. Therefore, higher concentrations of the vitirification solution do not seem to cause any problems in vitrification procedure. II. The effects of vitrification method 1-cell zygotes showed the survival rate between 78.8% and 92.4%. The lowest and the highest survival rate was observed in the 6.0 M and 4.0 M vitrification solution, respectively. 2-cell development rates varied from 77.6% to 91.3%. Blastocyst development rate was shown highest in 5.0 M and the lowest in 4.0 M solution. Therefore, the highest 2-cell and blastocyst development rate was observed in 5.0 M solution. III. Comparison of vitrification and slow freezing-thawing method on 1-cell zygotes This experiment showed that 1-cell zygotes had the highest survival and development rates in 5.0 M vitrification solution. Vitrified group of 1-cell zygotes, in the 5.0 M vitrification solution, were compared with the group processed in slow freezing-thawing method. The development rate into 2-cell and blastocyst as well as the survival rate were higher in the vitrified group than in the slowly freezed group. CONCLUSION: 1. The results demonstrate that the best cryoprotectant is a 5.0 M vitrification solution for 1-cell zygotes. 2. Vitrification method significantly increases the survival rate of the 1-cell zygote and its development into 2-cell and blastocyst. Equilibration and exposure time during the vitrification was remarkerbly short in this experiment. Total time, from the exposure to vitirification solution to storage in the liquid nitrogen, was taken only 90 seconds. In contrast, the slow freezing-thawing method have taken more than four hours. Taken together, we presume that the overall time used for the procedure contributes to the results as an important parameter. 3. The loading of 1-cell zygotes on the EM grid is technically more simple and takes less time than the straw or cryo vial method.

The Relationship between Placental Ratio and Neonatal Morbidity in Intrauterine Growth Restricted Infants / 대한산부인과학회잡지

An increased placental ratio has known to be associated with the occurrence of cardiovascular complications in adulthood among the intrauterine fetal growth restriction. A retrospective study on 202 singleton growth-restricted infants without major congenital anomalies born from Jan. 1995 to Feb. 2001 was performed to determine the relationship between placental ratio and neonatal morbidity. The cases were categorized into three groups according to the placental ratio (1SD above the mean). There were no differences in the maternal characteristics and antenatal complications except pregnancy induced hypertension between high placental ratio group and the other groups. It presented the trend that was toward the increase of placental weight and the decrease of birth weight in high placental ratio group. The infants with a high placental ratio had increasing tendencies of meconium stained amnionic fluid, hypocalcemia, phototherapy, asphyxia.

The Relationship between Placental Ratio and Neonatal Morbidity in Intrauterine Growth Restricted Infants / 대한산부인과학회잡지

An increased placental ratio has known to be associated with the occurrence of cardiovascular complications in adulthood among the intrauterine fetal growth restriction. A retrospective study on 202 singleton growth-restricted infants without major congenital anomalies born from Jan. 1995 to Feb. 2001 was performed to determine the relationship between placental ratio and neonatal morbidity. The cases were categorized into three groups according to the placental ratio (1SD above the mean). There were no differences in the maternal characteristics and antenatal complications except pregnancy induced hypertension between high placental ratio group and the other groups. It presented the trend that was toward the increase of placental weight and the decrease of birth weight in high placental ratio group. The infants with a high placental ratio had increasing tendencies of meconium stained amnionic fluid, hypocalcemia, phototherapy, asphyxia.

A case of Lipoleiomyoma of the Uterus / 대한산부인과학회잡지

No abstract available.

A Case of Uterine Fibroids Necrosis after Transarterial Embolization for Treatment of Uterine Fibroids / 대한산부인과학회잡지

Uterine fibroids are the most common benign tumor of the female genital tract. Traditional therapy for symptomatic fibroids has been either myomectomy or hysterectony, depending on whether futhur fertility is desire. A promised new altermative therapy-embolization of the uterine arteries- is now available. A 29 year-old woman was diagnosed of uterine fibroid by ultrasonogram and other techniques. We have experienced one case of uterine fibroid necrosis after transarterial embolization. Now we report a case of uterine artery embolization for treattement of uterine fibriods with a brief review.

Maternal and perinatal outcomes in triplet versus twin pregnancies with the result of Assisted Reproductive Technology / 대한산부인과학회잡지

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.

The Controlled Study between The Group Used Highly purified FSH and The Group Used FSH/hMG in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: It is known that normal follicular growth and pregnancy are possible using Follicular stimulating hormon(FSH) alone during controlled ovarian hyperstimulation(COH) for IVF-ET. The purpose of this study was to compare and analize the results of COH for IVF-ET between a group using only FSH-HP and a group using FSH/hMG METHOD: 111 cycle of the total 280 COH for IVF-ET cycles belonged to the FSH-HP group, and the FSH/hMG group accounted for remaining 169 cycles. The amount of gonadotropin administered, the duration of hormonal therapy, the number of embryos transfered, the endometrial thickness, and the pregnancy rate were compared between the two groups and statistically analized using the t-test. p values less than 0.05 deemed statistically significant. RESULT: There were no statistical differences on the amount of gonadotropin administered, the duration of hormone therapy, number of oocytes retrieved, nor the endometrial thickness between the two groups. However,the serum E2 level was significantly lower, and the number of embryos of high quality(GradeIandII) significantly higher in the FSH-HP group. In pregnancy rate, FSH-HP group shows higher than FSH/hMG group(38.8% VS 34.2%). but the difference was not large enough to be considered statistically significant. CONCLUSION: The results of this study show that compared to using FSH/hMG, treatment with FSH-HP alone allowed the retrieval of more embryos of high quality, and although not statistically significant, achieved a higher pregnancy rate, thus indicating that it can be used as an effective method for COH.

A Study on Morphological and Immunohistochemical Changes of the Myometrium in the Pregnant and Postpartum Rat / 대한해부학회지

This experiment was performed to investigate morphological and immunohistochemical changes of the connective tissue, the nerve and the smooth muscle cell in the pregnant and postpartum rat myometrium. The materials were the non-pregnant control, the 2-, the 4-, the 10-day gestation and the 1-, the 2-, the 6-day birth of rat myometrium. The light microscopic findings were examed after van Gieson and malachite green stainings. The reaction of nitric oxide synthase activity, apoptosis, type IV collagen, and estrogen receptor were examined immunochemically. The results were as follows: A. Light microscopic findings: 1. In the van Gieson staining for collagen fibers and smooth muscles, it showed the increase of pinky collagen fibers and yellow smooth muscle cells from the 2-day gestation. At the 1-day birth, the yellow hypertrophic smooth muscle cells were in the form of the papilla. The collagen fibers of the 2-day birth were more abundant than that of the 1-day birth. 2. In the malachite green staining for nerve fibers, it showed the blue spots. The size of spots of the 4-day gestation enlarged and at the 10-day gestation the number of fine spots was increased. At the 1-day birth, it showed the decreased number and increased size of spots. B. Immunohistochemical findings : 1. The NOS activity showed the increased positive reaction at the 2-day gestation. At the 10-day gestation, the outer zone of myometrium showed prominent positive. At the 1-day birth, the endothelium of the vessels were weakly positive. 2. The apoptotic reaction was localized at the connective tissue cells between the outer and inner zones of myometrium. The positive reaction cells were a few at the 1-day birth, several at the 2-day birth, and many at the 6-day birth. 3. The type IV collagen reaction appeared at the perivascualr area and the comnnective tissues of the inner zone. The positive reaction showed weak at the control, moderate at the 2-day gestation, and strong at the 4-day gestation. At the 1- and 2-day birth, the connective tissue of inner zone was moderately positive. 4. The estrogen receptor reaction cells appeared at the papillary outer zone of the 10-day gestation. The reaction cells were several at the 1-day birth and a few at the 2-day birth. C. Electron microscopic findings : 1. At the 10-day gestation, one group of smooth muscle cells had well-developed sarcoplasmic reticulum and the other group with abundant mitochondria appeared. At the 2-day birth, one group smooth muscle cells had degenerating processes and the other group with the serrated processes showed. At the 6-day birth, smooth muscle cells were degenerated. 2. Mitochondria were abundant in the smooth muscle cell with many processes of the 10-day gestation. The onset of mitochondrial degeneration began at the 2-day birth. The mean section of mitochondria was increased by the 2-day birth and markedly decreased at the 6-day birth. 3. At the 1-day and 2-day birth, the electron-dense region of cell membrane was increased and submembranous caveolae were decreased. The mean section of caveolae was the mostly decreased at the 10-day gestation, nearly restored at the 1-day birth and enlarged at the 6-day birth.

A Comparative Study of Clinical Symptoms between Pregnancy and Non-Pregnancy Groups in In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

Following IVF and ET it is common to develop clinical symptoms according to pregnancy outcome until day of pregnancy test(post ET day 16). But surprisingly, the squalae of day-case IVF and ET have not been reported . This study was analyzed on clinical symptoms after ET between pregnancy group and non-pregnancy group in 157 IVF and ET cycles from september, 1995 to June, 1996 at the department of Obstetrics and Gynecology, Yonsei University, Wonju Christian Hospital. The results obtained were as follows : 1. The breast engorgement was reported by 36 of 46(78.3 %) of our patients in pregnancy group and 65 of 111(58.6 %) of our patients in non pregnancy group. The results of both group showed significant difference(p0.05). However in pregnancy group, vaginal bleeding was noted from post ET day 8, which its incidence was peaked at post ET day 10 and its pattern was vaginal spotting. In non-pregnancy group, vaginal bleeding was mens like pattern and its incidence was peaked at post ET day 15. 3. The itching sensation on vagina was reported only in pregnancy group(4.3 %) and the urticaria and itching sensation on skin was reported only in non-pregnancy group(5.4 %). The results of both group did not show significant difference(p>0.05).

A Study of Clinical Parameters Influencing Human Zona Pellucida Thickness / 대한산부인과학회잡지

The purpose of present study was to assess which parameters influence human oocyte zona pellucida(ZP). Zone pellucida thickness was evaluated in 124 oocytes of 16 cycles IVF-ET with intracytoplasmic sperm injection(ICSI) between July 1995 and October 1995 at the department of obstetrics and Gynecology, Yonsei university, Wonju Christian Hospital. The zone pullucida thickness was 17.7+/-2.0micronm(mean+/-SD) for 107 metaphase II oocy- tes. The zona pullucida thickness was singinficantly different according to maximum estr- adiol(E2) value ; The mean thickness of Zona pellucida was thinner below 2000 pg/ml of E2 value than that above 2001 pg/ml of E2 value(p0.05).

A Clinical Study on Cesarean Hysterectomy / 대한산부인과학회잡지

This study analyzed the outcome of 26 cases of cesarean hysterectomy performed at Wonju Christian Hospital, College of medicine, Yonsei university during 15 years from January, 1982 to May, 1996. There were 27,602 deliveries during this period. Cesarean hysterectomy was performed in 11 of 10,373 cesarean section(0.11 %) and in 15 of 17,229 vaginal deliveries(0.09 %). The age of patients varied from 20 to 48. Indications for emergency cesarean hysterectomy were uterine atony (46.2 %), uterine rupture(26.9 %), and placenta accreta(19.2 %). The relative risk of emergency hysterectomy was 1.22(95 % confidence interval 0.56 to 2.65) for cesarean deliveries, 1.91(95 % confidence interval 0.73 to 4.98) for prior cesarean deliveries and 20.56(95 % confidence interval 10.85 to 38.95) for placenta previa. The patients who had cesarean hysterectomy received from 750 ml to 11,500 ml of blood transfusion with a mean of 3,500 ml. No significant differences in length of operating time, amount of blood loss and postoperative complications were found between total abdominal hysterectomy and subtotal abdominal hysterectomy. In about 1/2 of total patients (46.2 %), there were no operative complications. Maternal death was found in 1 case. Hemorrhage still remains main cause of maternal mortality, the decision of hysterectomy must be conjunction with maternal life saving and free from various dangerous sequalae. So in this study, clinical evaluation for cesarean hysterectomy and an attempt to identify risk factor that might pridict those patients likely to require emergency hysterectomy was made.

Latex agglutination inhibition test(UCG-slide test) and monoconal antibody - based enzyme immunoassay test (RAMP test) in the diagnosis of ectopic pregnancy / 대한산부인과학회잡지

No abstract available.