Ovarian cyst aspiration guided by transvaginal sonography in EWHA Woman's university hospital from 1993 June to 1995 April was performed in 18cases. And the results were as follows.

1) The mean age of patients was 32.2±10.7 years, i-gravida was 8 cases(44.5%). multigravida was 10cases(55.5%), and mean serum CA-125 level before aspiration was 29.5±15.1U/ml.

2) The chief complaints of patients were ; lower abdominal pain in 8 cases(44.5%), post TAH status in 3 cases(16.7%), and vaginal spotting in 2cases(11.0%)

3) The mean diameter of ovarian cyst by transvaginal sonography was 5.9±1.4cm.

4) The mean amount of cystic fluid was 110.8±84.5ml and in 15 cases the fluid was clear yellowish color. In 1 case, that was chocolate color, thick nature and it was compatible with endometrioma.

5) During the follow-up, 3 cases(16.7%) had recurrenece, for the treatment of recurrence, 1 case was by pelviscopy, 1 case was by reaspiration, and 1 case was simply followed-up.

Conclusively, benign ovarian cyst could be managed satisfactorily by transvaginal sonography guided aspiration of cyst. Careful examination using transvaginal sonography and assessment of serum CA-125 is recommended before managing ovarian cyst by transvaginal sonography guided aspiration. And cytologic examination of aspirated fluid is mandatory as well to rule out the existence of malignacy. Therefore, ovarian cyst aspiration guided by transvaginal sonography would be the complete treatment as well as the definite diagnosis.

I reviewed the 20 pregnancies after In Vitro Fertilization and Embryo Transfer in EWHA Woman's University Hospital from 1990 September to 1994 December. And the Results were as follows.

1) The mean age of patients were 31.7±3.9 and the average duration of infertility was 4.3±2.3 years.

2) The major cause of infertility was tubal factor and especially bilateral tubal obstruction was most frequent.

3) Controlled Ovarian Hyoerstimulation methods were FSH/hMG and GnRH-agonist/GSH/hMG(long, shohrt, and ultrashort protocol). Long protocol using GnRH-agonist/GSH/hMG had the highest pregnancy rate(35.3%).

4) Regarding the response to controlled ovarian hyperstimulation, serum estradiol level in the day of hCG administration(DO) was 3169.4±3611.5pg/ml. Do endometrium thickness was 9.3±2.7mm, the number of aspirated oocytes was 9.8±7.1, the number of preovulatory oocytes was 9.3±14/7.4mm, the number of cleaved oocytes was 6.1±6.3 and so fertilization rate was 66.3%.

5) The outcomes of pregnancy comprised chemical pregnancy(2 cases), abortion(7 cases), ectopic pregnancy(1 case), term delivery(9 cases), and ongoing pregnancy(1 cases). As considered the number of fetus, singleton pregnancy was in 13 cases(76.5%) and twin pregnancy was in 4 cases(23.5%).

In order to investigate the clinical application of media and fetal cord serum in human In Vetro Ferulization program, its preparation and quality control was performed and the results were as follows.

1) When the in vitro growth and developmental to hatching blastocyst of 2-cell stage mouse embyos was observed three times, the average developmental rate was 84.5% in m-KRB media with an addition of 0.3% bovine serum albumin. And m-KRB media was accepted as adequate to experiment.

When the in vitro growth and development to hatching blastocyst of 2-cell stage mouse embyos was observed three times in m-KRB media with an addition of 10% fetal cord blood serum, if the developmental rate was no significance between test media with control, we approved the serum as safe and used it in human in vitro fertilization program.

2) When the in vitro growth and development to hatching blastocyst of 2-cell stage mouse embyos was observed three times in the contol and Ham's F-10 media was accepted as adequate to experiment.

3) When the safe fetal cord serum was used in the human in vitro fertilization program, the average pregnancy rate was 33.3%.

Judging from above results, the strict quality control of media and fetal cord serum should be necessary for obtaining the high pregnancy rate in human in vitro fertilization program However, this kind of quality control system is very complex and time-consuming, so, therefore, the more effective and simple quality control system should be developed in the near future.

We reviewed IUI(28 cases), IPI(5 cases), POST(4 cases), GIFT(6 cases), performed in EWHA Woman's University Hospital from 1988 March to 1993 June. And the results were as follows.

1) The mean ages of patients were 29.9±3.7(IUI), 30.7±2.6(IPI), 29.3±1.2(POST), 30.3±4.3(GIFT) and the durations of infertility were 3.7±1.9(IUI), 3.0±1.9(IPI), 2.3±0.9(POST), 3.4±1.7(GIFT) years.

2) The major causes of infertility in IUI were tubal factor(9 cases), unexplained infertility(5 cases), in IPI and IUI tubal factor was 2 cases, and in GIFT, unexplained in fertility was 5 cases.

3) The major method of ovulation induction was clomiphene citrate in IUI, and FSH/hMG in IPI, POST and GIFT.

4) The result of pregnancy were 2 cases in IUI(7.1%), 1 case in IPI(20%), POST 1 case(25%), and 2 case in GIFT(33.%).

From Feb. 1989 to July 1993, 84 cases of microsurgical tubal reanastomosis were performed at the Department of Obstetrics and Gynecology, Ewha Womans University Hospital. And 49 cases of tubal reanastomosis were fo11owed-up more than 6 months after operation.

The charateristics of 84 reanastomosis and the results of 49 reanastomosis which have been fol1owed up more than 6 months are as follows :

1) At the time of reanastomosis, mean age of the patients was 32.5 years and average interval between sterilization and reanastomosis was 6.0 years. The mean postoperative tubal lengthwas 5.5cm.

2) The site of the reanastomosis in majority is isthmic to isthmic portion(85.7%) and cornus to isthmic(8.3%).

3) After more than 6 months of postoperative fo11ow-up, it revealed a pregnancy rate of 63.2% (31/49). And by the sterilization type, the pregnancy rate is 68.7% (11/16) in ring group, 63.3% (19/30) in cautery group.

4) The outcome of the 31 pregnancies after reanastomosis were 26 cases of full term delivery, 2 ongoing pregnancy, 2 abortion and 1 tubal pregnancy.