Clinical and Experimental Reproductive Medicine

  • 제34권4호
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  • Pages.305-312
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  • 2007
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  • 2233-8233(pISSN)
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  • 2233-8241(eISSN)
대한생식의학회 (The Korean Society for Reproductive Medicine)
권호 표지

정상 정자 소견을 나타내는 불임 부부에서 일반적인 체외수정과 세포질내 정자주입술을 병행하는 분할 수정법의 효용성

Efficacy of the Split Insemination Method Combining Conventional IVF and ICSI in Non-male Factor Infertile Couples with Normal Sperm Parameters

  • 홍승범 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 박동욱 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 신미라 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 최수진 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 이선희 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 송인옥 (관동대학교 의과대학 제일병원 산부인과학교실) ;
  • 전진현 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실)
  • Hong, Seung-Bum (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Park, Dong-Wook (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Shin, Mi-Ra (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Choi, Su-Jin (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Lee, Sun-Hee (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Song, In-Ok (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Jun, Jin-Hyun (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
  • 발행 : 2007.12.31
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초록

목 적: 본 연구에서는 일반적인 체외수정과 세포질내 정자주입술을 병행하여 시행하는 분할 수정법의 효용성을 정상적인 정자 소견을 나타내는 비남성요인 불임 환자의 체외수정 및 배아이식술에서 살펴보고자 하였다. 연구방법: 제일병원 아이소망센터에서 정자 소견상 결함이 없는 비남성요인 불임 환자에게 분할 수정법을 이용한 505주기의 임상 결과를 후향적으로 분석하였다. 획득된 난자는 무작위로 나누어 일반적인 체외수정이나 세포질내 정자주입술을 이용하여 수정을 시켰다. 수정란은 이식할 때까지 2$\sim$5일간 배양하였고, 잉여의 수정란과 배아는 동결보관하여 동결-융해 이식에 사용하였다. 수정 방법에 따른 임상 결과를 통계학적인 방법으로 비교하였다. 결 과: 획득된 난자의 수정율은 분할 수정법을 시행하였을 때 일반적인 체외수정보다 세포질내 정자주입술에서 통계적으로 유의하게 높게 나타났다 (52.9$\pm$28.0% vs 62.5$\pm$22.3%, p<0.01). 전체적인 수정의 실패는 분할 수정법을 시행한 505주기 중에서 단지 2주기에서만 (0.4%) 나타났으며, 수정 실패와 0$\sim$30% 이하의 수정률을 나타내는 빈도는 세포질내 정자주입술에서 일반적인 체외수정보다 통계적으로 유의하게 낮았다 (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). 분할 수정주기에서의 신선 배아와 동결-융해 배아이식 후 분만율은 각각 40.0% (185/462)와 35.0% (55/157)였으며, 일반적인 체외수정이나 세포질내 정 자주입술로 얻어진 배아의 착상률과 분만율은 유의적인 차이가 나타나지 않았다. 결 론: 결론적으로 비남성요인 불임 환자의 보조생식술에서 분할 수정법이 수정 실패와 낮은 수정율을 방지하고 성공적인 임상 결과를 제공할 수 있는 효과적인 방법으로 사료된다.

Objective: To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. Method: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002$\sim$2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2$\sim$5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. Results: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5$\pm$22.3% vs 52.9$\pm$28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. Conclusion: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.

키워드

참고문헌

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