신생아제대혈청이 난자성숙과 난구세포 분산에 미치는 영향

이여일,박현정,권영숙,Lee, Yu-Il,Park, Hyun-Jeong,Kwon, Young-Suk 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.1

This study was performed to investigate the stimulating effect on oocyte maturation and cumulus cell expansion in TC199 media by human cord serum (HCS) supplementation. Immature mouse oocyte cumulus complexes (OCCs) were cultured in TC199 media supplemented with bovine serum albumin (BSA), HCS and human chorionic gonadotropin (hCG) instead of luteinizing hormone (LH) respectively, and the expression of cumulus expansion and oocyte maturation were observed. After 4hr and 24hr culture with or without OCCs, media containing 0.4% BSA, 10% HCS and 10 IV hCG respectively were collected and analyzed for changing concentrations of estradiol $(E_2)$, progesterone $(P_4)$, testosterone (T), and $PGF_{2\alpha}$. There were no elevation of $E_2$, T, and $PGF_{2\alpha}$ by OCCs culture, but minute elevation of $P_4$ level by 24hr OCCs culture in hCG supplementation (p=0.048). The stimulating pattern of cumulus expansion of OCCs by HCS and hCG supplementation was similar to our previously report using Ham's F-10 media, however oocyte maturation rates after 24hr OCCs culture in all media were increased by $20\sim30%$ compared to Ham's F-10 media. These results suggest that LH in HCS induce cumulus expansion probably by $P_4$ secretion of OCCs, and TC199 is efficient media for immature mouse oocyte maturation.

경질초음파검사를 이용한 고위험자연유산 환자의 관리에 관한 연구

이여일,장장순 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.9

1989년 8월부터 1990년 9월까지 만 1년 2개월동안 자연유산이 일어날 위험이 많아고 인정된 43명의 임산부를 대상으로 임신 첫 3개월동안 경질초음파검사를 이용해서 1주간격으로 추적하여 다음과 같은 성적을 얻었다. 1. 대상환자는 불임치료 후 임산부가 65.1%로 가장 많았고, 절박유산이 37.2%, 반복 또는 습관성유산이 11.6%, 그리고 전번 자연유산이 9.3%의 순이었다. 2. 전체 대상환자의 유산율은 23.3% 이었으며, 불임치료 후 임신시는 17.9%, 절박유산시는 31.2% 그리고 반복 또는 습관성유산과 전번 자연유산은 각각 20%와 25%의 유산율을 나타내었다. 3. 임신유지군에서 임신낭포는 임신 4주, 태아심박동은 임신 5∼6주, 태아 두둔 거리측정은 임신 5∼6주, 난황난은 임신 6∼7주, 양막강, 사지, 제대, 그리고 뇌실은 임신 7∼8주, 그리고 대뇌겸과 태아운동은 임신 8주이후에 관찰되었고, 태아 두둔거리에 따른 임신주수와 임상적 임신주수는 거의 일치된 소견을 보였다. 4. 직경 26mm이상의 임신낭포에 태아심박동이 없던 경우는 결국 모두 유산되었으며, 일단 임신낭포가 나타나면 임신유지군에서 전 예가 2주이내에 태아심박동을 확인할 수 있어, 임신낭포안에 심박동이 없더라도 최소한 2주이상의 추적관리가 필수적이며 또한 태아심박동이 발견되기만 하면 대부분인 97.1%에서 임신이 지속되었다. 5. 임신유지 실패군은 대부분이 배아나 태아의 구조물이나 기능이 없거나, 있더라도 추적 중에 태아 사망 후 소실되었다. 6. 따라서 경질초음파검사를 이용한, 자연유산이 우려된 임신 첫 3개월이내의 임산부에 대한 추적관리는 배아의 구조물과 기능의 변화를 감안하여 일정한 간격으로 연속적으로 시행한다면 효과적이고 효율적으로 수행될 수 있을 것으로 사료된다. Transabdominal sonography has been, for the past two decades, used as an effective diagnostic and research tool in obstetrics. Its use in the first trimester is relatively limited and mostly diagnostic in nature. The introduction of the higher frequency transvaginal transducer probe, with its higher resloution of the images, opens new possibilities to study early gestation. There is a need for techniques which will allow an early diagnosis to be made in high risk patients of early pregnancy failure, preferably with such certainty that a more active line of management can be pursed if so desired. A total of 164 transvaginal scans were performed from 4 to 12 weeks` gestation in the high risk patients of early pregnancy failure. The sequential appearance of 9 embryonal structures or functions were examined: (1) the gestational sac appeared in week 4: (2) the fetal pole with detectable heart beat was first seen in week 5~6: (3) the yolk sac was present from week 6~7:(4) the single unpartitioned ventricle in the brain, the amnionic sac and the body stalk or umbilical cord marked week 7: (5) the falx cerebri and fetal motion appeared during week 8, respectively in continued pregnancy. A sac greater than 26 mm in diameter without fetal heart beat is a poor prognostic sign. Before a live embryo is visualized in the intrauterine gestational sac, no sonographic features were found to be reliable in differentiating viable from nonviable pregnancy (presenting as an empty gestational sac) on a single sonographic examination. Serial vaginal sonography is effective and efficient in the diagnosis and management of early pregnancy failure.

일반연제 발표 : 생식내분비 및 불임 ; 체외수정 실패 정자에 대한 전자현미경적 연구

이여일,나재형 대한산부인과학회 1993 대한산부인과학회 학술대회 Vol.72 No.-

원발성 무월경 환자에 대한 세포유전학적 연구

이여일,김승국 대한산부인과학회 1993 Obstetrics & Gynecology Science Vol.36 No.4

1988년 1월부터 1991년 4월까지 전남대학교 병원불임 및 부인과 내분비크리닉에 내원한 28 명의 원발성 무월경환자를 대상으로 시행한 염색체검사 및 임상소견을 분석하여 다음과 같은 성적을 얻었다. 1. 정상 여성핵형을 보인 경우는 15명(53.3%)이었고, 비정상 핵형을 보인 경우는 13명(46.5%) 이었다. 2. 비정상 핵형을 보인 13명중 46,XY 남성핵형을 보인 1예를 제외한 12예가 터너 또는 터너양증후군의 핵형을 보였고 이를 세분하면 45,X를 보인 경우가 5례(17.8%), 46,XXp-가 2예, 그외 45,Xp-, 46,Xdup(X), 45,X/46,XXq-, 45,X/46,Xi(xq), 45,X/46,XX가 각각 1예씩 나타났었다. 3. 여러 터너증후군의 유형중 45,X, 46,Xdup(X), 45,X/46,XXq-에서 특징적 임상소견인 단신, 익 상경, 외반주, 유방 발육부전 및 성선자극호르몬 상승을 보였으나, 45,X/46,XX에서는 단신과 유방 발육부전, 45,X/46Xi(Xq)는 유방 발육부전과 성선자극호르몬 상승, 그리고 45,Xp-는 외반주를 동반하지 않았다. 4. 정상 46,XX핵형인 15명중 생식기 기형이 동반된 경우가 8명(53.3%)있었고, 생식기 기형 의 동반이 없었던 7명중 성선자극호르몬 저하가 4예 그리고 각각 1예에서 정상 또는 상승 치를 나타내었다. 5. 이상의 결과로 미루어 보아 원발성 무월경 환자에 대한 염색체 핵형분석은 반드시 수행되 어야 할 필수적인 검사이며, 신체적 이상 여부와 성선자극호르몬 측정을 보조적으로 시행하 여 참고하면 원인 분류에 도움이 될 것으로 사료된다. This investigation represents a cytogenetic study of 28 women with primary amenorrhea who had visited our Reproductive Endocrinology and Infertility Clinic at the Chonnam University Hospital between January 1988 and April 1991. In sixteen of them, the chromosomal complements were normal 46,XX in 15 patients (53.5%) and 46,XY in one patients (3.6%). In twelve (42.9%) of them, the X chromoses were either missing or anomalous, and the chromosomal analysis of these patients revealed five patients with 45,X karyotypes (17.8%), two patients with 46,XXp- karyotypes (7.1%), and five patients with 45,Xp-, 46,X dup(X), 45,X/46, XXq-, 45,X/46,X,I(Xq) and 45,X/ 46,XX karyotypes respectively. Because the considerable patients of primary amenorrhea had the various cytogenetic abnormalities, the chromosomal analysis is advocated as a primary tool in the evaluation of primary amenorrheic patients.

임신중 파종성 혈관내응고

이여일 대한산부인과학회 1983 대한산부인과학회 학술대회 Vol.51 No.-

인간난자의 체외수정 및 자궁내 배아이식에 관한 연구 호남지방 최초의 시험관아기 임신 및 분만

이여일,임영경,변지수 대한산부인과학회 1991 대한산부인과학회 학술대회 Vol.68 No.-

무월경에 대한 검사

이여일 대한산부인과학회 1993 연수강좌 Vol.23 No.-

난자 및 배아성숙이 시험관아기시술 성공률에 미치는 영향

이여일,박현정,김재훈 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.5

There are a number of factors affecting the pregnancy rate in in vitro fertilization (IVF): the etiology of infertility, ages of husband and wife, the type of ovarian stimulation, the number of aspirated oocytes, the maturity of oocyte, embryo quality, the number of fertilized oocytes, the cumulative embryo score, and the number of embryos transferred. Among them the maturity of oocyte and the quality of embryo appear to be the most important factors influencing the pregnancy rate. The aim of this study designed to evaluate the effect of oocyte maturity, embryo quality, the number of embryos transferred, and the cumulative embryo score to fertilization rate on whether the patient conceived or not. A total of 146 consecutive cycles of in vitro fertilization-embryo transfer(IVF-ET) were studied using two ovarian hyperstimulation protocols; follicular stimulating hormone(FSH)/ human menopausal gonadotropin(HMG)/human chorionic gonadotropin(hCG) and gonadotropin releasing hormone agonist(GnRH-a)/FSH/HMG/hCG. Following were the results. 1. The quality and quantity of oocytes and embryos, fertilization rate, and cumulative embryo score between two ovarian hyperstimulation protocols were not different. 2. The more mature oocytes exhibited, the greater fertilization rates in both methods (p$lt;0.01). 3. The average numbers of embryos transferred were 3.65+-0.27 in conceived group and 2.54+-0.18 in nonconceived group, which was statistically higher in conceived group (p$lt;0.001). 4. The pregnancy rate was higher if any matured embryo(Grade I) was present among the embryos transferred(p$lt;0.05). 5. The average cumulative embryo score was 69.70+-6.13 inconceived group and 43.51 +-3.41 in nonconceived group, which was statistically higher in conceived group(p$lt;0.001). These data suggest that the pregnancy rate is higher when the oocyte maturation is Better, the number of embryos transferred is greater, there is at least one matured embryo among the embryos transferred, and the cumulative embryo score is higher.

자궁강내 인공수정에 관한 임상적 연구

이여일,임영경 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.7

Methods used for artificial insemination with husband's semen ( AIH ) have undergone continuous revision in the hope of increasing the pregnancy rate obtained. We report our methodology using technology developed for in vitro fertilization to prepare sperm for intrauterine insemination. Our overall pregnancy rate is 40%. In this preliminary study several parameters are compared with the pregnancy rates achieved.

정자 세정후 Swim-up 처치가 정자의 운동성에 미치는 영향

이여일,Lee, Yu-Il 대한생식의학회 1991 Clinical and Experimental Reproductive Medicine Vol.18 No.1

Thirty five couples were treated by intrauterine insemination with sperm prepared by a washing and swim-up method. Fifteen women conceived(42.9%). Sperm washing and swim-up was found to significantly improve sperm motility for men of infertile couples and the increment of percent sperm motility after sperm preparation allowed significant differentiation of pregnant and nonpregnant patients in asthenozoospermia(submotile) group (p<0.01). The author suggest that the increment of percent sperm motility after sperm washing and swim-up could be a useful screening tool for in vitro procedure proposed to improve fertility in the intrauterine insemination of asthenozoospermia.