ObjectiveTo investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups.MethodsWomen with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/m2, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes.ResultsThere was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups (p<0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups (p<0.02).ConclusionNon-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia.

ObjectiveTo determine the age specific serum anti-Müllerian hormone (AMH) reference values in Korean women with regular menstruation.MethodsBetween May, 2010 and January, 2011, the serum AMH levels were evaluated in a total of 1,298 women who have regular menstrual cycles aged between 20 and 50 years. Women were classified into 6 categories by age: 20-31 years, 32-34 years, 35-37 years, 38-40 years, 41-43 years, above 43 years. Measurement of serum AMH was measured by commercial enzyme-linked immunoassay.ResultsThe serum AMH levels correlated negatively with age. The median AMH level of each age group was 4.20 ng/mL, 3.70 ng/mL, 2.60 ng/mL, 1.50 ng/mL, 1.30 ng/mL, and 0.60 ng/mL, respectively. The AMH values in the lower 5th percentile of each age group were 1.19 ng/mL, 0.60 ng/mL, 0.42 ng/mL, 0.27 ng/mL, 0.14 ng/mL, and 0.10 ng/mL, respectively.ConclusionThis study determined reference values of serum AMH in Korean women with regular menstruation. These values can be applied to clinical evaluation and treatment of infertile women.

ObjectiveTo investigate whether natural killer (NK) cell and autoimmune antibody acts synergistically, by the action of autoantibodies to increase NK cell number and cytotoxicity, to decrease uterine blood flow during early pregnancy in pregnant women with a history of recurrent spontaneous abortion (RSA).MethodsSeventy-five pregnant women (between 5 and 7 weeks gestation) with a history of unexplained RSA were included in the study group. Forty-one pregnant women without a history of RSA were included as controls. All women with a history of RSA were tested for autoantibodies and number of peripheral blood natural killer (pbNK) cell by flow cytometry. Study populations were stratified into four groups by existence of autoantibody and degree of increase of pbNK cells. The uterine radial artery resistance index (RI) was measured by color-pulsed Doppler transvaginal ultrasound.ResultsThe mean RI of the autoimmune antibody-positive (AA+) group (0.63±0.09) was significantly higher than that of the normal control group (0.53±0.10, P=0.001). The mean RI of the AA+/only-NK elevated (eNK) group (0.63±0.09) was significantly higher than those of the only-AA+ group (0.55±0.07, P=0.019) and the only-eNK group (0.57±0.07, P=0.021).ConclusionConcurrent elevation in NK cells and autoimmunity results in decreased uterine blood flow during early pregnancy. However, the majority of cases of RSA remain unexplained and larger scale studies are needed to confirm our conclusion and to develop diagnostic and therapeutic plans for women with a history of RSA.

ObjectiveTo evaluate the difference of serumanti-Müllerian hormone (AMH) levels in women between undergoing previous ovarian surgery with endometriosis and controls. MethodsWe reviewed medical records and evaluated the serum AMH levels of 217 women (26−40 years old) between March 2010 and January 2011, retrospectively. One hundred five patients were previously undergone the ovarian surgery of endometriosis (study group) and 112 women has never undergone ovarian surgery as controls (control group). Exclusion criteria was following factors: irregular menstruation, polycystic ovary syndrome, high BMI (≥30 kg/m 2 ), other endocrine disease. ResultsThe mean age in study group was not different with control group (32.5±3.6 vs. 33.0 ± 3.8 year). The mean serum AMH levels significantly lower in the study group than in control (2.82 ± 2.4 ng/mL vs. 3.82 ± 2.8 ng/mL, P=0.005). When we analyzed the serum AMH levels according to age groups, the patients above 31 years showed significantly lower levels than control (31−35 years, 2.41±1.7 ng/mL vs. 3.84 ± 2.6 ng/mL, P=0.005; 36−40 years, 1.36 ± 2.0 ng/mL vs. 2.68±2.7 ng/mL, P=0.018) The serum AMH levels didn't show any statistical difference in aspect of bilaterality, endometriosis stage, cyst size (≥6 cm). ConclusionWe could consider relatively low serum AMH levels in patients with ovarian endometriosis after surgical treatment.