고식적 체외수정시술과 난자 세포질내 정자주입술에 의해 태어난 아이의 주산기 결과 및 선천성 기형 발생빈도의 비교 연구

임정은,유근재,이종표,이문섭,현우영,전진현,홍수정,송지홍,송인옥,백은찬,최범채,손일표,궁미경,강인수,전종영,박인서,Lim, Jeong-Eun,Yoo, Keun-Jai,Lee, Jong-Pyo,Lee, Moon-Seob,Hyun, Woo-Young,Jun, Jin-Hyun,Hong, Soo-Jeong,Song, Ji-Hong,Song, In-Ok,Paik, 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.3

The safety of ICSI as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestational age $({\pm}SEM)$ and birth weight in singleton pregnancy were $38.8{\pm}1.9$ weeks and $3209.7{\pm}501.9gm$ in IVF group, $39.0{\pm}2.2$ weeks and $3289.9{\pm}479.5gm$ in ICSI group, respectively. Mean gestational age and birth weight in twins were $36.8{\pm}2.1$ weeks and $2512.8{\pm}468.0gm$ in IVF group, $36.5{\pm}2.8$ weeks and $2492.7{\pm}537.1gm$ in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twins; for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.

노블리스 오블리주-장학생 선발 조건이 '금연'?

송인옥,Song, In-Ok 벤처기업협회 2006 벤처다이제스트 Vol.95 No.-

소형 망원경을 이용한 천체의 분광관측과 교육적 활용

송인옥,백창현,이정주,황인준,Song, In-Ok,Baek, Chang-Hyeon,Lee, Jeong-Ju,Hwang, In-Jun 한국천문학회 2012 天文學會報 Vol.37 No.2

국내의 교육기관에서는 망원경과 검출장비의 한계로 천체의 측광관측에 중점을 둔 실험교육을 하고 있으며 천체의 물리, 화학적 특성을 이해하는데 필수적인 천체분광 실험교육은 원활하지 못한 상황이다. 천체분광 실험 교육을 위하여 과학교육용 실험장비인 랩주니어(Lab-Junior)를 이용하여 소형망원경으로도 천체의 스펙트럼을 얻을 수 있는 어댑터를 개발하였다. 5인치 망원경에 랩주니어 장비를 장착하여 달과 행성의 태양반사 스펙트럼을 얻을 수 있었고 12인치 망원경에 장착하여 데네브(deneb) 같은 밝은 천체의 스펙트럼을 얻을 수 있었다. 이 발표에서는 랩주니어를 이용하여 관측된 스펙트럼 데이터를 분석해 보고 학교 현장에서 교육적 활용 방안을 소개하고자 한다. 개발된 장비를 활용한다면 고가의 분광장치가 없는 학교나 천문교육시설에서도 손쉽게 천체분광 실험 교육프로그램을 운영할 수 있을 것이다.

불임환자의 착상기 자궁내막에서 leukemia inhibitory factor의 발현에 관한 연구

송인옥(In Ok Song),김계현(Kye Hyun Kim),유근재(Keun Jai Yoo),송지홍(Ji Hong Song),궁미경(Mi Kyoung Koong),전종영(Jong Young Jun),허영범(Young Bubm Huh),강인수(Inn Soo Kang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.5

N/A Objective : To determine the expression of endometrial leukemia inhibitory factor (LIF) in infertile women and to compare it with that of fertile women during the window of implantation. Methods : Endometrial biopsies were performed during the window of implantation from 10 normal fertile and 15 infertile women (5 unexplained infertility, 5 endometriosis and 5 tubal disease with hydrosalpinx). We performed immunohistochemistry using paraffin-embedded endometrial tissues. Results : In fertile and infertile women, the staining intensities of LIF in the glandular epithelium were significantly higher (p<0.01) than those of stromal cells. There was no significantly difference in the expression of LIF between the glandular epithelium of infertile women with endometriosis or hydrosalpinx and those of fertile women. However, the staining intensities of LIF in the glandular epithelium of unexplained infertility patients were significantly lower (P<0.01) than those in fertile women. The staining intensities of LIF in stromal cell of women with unexplained infertility, endometriosis and hydrosalpinx were similar to those in fertile women. Conclusions : This study demonstrated that the glandular epithelial cells are more important sites of LIF secretion than stromal cells. The expression of endometrial LIF may be decreased in women with unexplained infertility during the window of implantation. Therefore, this result suggest that abnormalities of LIF expression in infertile women may underlie endometrial dysfunction in the adhesive phase of implantation.

드론 안전성 확보를 위한 한국-EU 비교법적 연구

송인옥 ( In Ok Song ),송동수 ( Dongsoo Song ) 이화여자대학교 법학연구소 2021 法學論集 Vol.25 No.3

드론은 전 세계적으로 상용화되고 있고, 앞으로 그 활용 분야가 더욱 넓어질 것으로 예측된다. 한편 드론의 활용범위가 확대됨에 따라 드론 불법비행, 충돌 및 추락사고, 사생활 침해 문제가 빈번히 발생하고 있어 드론의 안전성 확보가 핵심적인 문제로 대두되고 있다. 이러한 배경 속에서 우리나라는 2019년 「드론법」을 제정하여 드론산업 육성과 안전성 확보를 위한 기반을 조성하고 있다. 그러나 「드론법」은 드론산업 육성에 초점이 맞추어져 있고, 안전과 관련된 사항은 「항공안전법」을 비롯한 개별 특별법에 따라 규율되어 드론의 안전성 확보가 효과적으로 이루어지지 못하고 있다. 반면 EU는 2018년 항공 관련 규칙을 새롭게 제정하여 드론의 관리체계를 구체화하고, 그에 대한 책임을 명확히 해 드론 비행의 안전성을 확보하고 있다. 특히 드론에 CE 마크 및 등급식별 라벨을 부착하여 드론이 최소한의 기술적 기준을 준수하고 있음을 증명하고 있다. 그리고 드론의 조종사와 제작자, 수입업자, 유통업자에 드론의 안전성 확보를 위한 일정한 의무를 부여하여 체계적인 안전관리가 이루어지고 있다. 본 논문에서는 우리나라와 EU의 드론의 안전 관련 법규의 비교를 통하여 우리나라에서 드론의 안전성을 강화하기 위한 다음과 같은 개선방안을 제안하고 있다. 먼저 드론의 불법비행에 대응하기 위하여 국가중요시설에 공역에서의 방어체계를 구축하여야 한다. 그리고 드론의 기술적 안전성 확보를 위하여 드론이 우리나라의 법적 기준을 충족하고 있음을 증명할 수 있는 인증제도를 도입하여야 한다. 또한, 드론의 수입업자와 유통업자에 기체의 안전성을 다시 한번 확인할 의무, 드론을 관리하고 비행하는 데에 필요한 정보를 제공할 의무를 부과하여야 한다. 마지막으로 법적 안정성의 확보를 위하여 국토교통부 고시에 규정되어 있는 드론 제작자와 소유자의 드론 안전성 확보의무와 유지책임을 법령의 형식으로 변경하여야 한다. 이로써 드론으로 인해 발생하는 사고를 완화하고, 드론의 안전성을 강화할 수 있을 것이다. Drones are being commercialized all over the world, and it is expected that their utilization will expand in the future. Meanwhile, as the range of drones expands, there are frequent problems with illegal flight, crashes, and invasion of privacy of drones, and thus securing safety of drones is emerging as a key issue. Against this backdrop, Korea enacted the 「Act on Promotion of Utilization of Drones and Creation of Infrastructure Therefor」 in 2019 to create a foundation for fostering the drone industry and securing safety. However, safety-related matters are regulated under individual special laws, including the 「Aviation Safety Act」, and thus the safety of drones is not effectively secured. On the other hand, the EU established new aviation-related rules in 2018 to shape the drone’s management system and clarify its responsibilities to ensure the safety of drone flight. In particular, the drone is systematically managed by attaching CE marks and grades to prove that the drone complies with minimum technical standards, and by giving certain obligations to the drone manufacturers, pilots, importers, and distributors to ensure the safety of the drone. In this paper, we compare these drone-related laws in Korea and the EU to derive the following improvement measures to enhance the safety of drones in Korea. First of all, in order to secure the technical safety of drones, a certification system that can prove that drones meet the legal standards of Korea should be introduced. It also gives the importer and distributor of the drone the obligation to double-check the safety of the gas and to provide the information necessary to manage and fly the drone. Finally, in order to secure legal stability, the law stipulates the responsibility of drone manufacturers and owners of drones prescribed in the Ministry of Land, Infrastructure and Transport’s notice to secure drone safety. This reduces accidents caused by drones and strengthens the safety of drones.

국가중요시설의 드론테러 예방 및 대응을 위한 법·제도적 개선방안

송인옥 ( Song In Ok ) 연세대학교 법학연구원 2021 法學硏究 Vol.31 No.3

최근 드론이 다양한 분야에서 활용되고, 그 취득이 용이하게 됨에 따라 드론이 각종 범죄 수단으로 활용되는 사례가 빈번하게 발생하고 있다. 특히 드론을 이용하여 국가중요시설을 공격하는 이른바 드론테러가 전 세계적으로 끊임없이 발생하고 있고, 우리나라 역시 그와 같은 위험으로부터 자유로울 수 없는 상황에 처해있다. 공항, 발전소와 같은 국가중요시설은 국가안보와 국민생활에 중대한 영향을 주는 시설이어서, 그에 대한 테러공격은 심각한 피해를 야기한다. 따라서 세계 각 국가에서는 드론테러로부터 국민의 생명과 재산을 보호하고, 공공의 안전을 확보하기 위하여 이른바 “안티드론”시스템을 도입하는 등 각종 노력을 기울이고 있다. 한편 우리나라는 드론의 활용을 촉진하기 위한 방향으로 법과 정책이 추진되고 있을 뿐, 드론으로 인하여 발생할 수 있는 각종 위험에 대한 예방 및 대응체계의 구축은 미흡한 실정이다. 우리나라의 국가중요시설이 드론을 활용한 공격에 취약함을 알 수 있는 사건이 실제로 여러 차례 발생하였으나 여전히 예방 및 대응책은 마련되지 못하고 있다. 본 논문에서는 드론테러로부터 국가중요시설을 보호하기 위하여 관련 법·제도의 개선방안을 제시하고자 한다. 먼저 각종 규제로 활발히 활용되지 못하고 있는 안티 드론을 국가중요시설에 한정하여서라도 실질적으로 활용하게 하고, 드론테러 발생 시 신속한 대응이 이루어질 수 있도록 각종 테러의 예방 및 대응 활동을 규정하고 있는 「국민보호와 공공안전을 위한 테러방지법」의 개정을 제안한다. 구체적으로는 국가중요시설에 대한 안티드론을 구축하고, 그에 대한 초동조치를 국가중요시설 관리자에게 의무화할 것을 제안한다. 그리고 현재 국가중요시설의 안티드론 혹은 드론테러와 관련된 내용을 전담하는 부서가 없는 점을 개선하여 일원화된 관리체계를 구축할 것을 제안한다. 이와 같은 법·제도의 개선을 통하여 적극적으로 활용되지 못하고 있는 안티드론의 활용을 촉진하고, 드론테러에 대해 신속하고 적극적인 대응을 끌어내 드론테러로부터 국민의 생명과 재산, 공공의 안전을 확보하고자 한다. Recently, as drones are being used in various fields and as acquisition has become easier, there have been frequent cases in which drones are used for various criminal means. In particular, so-called drone terrors that attack key national facilities have been constantly occurring around the world, and Korea is also in a situation where it cannot be free from such dangers. State-critical facilities such as airports and power plants have a significant impact on national security and people's lives, and terrorist attacks can cause serious damage. Therefore, countries around the world are making various efforts to protect people's lives and property from drone terrorism and to secure public safety. Meanwhile, laws and policies are being promoted to facilitate the use of drones in Korea, while the establishment of a system to prevent and respond to various risks that may arise from drones is insufficient. Several incidents have actually occurred that indicate that Korea's key national facilities are vulnerable to attacks using drones, but preventive and countermeasures have yet to be prepared. In this paper, we intend to present measures to improve related laws and systems to protect key national facilities from drone terrorism. First of all, we propose to revise the Anti-Drones Act for the Protection of the People and Public Safety, which stipulates the prevention and response of various terrorism activities so that anti-drones, which are not actively used due to various regulations, can be used only in key national facilities. Specifically, it is suggested that anti-drones be established for critical national facilities and that initial measures become mandatory for facility managers. We also propose to establish a unified governmental management system as there is no department dedicated to anti-drone or drone terrorism in current state-critical facilities. Through such legal and systematic improvements, the government aims to promote the use of anti-drone, which has not been actively utilized, and to secure the public and protect property, by quickly and actively responding to drone terrorism.

난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구

김미란,송인옥,연혜정,최범채,백은찬,궁미경,손일표,이진우,강인수,Kim, Mee-Ran,Song, In-Ok,Yeon, Hye-Jeong,Choi, Bum-Chae,Paik, Eun-Chan,Koong, Mi-Kyoung,Song, Il-Pyo,Lee, Jin-Woo,Kang, Inn-Soo 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.2

Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

Efficacy of Frozen-Thawed ET in Patients with Old Age or Non-Pregnant in Fresh ET Cycles

최수진,이선희,송인옥,궁미경,강인수,전진현,Choi, Su Jin,Lee, Sun Hee,Song, In Ok,Koong, Mi Kyoung,Kang, Inn Soo,Jun, Jin Hyun The Korean Society for Reproductive Medicine 2006 Clinical and Experimental Reproductive Medicine Vol.33 No.4

목 적: 동결-융해 배아이식은 보조생식술에서 환자들에게 보다 많은 임신의 기회를 제공해줄 수 있는 방법으로 이용되고 있다. 본 연구에서는 예후가 좋지 않은 환자들에서 동결-융해 배아이식의 효용성을 알아보고자 하였다. 연구방법: 나이가 많은 고령 환자군 (38~44세)과 신선주기 배아이식에서 임신 실패군을 연구대상으로 하였다. 과배란 유도를 통해 채취한 난자를 일반적인 체외수정 또는 세포질내 정자주입술을 시행하여 수정을 유도하고, 잉여의 전핵 또는 난할 시기의 배아를 완만동결법으로 동결하였다. 동결보관 배아는 급속융해법으로 융해하여 호르몬요법을 시행한 환자의 자궁에 이식하였다. 신선 배아이식과 동결-융해 배아이식 과정에서의 배아 상태, 임신율, 착상률 등을 통계적인 방법으로 분석하였다. 결 과: 나이가 많은 고령군에서 신선 배아이식을 시행한 환자들과 동결-융해 배아이식을 시행한 환자들의 평균 연령은 $40.0{\pm}1.8$세 (n=206)와 $39.9{\pm}1.9$세 (n=69)로 통계적으로 유의한 차이가 없었으나, 임상적인 임신율과 착상률은 동결-융해 배아이식에서 29.0%와 11.2%로 신선 배아이식의 16.5%와 7.0%에 비해 통계적으로 유의하게 높게 나타났다. (p<0.05). 첫 번째 신선 배아이식에서 임신 실패군의 연속되는 신선 배아이식 환자군 ($31.2{\pm}2.3$, n=40)과 동결-융해 배아이식 환자군 ($31.9{\pm}3.1$, n=119)에서의 평균 연령은 차이가 없었으며, 임상적 임신율 (42.5% vs 40.3%)과 착상률 (22.6% vs 18.8%)도 유사하였다. 결 론: 본 연구에서는 동결-융해 배아이식이 고령 환자들에서 효과적으로 임신율과 착상률을 높일 수 있음을 보여주고 있다. 이러한 결과는 과배란 유도에 따른 자궁의 착상 환경 변화가 고령 환자들에서 임신율과 착상률을 저하시키는 것과 관련이 있을 것으로 생각된다. Objective: The aim of this study was to evaluate the efficacy of frozen-thawed ET in poor prognosis patients such as the old age (38~44 years; OA group) and the patients who did not achieve clinical pregnancy with the first fresh ET cycle (non-pregnant patients; NP group). Methods: Laboratory and clinical data were collected from fresh and frozen-thawed ET cycles of OA and NP group. Controlled ovarian hyperstimulation (COH) and conventional insemination or ICSI, in vitro culture and ET were performed by routine procedures. Supernumerary embryos were frozen by the slow freezing method, and frozen embryos were thawed by the rapid thawing method. Embryo development, pregnancy and implantation rates were statistically analyzed by Student t-test and chi square test Results: Mean ages were similar between fresh ET ($40.0{\pm}1.8$ years, n=206) and frozen-thawed ET ($39.9{\pm}1.9$ years, n=69) cycles in OA group. However, the clinical pregnancy and implantation rate of subsequent frozen-thawed ET significantly higher than those of fresh ET cycles (29.0% and 11.2% vs. 16.5% and 7.0%, p<0.05). In NP group, there was no difference in the mean age between fresh ET ($31.2{\pm}2.3$ years, n=40) and frozen-thawed ET ($31.9{\pm}3.1$ years, n=119) in subsequent cycles. The clinical pregnancy and implantation rates were similar between the subsequent fresh ET (42.5% and 22.6%) and the frozen-thawed ET (40.3% and 18.8%). Conclusion: In old age patients, higher pregnancy rate of frozen-thawed ET compared to fresh ET cycles in this study. It may be related that better uterine environments for implantation in frozen-thawed ET cycles than that of non-physiological hormonal condition in uterus of fresh COH cycles.

생식샘자극호르몬 분비호르몬 길항제를 이용한 난소자극 투여법에서의 경구복합피임제의 전처지: 비교 연구

추연실 ( Youn Sil Choo ),한애라 ( Ae Ra Han ),양승헌 ( Seung Heon Yang ),성나영 ( Na Young Sung ),차선화 ( Sun Hwa Cha ),김혜옥 ( Hye Ok Kim ),박찬우 ( Chan Woo Park ),송인옥 ( In Ok Song ),궁미경 ( Mi Kyoung Koong ),강인수 ( In S 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.10

목적 생식샘자극호르몬 분비호르몬 길항제를 이용한 난소자극 투여법에서 경구복합피임제의 전처치가 체외수정시술의 결과에 미치는 효과에 대해 평가해 보고자 하였다. 연구방법 2009년 9월 1일에서 2010년 2월 28일까지 본원 불임센터에서 체외수정시술을 위해 총 194회의 생식샘자극호르몬 분비호르몬 길항제 요법을 시행한 환자 중 경구복합피임제를 전처치한 경우와 그렇지 않은 경우의 체외수정 및 배아이식술의 진료 기록을 찾아 후향적으로 분석하였다. 결과 경구복합피임제 전처치군의 경우 사용된 생식샘자극호르몬의 사용량이 전처치하지 않은 군보다 많았다(3019.38±1379.00 vs. 2551.52 ± 1157.05 IU, P = 0.054). 난소 자극 시작부터 난소 채취를 위한 마지막 생식샘자극호르몬의 투여일까지 기간 또한 경구복합피임제 전처치 군(11.5 ± 2.0)에서 전처치하지 않은 않은 군(9.5 ± 1.9)에 비해 통계학적으로 의미 있게 길었다(P = 0.000). 배아 총 획득 갯수(2.8 ± 0.9 vs. 2.5 ± 1.0, P = 0.055) 및 난자수정률(77.2% vs. 65.5%, P = 0.017) 또한 경구복합피임제 전처치 군에서 처치 하지 않은 군에 비해 통계학적으로 의미 있게 높았다. 한편, 임신율에 있어서는 두 그룹 간에 통계학적으로 유의한 차이가 없었다(39.4% vs. 30.0%; P = 0.0304). 결론 체외수정시술을 위한 생식샘자극호르몬 분비호르몬 길항제 사용 시 경구복합피임제를 전처치 하였을 때, 그렇지 않은 군에 비해 최종적인 체외수정시술의 결과적인 측면에서 현저한 장점은 없는 것으로 보인다. 하지만 좀 더 명확한 결론을 도출하기 위해서는 더 많은 연구군을 포함한 전향적인 연구가 필요할 것으로 생각된다. Objective To evaluate whether oral contraceptive pill (OCP) pretreatments in gonadotropin-releasing hormone (GnRH) antagonist ovarian stimulation protocols takes positive effects on in vitro fertilization (IVF) outcomes in respect to retrieved oocyte number, oocyte maturation rate, fertilization rate, good quality embryo rate, cycle cancellation rate, pregnancy rate and clinical abortion rate. Methods A total of 194 cycles using GnRH antagonist protocol was performed at infertility clinic of our institute from September 1st, 2009 to February 28th, 2010. The medical records of GnRH antagonist protocols for IVF with or without OCP pretreatment in our IVF unit were retrospectively analyzed. We compared the IVF outcomes between OCP pretreated (n=41) and no pretreatment group (n=153). Results In cycles with OCP pretreated group, the total used dosage of gonadotropin (3019.38±1379.00 IU) were higher than that of no pretreatment group (2551.52 ± 1157.05 IU, P = 0.054). The duration of ovarian stimulation in OCP pretreated group (11.5 ± 2.0) was significantly longer than that of control group (9.5 ± 1.9, P = 0.000). The number of gained total embryo (2.8±0.9 vs. 2.5±1.0, P = 0.055) and fertilization rate (77.2% vs. 65.5%, P = 0.017) were significantly higher in OCP pretreated group. There is no significant difference in pregnancy rate between two groups (39.4% vs. 30.0%, P = 0.304). Conclusion OCP pretreatment before GnRH antagonist protocol for IVF appears not to have reliable benefit in terms of IVF outcomes. Wellcontrolled and large-scaled studies are needed.

습관성유산 및 불임환자에서 자궁중격절제술 후 임신의 결과

송지홍(Ji Hong Song),유근재(Keun Jai Yoo),송인옥(In Ok Song),백은찬(Eun Chan Paik),최범채(Bum Chae Choi),손일표(Il Pyo Son),전종영(Jong Young Jun),박인서(In Sou Park),궁미경(Mi Kyoung Koong),강인수(In Soo Kang) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12

N/A Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.