The media for assisted fertilization from Medi-Cult is based on a Synthetic Serum Replacement(SSR). The main principle of SSR is a metal iron buffer containing a balanced mixture of iron and trace metals. Recently, Synthetic Serum Supplement(SSS) and Medi-cult are commonly used.

These synthetic substitutes have some advandages, such as safty from viral contamination and no needs of bioassay.

To compare the usefulness between the Medi-cult and Ham's F-10 supplemented with fetal cord serum for the culture medium of in vitro fertilization, fertilization rate, cleavage rate and pregnancy rate were studied. It is concluded that Medi-cult was better than Ham's F-10 supplemented with fetal cord serum according to fertilization rate, cleavage rate, pregnancy rate and ongoing pregnancy, but that differences did not have statistical significance.

Intraperitoneal hemorrhage during reproductive age usually result from ruture of ectopicpregnancy, corpus luteum, and endometrioma.

The symptom and sign of the corpus luteum hemorrhage is lower abdominal pain and tenderness so differential diagnosis with ectopic pregnancy is needed.

The sonographic findings of corpus luteum hemorrhage is free blood in cul de sac and adnexal mass. In the case of hemorrhagic corpus luteum of the considerable size with evidence ofintraperitoneal hemorrhage, operative intervention may be necessary. But operation is complicated and have some hazard.

So we reported these cases of hemorrhagic corpus luteum with intraperitoneal hemorrhagetreated by transvaginal sonogrphy successfuly.

After menopause, the incidence of osteoporosis and cardiovascular is increased and the cause of both disease is estrogen deficiency. So we evaluated the relationship between serum lipid profile which is a good indicator of the cardiovascular disease and spinal bone mineral density. Spinal BMD was measured by dual photon absorptiometry and serum lipid profile and alkaline phosphatase, total calcium measured before initiating hormone replacement therapy. Z score was correlated with inversely with alkaline phosphatase(r=-0.35, p<0.05). Serum lipid level were divided into high and low risk category, after adjustment of risk category total cholesterol had significant affects on relationship with spinal Z score. Our results suggest that postmenopausal women with low Z score also have high total cholesterol should be cosidered as a special high risk group for prevention of cardioavascular disease.

Thanatophoric dwarfism is a short limb dwarf condition which usually results in death shortly after birth. It has been confused with achondroplastic and another congenital short limb dwarf condition. We now report a case of thanatophoric dwarfism in a 29-year-old woman, based on prenatal sonographic, radiological and autopsy findings with a review of literatures.

The diagnosis of cervical incompetency is routinely accomplished by reviewing the clinical history and pelvic examination subjectively. Rescently by using ultrasonography. the objective method in diagnosis of cervical incompetency was developed. Especially, the transvaginal sonography can provide clear visualization of uterine cervix with an empty bladder without distrosion of cervix which was developed when abdominal sonography with distended bladder.

So author performed the study in 46 cases of pregnant women of which menstrual age was 12 weeks to 36 weeks(normal control group 36 cases, risk group 11 cases) during the period of May, 1992 to Febburary, 1993. And these two groups were performed trasvaginal sonography and measured length and diameter of cervix.

And the result were follows ;

1) The mean age was higher in risk group than normal control group, the gestational age was not significantly different between two groups, and the gravity and parity was higher in risk group than normal control group.

2) As measuring the length and diameter of cervical canal by transvaginal sonogram in nullipara and multipara in normal control group, each measurements were not significantly different between nullipara and multipara.

3) The mean length of cervix by transvaginal sonography was 3.0±0.97cm in risk group, 4.7±0.89cm in normal control group and the cervical length was significantly shorter in risk group than normal control group(P<0.01).

4) The mean diameter of cervix by transvaginal sonogram was 2.0±0.37cm in risk group, 0.5±0.21cm in normal control group and the diameter of cervix was significantly greater in risk group than normal control group(P<0.01).

Transvaginal sonographic measurement of cervical length and diameter in diagnosis of incompetent internal os of cervix is noninvasive and relatively objective method.

We have reviewed 35 cycles in 27 patients who underwent IVF and ET with reasonable indications from March 1992 to February 1993. The method of ovarian hyperstimulation were FSH/hMG/hCG(N=10), GnRH agonist(N=24), C.C./hMG/hCG(N=1).

The results were as follows ;

1) The mean age of patients was 33.04±4.17 and mean duration of infertility was 5.52±3.37 years.

2) Major indications for IVF and ET were tubal factor(77.80%), peritoneal factor(18.50%), and unexplained infertility(3.70%).

3) In the past history of patients, there were previous ectopic pregnancy in 5 cases(17.24%), previous tuboplasty in 5 cases(17.24%), pevic inflammatory disease in 4 cases(16.00%), and tuberculosis in 3 cases(12.00%).

4) The cancellation was only one case in FSH/hMG/hCG group.

5) The timing of hCG administration in FSH/hMG/hCG group was 9.56±1.50 day and GnRH-a group was 9.17±0.99 day.

6) The mean numbers of follicles larger than 16mm were 6.78±4.71 in FSH/hMG/hCG group and 5.33±3.82 in GnRH-a group.

7) The mean numbers of oocyte aspirated were 6.44±3.17 in FSH/hMG/hCG group and 5.54±2.27 in GnRH-a group.

8) The fertilization and cleavage rate was 59.93±33.91% in FSH/hMC/hCG group and 57.61±30.81 in GnRH-a group.

9) The mean number of embryos transfered were 4.56±3.69 in FSH/hMe/hCG group and 3.38±2.10 in GnRH-a group.

10) Pregnancy rate were 22.2% in FSH/hMG/hCC group and 25% in GnRH-a group.

11) There were 8 cases of pregnancies which consisted of two live births of 3 babies, 3 cases of ongoing pregnancies, one spontaneous abortion, two chemical pregnancies.

We experienced a case of trisomy 16 discovered with missed abortion in pregnancy achievedby IVF-ET. Spontaneous abortion rate after IVF-ET was higher than normal pregnancy. Chro-mosome anomalies had been reported in spontaneous abortions after IVF-ET. We had attempted to karyotype which miscarriged gestational 8 weeks, and the result was found trisomy 16.So we reported the case with a brief review of literatures.