Uterine lipoleiomyoma presenting as an ovarian dermoid cyst

( Juyeon Kang ),( Subeen Lee ),( Heejeong Kim ),( Hyejin Lee ),( Dayong Lee ),( Taek Hoo Lee ),( Jisun Lee ) 대한산부인과학회 2021 대한산부인과학회 학술대회 Vol.107 No.-

A retrospective analysis of the follicle-stimulating hormone starting dose in expected normal responders undergoing their first in vitro fertilization cycle: proposed dose versus empiric dose

Lee, Dayong,Han, Soo Jin,Kim, Seul Ki,Jee, Byung Chul The Korean Society for Reproductive Medicine 2018 Clinical and Experimental Reproductive Medicine Vol.45 No.4

Objective: The purpose of this retrospective study was to evaluate the appropriateness of various follicle-stimulating hormone (FSH) starting doses in expected normal responders based on the nomogram developed by La Marca et al. Methods: A total of 117 first in vitro fertilization cycles performed from 2011 to 2017 were selected. All women were expected normal responders and used a recombinant FSH and flexible gonadotropin-releasing hormone antagonist protocol. The FSH starting dose was empirically determined (150, 225, or 300 IU). The FSH starting dose indicated by La Marca's nomogram was determined using female age and serum $anti-M{\ddot{u}}llerian$ hormone or basal FSH levels. If the administered dose was exactly the same as the proposed dose, the cycle was assigned to the concordant group (34 cycles). If not, it was assigned to the discordant group (83 cycles). Optimal ovarian response was defined as a total of 8-14 oocytes, hypo-response as < 8 oocytes, and hyper-response as > 14 oocytes. Results: Between the concordant and discordant group, ovarian response (optimal, 32.4% vs. 27.7%; hypo-response, 55.9% vs. 54.2%; and hyper-response, 11.8% vs. 18.1%) and the number of total or mature oocytes were similar. Ovarian hyperstimulation syndrome was rare in both groups (0% vs. 1.2%). The implantation rate, clinical pregnancy rate, miscarriage rate, and live birth rate were all similar. Conclusion: The use of the proposed FSH starting dose determined using La Marca's nomogram did not enhance the optimal ovarian response rate or pregnancy rate in expected normal responders. Individualization of the FSH starting dose by La Marca's nomogram appears to have no distinct advantages over empiric choice of the dose in expected normal responders.

Management of endometriosis-related infertility: Considerations and treatment options

Lee, Dayong,Kim, Seul Ki,Lee, Jung Ryeol,Jee, Byung Chul The Korean Society for Reproductive Medicine 2020 Clinical and Experimental Reproductive Medicine Vol.47 No.1

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

The impact of COVID-19 on human reproduction and directions for fertility treatment during the pandemic

Lee Dayong 대한생식의학회 2021 Clinical and Experimental Reproductive Medicine Vol.48 No.4

Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly, resulting in a pandemic. The virus enters host cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2). These enzymes are widely expressed in reproductive organs; hence, coronavirus disease 2019 (COVID-19) could also impact human reproduction. Current evidence suggests that sperm cells may provide an inadequate environment for the virus to penetrate and spread. Oocytes within antral follicles are surrounded by cumulus cells, which rarely express ACE2 and TMPRSS2. Thus, the possibility of transmission of the virus through sexual intercourse and assisted reproductive techniques seems unlikely. Early human embryos express coronavirus entry receptors and proteases, implying that human embryos are potentially vulnerable to SARS-CoV-2 in the early stages of development. Data on the expression of ACE2 and TMPRSS2 in the human endometrium are sparse. Moreover, it remains unclear whether SARS-CoV-2 directly affects the embryo and its implantation. A study of the effect of SARS-CoV-2 on pregnancy showed an increase in preterm delivery. Thus, vertical transmission of the virus from mother to fetus in the third trimester is possible, and further data on human reproduction are required to establish this possibility. Based on analyses of existing data, major organizations in this field have published guidelines on the treatment of infertility. Regarding these guidelines, despite the COVID-19 pandemic, reproductive treatment is crucial for the well-being of society and must be continued under suitable regulations and good standard laboratory practice protocols.

The efficacy of intrauterine instillation of granulocyte colony-stimulating factor in infertile women with a thin endometrium: A pilot study

Lee, Dayong,Jo, Jae Dong,Kim, Seul Ki,Jee, Byung Chul,Kim, Seok Hyun The Korean Society for Reproductive Medicine 2016 Clinical and Experimental Reproductive Medicine Vol.43 No.4

Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.

Corrigendum to "Management of endometriosis-related infertility: Considerations and treatment options"

Lee, Dayong,Kim, Seul Ki,Lee, Jung Ryeol,Jee, Byung Chul The Korean Society for Reproductive Medicine 2020 Clinical and Experimental Reproductive Medicine Vol.47 No.2

Evaluation of normal morphology, DNA fragmentation, and hyaluronic acid binding ability of human spermatozoa after using four different commercial media for density gradient centrifugation

Lee, Dayong,Jee, Byung Chul The Korean Society for Reproductive Medicine 2019 Clinical and Experimental Reproductive Medicine Vol.46 No.1

Objective: Density gradient centrifugation (DGC) is frequently used to isolate high-motility fractions of spermatozoa. We compared the efficacy of four DGC media in terms of the percentage of morphologically normal spermatozoa, DNA fragmentation level, and hyaluronic acid (HA) binding ability. Methods: Thirty men with a total motile spermatozoa count > 80 million participated. Semen samples were divided into four aliquots, which were processed using PureSperm, PureCeption, Sidney, and SpermGrad media, respectively. The DNA fragmentation level was measured using the Halosperm assay kit and HA binding ability was measured using the HBA assay kit. Results: The mean percentage of morphologically normal spermatozoa was significantly enhanced after DGC using all four media (10.3%, 9.9%, 9.8%, and 10.7%, respectively; p< 0.05 for each when compared with 6.9% in raw semen). The DNA fragmentation level was significantly reduced after DGC using PureSperm, PureCeption, and SpermGrad media (6.0%, 6.5%, and 4.9%, respectively; p< 0.05 for each when compared with 11.2% in raw semen), but not after DGC using Sidney media (8.5%, p> 0.05). HA binding ability did not change after DGC using any of the four media. Conclusion: The four media were equally effective for obtaining a sperm fraction with highly motile, morphologically normal sperm. PureSperm, PureCeption, and SpermGrad media were equally effective for acquiring a sperm fraction with less DNA fragmentation.

Gonadotropin releasing hormone antagonist administration for treatment of early type severe ovarian hyperstimulation syndrome: a case series

( Dayong Lee ),( Se Jeong Kim ),( Yeon Hee Hong ),( Seul Ki Kim ),( Byung Chul Jee ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.5

Objective To report an efficacy of gonadotropin releasing hormone (GnRH) antagonist administration after freezing of all embryos for treatment of early type ovarian hyperstimulation syndrome (OHSS). Methods In 10 women who developed fulminant early type OHSS after freezing of all embryos, GnRH antagonist (cetrorelix 0.25 mg per day) was started at the time of hospitalization and continued for 2 to 4 days. Fluid therapy and drainage of ascites was performed as usual. Results Early type OHSS was successfully treated without any complication. At hospitalization, the median (95% confidence interval [CI]) of the right and the left ovarian diameter was 10.0 cm (7.6 to 12.9 cm) and 8.5 cm (7.5 to 12.6 cm). After completion of GnRH antagonist administration, it was decreased to 7.4 cm (6.2 to 10.7 cm) (P=0.028) and 7.8 cm (5.7 to 12.2 cm) (P=0.116), respectively. The median duration of hospital stay was 6 days (3 to 11 days). Trans-abdominal drainage of ascites was performed in 2 women and drainage of ascites by percutaneous indwelling catheter was performed in 4 women. No side effect of GnRH antagonist was noted. Conclusion GnRH antagonist administration appears to be safe and effective for women with fulminant early type OHSS after freezing all embryos. Optimal dose or duration of GnRH antagonist should be further determined.

Magnetic resonance imaging texture analysis for the evaluation of viable ovarian tissue in patients with ovarian endometriosis: a retrospective case-control study

( Dayong Lee ),( Hyun Jung Lee ) 영남대학교 의과대학 2022 Yeungnam University Journal of Medicine Vol.39 No.1

Background: Texture analysis has been used as a method for quantifying image properties based on textural features. The aim of the present study was to evaluate the usefulness of magnetic resonance imaging (MRI) texture analysis for the evaluation of viable ovarian tissue on the perfusion map of ovarian endometriosis. Methods: To generate a normalized perfusion map, subtracted T1-weighted imaging (T1WI), T1WI and contrast-enhanced T1W1 with sequences were performed using the same parameters in 25 patients with surgically confirmed ovarian endometriosis. Integrated density is defined as the sum of the values of the pixels in the image or selection. We investigated the parameters for texture analysis in ovarian endometriosis, including angular second moment (ASM), contrast, correlation, inverse difference moment (IDM), and entropy, which is equivalent to the product of area and mean gray value. Results: The perfusion ratio and integrated density of normal ovary were 0.52±0.05 and 238.72±136.21, respectively. Compared with the normal ovary, the affected ovary showed significant differences in total size (p<0.001), fractional area ratio (p<0.001), and perfusion ratio (p=0.010) but no significant differences in perfused tissue area (p=0.158) and integrated density (p=0.112). In comparison of parameters for texture analysis between the ovary with endometriosis and the contralateral normal ovary, ASM (p=0.004), contrast (p=0.002), IDM (p<0.001), and entropy (p=0.028) showed significant differences. A linear regression analysis revealed that fractional area had significant correlations with ASM (r²=0.211), IDM (r²=0.332), and entropy (r²=0.289). Conclusion: MRI texture analysis could be useful for the evaluation of viable ovarian tissues in patients with ovarian endometriosis.

메타커머스 스토어 VMD의 특성 연구 - 플레이투게더 스토어를 중심으로 -

이다용 ( Lee Dayong ),김선영 ( Kim Sunyoung ) 한국상품문화디자인학회 2023 상품문화디자인학연구 Vol.72 No.-

메타커머스 스토어는 메타버스에서 상품(아이템)을 구매 또는 경험할 수 있는 상점 형태의 공간으로, 주로 기존 메타버스 플랫폼 내에서 상품 판매나 브랜드 체험을 위해 활용된다. 본 연구는 오프라인과 비교하여 사용자의 경험에 영향을 주는 메타커머스 스토어 VMD의 특성을 규명하고자 하였다. 연구 방법은 문헌연구, 현장 관찰, 인터뷰를 활용한 자료의 삼각화를 통해 동일한 현상에 대한 다각적 관점을 반영하고자 했다. 사례는 오프라인과 메타버스 모두에서 스토어를 운영 중인 ‘라인프렌즈’의 플레이투게더 스토어를 선정하였다. 연구 결과 첫째, 메타커머스 스토어는 오프라인 스토어를 대체할 수는 없으나, 기존에 온라인상에서 경험하지 못한 공간 경험을 제공하여 브랜딩과 마케팅에 도움을 준다. 둘째, 메타커머스 스토어에서 구성요소의 중요 순위는 파사드 > VP > 벽·바닥 순으로 나타났다. 셋째, 메타커머스 스토어 VMD 구성요소에는 기존 오프라인 스토어 요소에 경험적 요소(재미, 상호작용)가 추가되어야 한다. 넷째, 오프라인에서의 시·공간의 물리적 한계를 극복한 경험을 제공하며, 기존 온·오프라인 스토어와 다른 마케팅과 브랜드 경험을 줄 수 있기 때문에 메타커머스 스토어의 지속가능성에 대한 전문가와 일반인들의 평가는 모두 긍정적으로 나타났다. The metacommerce store is a space in the form of a store where you can purchase or experience products or items on Metaverse, and is mainly used for selling products or brand experiences within the existing Metaverse platforms. This study attempted to investigate the characteristics of the metacommerce store VMD that affect the user’s experience compared to offline. The research method attempted to reflect a multilateral perspective on the same phenomenon through triangulation of data using literature research, field observation data, and interviews. We selected the Play Together store of ‘Line Friends’, which operates stores both offline and metaverse as a case. As a result, first, metacommerce stores could not replace offline stores, but they help branding and marketing by providing spatial experiences that have not been experienced online before. Second, the important ranking of components in the meta-commerce store was in the order of facade > VP > wall and floor. Third, it was found that empirical elements (fun, interaction) should be added to the existing offline store elements in the meta-commerce store VMD component. Fourth, both experts and the general public generally evaluated the sustainability of the metacommerce store positively because it provides an experience of overcoming the physical limitations of time and space offline and can give marketing and brand experience different from existing online and offline stores.