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Objective Simultaneous mifepristone 200 mg and vaginal misoprostol 800 μg produces a complete abortion rate of approximately 90% at up to 63 days of gestation. The aim of this study was to determine the effectiveness of concurrent administration of mifepristone 200 mg and vaginal misoprostol 600 μg with respect to early medical abortion. Materials and Methods A total of 254 women with undesired pregnancies of less than 49 days of gestation were enrolled. All women received oral mifepristone 200 mg and vaginal misoprostol 600 μg concurrently. Follow-up assessment by transvaginal ultrasonography was performed 3 days and 2 weeks after treatment. Results Efficacy outcome was analyzed for 242 women (95.3%) after excluding 12 individuals lost to follow-up. The complete abortion rate was 92.6%. The mean induction to abortion interval was about 5.8 hours. The mean bleeding duration was about 12.6 days. The women indicated that the side effects were tolerable and 90% of them said that their experience was satisfactory. Conclusion Concurrent administration of oral mifepristone 200 mg and vaginal misoprostol 600 μg is an efficacious regimen for medical abortion of pregnancies up to 49 days of gestation.

To compare the clinical outcome of IVF treatment after pituitary suppression with two different oral contraceptives (OCs).65 patients who received IVF treatment was classified into 2 groups based on the difference of OCs they used for pituitary suppression before ovarian hyperstimulation. Group 1 included 36 patients who received monophasic OCs. Group 2 included 29 patients who received triphastic OCs. Both groups received the OCs from the 5th day of the cycle for consecutive 21 days. The hormone profiles after OCs and clinical outcome of IVF treatment were compared between two groups. Two-sample t-tests and X2 tests were used for statistical analyses. P0.05 was considered statistically significant.The mean age and basal hormone profiles were comparable between two groups. After ovulation suppression with different OCs, the day 2 FSH and LH value revealed statistically significant difference between two groups(4.2+/-1.8 vs 6.0+/-2.6; 2.7+/-2.0 vs 4.2+/-3.3 respectively). The numbers of oocyte per retrieval and fertilization rate were comparable between two groups, but higher quality embryos as revealed by the cleavage speed were noted in the triphastic OCs group. Although statistically not significant, higher implantation rate and pregnancy rate were also noted in the triphastic OCs group.Different OCs for pituitary suppression can result in different hormone profiles. Ovulation induction in IVF treatment should be individualized according to these hormone changes to achieve the optimal clinical outcome. Triphastic OCs exceeds monophastic OCs in producing good quality embryo in IVF-ET treatment.

Objective: To determine whether three-dimensional ultrasonography can increase the ability to evaluate the ovary and follicles, especially in women with polycystic ovary disease (PCOD). Design: Prospective clinical study. Setting: University hospital endocrine and infertility center. Patient(s): Sixty-six patients undergoing routine gynecologic evaluation were divided into two groups: the normal control group consisted of 22 patients, and there were 44 patients with PCOD. Intervention(s): Three-dimensional ultrasonography was performed to store and document whole volumes of the ovaries for evaluation. Main Outcome Measure(s): Three perpendicular planes of bilateral ovaries are rotatable to obtain the largest dimensions. The three-dimensional volume was measured using the trapezoid formula. Result(s): The ovaries of the patients with PCOD were larger in size, area, and volume than those of normal controls. Conclusion(s): Stroma and volume determinations can be obtained more accurately by three-dimensional images than by traditional ultrasonography. Three-dimensional ultrasonography not only facilitates noninvasive evaluation and volume calculation but also completes the examination in a short time without increasing patient discomfort.

Objective The aim of this study was to identify an optimal stimulation protocol for intrauterine insemination (IUI) to obtain an acceptable pregnancy rate and low frequency of multiple pregnancies. Materials and Methods In total, 340 patients, who received intrauterine insemination because of ovulation dysfunction, were enrolled in this study. Group I consisted of 203 patients who received recombinant FSH (r-FSH) 150U every other day as an ovulation induction agent. Group II consisted of 137 patients who received r-FSH 100U every other day as an ovulation induction agent. All patients in both groups also received clomiphene citrate 100 mg/day for consecutive five days from the fifth day of the cycle. Only patients with at least two follicles >18 mm on the human chorionic gonadotropin injection days were included in this study. Results The clinical pregnancy rate was 14.8% (30/203) in Group I compared with 20.4% (28/137) in Group II, p > 0.05. The incidence of multiple pregnancy was 41.7% (10/24) in Group I compared with 12.5% (3/24) in Group II, p Conclusions The concurrent use of low-dose r-FSH and clomiphene citrate would seem not only to be cost-effective but also highly satisfactory in that it prevents high-order multiple pregnancies.

To evaluate the effect of laparoscopic ovarian cystectomy for endometrioma on the clinical outcome of IVF treatment.Patients who received IVF treatment were retrospectively classified into two groups. Group 1 included 95 patients who received IVF due to tubal occlusion. Group 2 included 127 patients who had received laparoscopic ovarian cystectomy for endometrioma(s) followed by IVF treatment. Clinical outcomes of IVF treatment were compared between two groups.More oocytes were harvested per retrieval in Group 1 than Group 2 (p0.05). The fertilization rate was higher in Group 1 than Group 2 (p0.05). Although the implantation rate was higher in Group 2 (p0.05), the clinical pregnancy rate revealed no statistically significant difference between the two groups.Women who received ovarian cystectomy for endometriomas have fewer oocytes harvested during IVF treatment. However, their chance of pregnancy was comparable to patients with tubal problems who underwent IVF treatment.

Ovarian hyperstimulation syndrome (OHSS) is a potentially severe complication following ovarian stimulation. It has a clinical spectrum ranging from a mild form, which accounts for most cases, to moderate and severe forms that occur rarely but deserve special attention since they are life threatening [1]. Clinical manifestations of OHSS can be classified into (1) mild, with abdominal distension; (2) moderate, with ascites; (3) severe, with apparent ascites and/or effusion (pleural, rarely pericardial); and (4) hypovolemic shock, acute renal and respiratory failure, and thrombotic disorders [2]. This syndrome is an iatrogenic disorder, which is not yet fully understood, and carries a significant risk of morbidity and mortality. Despite close monitoring during ovarian stimulation and rigid guidelines and criteria for canceling cycles, OHSS still occurs. Owing to the increased use of therapeutic strategies for infertility, the pulmonary complication of this syndrome should be suspected on clinical grounds and identified early to allow for more appropriate diagnosis and management [3]. We report a patient whose only manifestation of OHSS was unilateral pleural effusion with no ascites. A 35-year-old woman came to our hospital for in vitro fertilization and embryo transfer treatment because of bilateral tubal occlusion. She received oral pills and standard downregulation during the previous cycle before ovarian stimulation. Ovulation induction, using recombinant follicle stimulating hormone (r-FSH; 225 IU/ day for 8 days, up to a dose of 1650 IU) and human menopausal hormone (HMG; 150 IU/day for 3 days, up to a dose of 450 IU), was then started on day 3 after