, Hyang Mee Kim, Young Soo Son, Han Ki Yu To assess intraovarian blood flow Doppler parameter during the natural and controlled ovarian hyperstimulation cycles in early follicular, periovulatory and midluteal phase each other.
Serial measurement throught the menstrual phase in natural 9 cases and controlled ovarian hyperstimulation cycles 14 cases. We measure the doppler parameter which were PI, RI, and A/B ratio by transvaginal ultrasound-color flow doppler.
No differences were observed between the two groups. During the natural cycle, ovarian blood flow velocity has a pulsatility index(PI) was 0.68, 0.68 and A/B ratio was 3.37, 3.38 respectively, which were not statistically significant. And so, during the controlled ovarian hyperstimulation cycle blood velocity was a PI of 1.43, 1.38, 0.87 in early follicular, periovulatory and midluteal phase, RI was 0.67, 0.66, 0.77 and A/B ratio was 3.29, 2.42, 2.35 respectively, which were not statistically significan, too.
Transvaginal ultrasound-color Doppler velocimetry is easy application and comfortable to physician and patient. And the image of pelvic organ and pathophysiologic condition are concerned by sonogram tools especially doppler measurement. We think that the sonographic information are very available to evaluated clinical result and outcome, of ART future.
, Hyang Mee Kim 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.
, Seung Eun Oh, Young Soo Son, Han Ki Yoo, Bock Hi Woo 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.
, Ji A Ryu, In Ok Song, Hye Won Chung, Jung Ja An, Young Soo Son, Eun Chul Chung, Bock Hi Woo 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.
, Hye Won Chung, Young Soo Son, Sun Hee Chun, Bock Hi Woo, Seong Eun Oh 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.
, Young Soo Son, Han Ki Yoo, Bock Hi Woo 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.%).
, Ok Kyeung Lim, Mi Hye Park, Hyo Kyeung Shin, Hang Mee Kim, Young Soo Son, Bock Hi Woo, Ho In Chung, Jung Soo Shu Diffuse pulmonary Iymphangitic involvement secondary to cervical carcinoma is a rare form of pulmonary metastatic disease. A patient with recurrent squamous cell carcinoma of cervix presented with rapid deterioration with marked respiratory symptoms suggestive of pulmonary embolism and right heart faiure, with which the disease is often confused.
Pulmonary Iymphangitic spread of the cancer was found postmortem. The pathogenesis of pulmonary Iymphangitic carcinomatosis is reviewed and diagnostic evaluation discussed.
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