Controlled ovarian hyperstimulation(COH) for in vitro fertilization and embryo transfer(IVFET) often results in the production of more embryos than can be efficaciously transferred at one time. However, embryo cryopreservation provides a mechanism by which additional embryos can be stored for later thawing and transfer. From November, 1990 to October, 1992, we completed 42 transfer cycles of cryopreserved pronucleus(PN) l-cell embryos using the fixed protocol of hormonal replacement therapy in a physiological manner regardless of individual ovarian function. Artificial endometrial stimulation was performed with only exogenous estradiol and progesterone(E-P) in 36 transfer cycles (Group I) and with gonadotropin-releasing hormone agonist(GnRHa) and exogenous estradiol and progesterone(GEEP) in 6 transfer cycles(Group II ). The results were as follows. 1. The Survival rate of total cryopreserved-thawed embryos was 64.9%(198/305): 64.9% (172/265) in Group I and 65.0% (26/40) in Group II. 2. Total 168 embryos were transferred with an average of 4.7 per ET in Group I and total 26 embryos were transferred with an average of 4.3 per ET in Group II. 3. The pregnancy rate(PR) per cryopreserved-thawed ET and the implantation rate was 33.3 %(14/42) and 6.7%(13/194), respectively. The PRs per cryopreserved-thawed ET were 30.6% (11/36) in Group I and 50.0% (3/6) in Group II without significant difference. 4. The take home baby rate was 11.1%(4/36) in Group I and 33.3% (2/6) in Group II.

Failure of in vitro fertilization may occur even though oocyte and semen parameters seem satisfactory. Quantified ultrastructural study of spermatozoa was performed in three cases of failed in vitro fertilization. The results were compared to those of four fertile men. Quantification was achieved by cataloguing cell defects of the spermatozoon heads and mid/principal pieces of the flagella. Using the data from each specimen, the percentages of total cellular abnormalities in the head/mid/principal pieces were established. The percentages of anomalies of the midpiece and of the principal piece were not significantly different between failed cases and controls. The percentage of cell alterations of the head (96-100 vs 75${\pm}$3,4%), the percentage of combined anomalies of the head (80-86 vs 52.5${\pm}$1.9%), and the percentages of nuclear shape deformation (68-86 vs 47.5${\pm}$6.3%), acrosomal defects (86-96 vs 50${\pm}$4.3%), and postacrosomal sheath defects (78-88 vs 44.5${\pm}$7.2%) of the head were significantly different between failed cases and controls. Due to the cost and time involved in processing semen samples for electron microscopy, the widespread application of this technique to all couples presenting for IVF certainly is not warranted. However, in selected instances electron microscopy may play a crucial role in identifying an occult male factor.

With the indirect immunobead antisperm antibody test(IBT) a prospective study was conducted to evaluate the immune status of 38 men before and after vasovasostomy. The pregnancy and postoperative semen analysis were evaluated. The results were compared between pregnant (n=14) and non-pregnant(n=24) group. The postoperative sperm motility was inversely correlated with the titer of the preoperative and postoperative IgG(p<0.01). The preoperative and postoperative titer of IgG were significantly higher than the titer of IgA or IgM(p<0.05). The mean percentage of the positive IBT(20 per cent binding or more) of the pregnant group was significantly lower than non-pregnant group in the preoprative and postoperative IgG(p<0.05). Immunobead binding restricted to the head and tail of a sperm in IgG was predominant and significantly lower in the pregnant group (p<0.05). In conclusion, IgG especially immunobead binding to the head and tail can be used as a sensitive screening assay for antisperm antibodies after vasovasostomy.

This study was carried out to investigate the effect of the timing and dose of human chorionic gonadotropin(hCG) on oocyte recovery, in vitro fertilization, and preimplantation development in superovulation of mouse. F1 hybrid($C57BL{\times}CBA$) mice were obtained and superovulation was induced in female mice by sequential intraperitoneal injection of PMSG and hCG. In the first series of experiments, mice received 5 IU of PMSG given intraperitoneally, and 48 hours later were injected 1 IU, 5 IU, or 10 IU of hCG respectively. In the second series of experiments, mice received 5 IU of PMSG given intraperitoneally and were injected 5IU of hCG 36, 48, or 60 hours later respectively. 1. When the mice received 5 IU of PMSG given intraperitoneally and 48 hours later were injected 1 ItT, 5 IU, or 10 IU of hCG respectively, there were no differences in the total number of the oocytes obtained from the three experimental groups. When the cultures were examined 48 hrs after the termination of insemination the proportion of unfragmented oocytes which had developed over two-cell stage was observer to be lowest in 10 IU hCG group. When the cultrues were examined 120 hour after termination of insemination the proportion of embryos which had developed to the blastocyst stage was observed to be significantly higher in 10IU hCG group than 5IU hCG group(p<0.05), but there was no difference between 10 IU hCG group and 1IU hCG group. 2. When the mice received 5 IU of PMSG and were injected 5 IU of hCG 36, 48, or 60 hours later respectively, there were no differences in the total number of oocytes obtained from the three experimental groups. When cultures were examined 48 hour after the termination of insemination the proportion of unfragmented oocytes which had developed over two-cell stage was observed to be significantly lower in 36 hour interval group than 48 hour interval and 60 hour interval group(p<0.05). When the cultures were examined 120 hour after termination of insemination the proportion of embryos which had developed to the blastocyst stage was found to be higher in 60 hour interval group than 36 interval or 48 hour interval group (P<0.05), and the proportion of hatching blastocyst was found to be higher in 60 hour interval group as well. In this study, it was concluded that the administration of adequate dose of hCG, and long (60 hour) PMSG-hCG interval were necessary in superovulation of mice($C57BL{\times}CBA$) in order to get a large number of oocytes which had an early oocytes which had an early embryonic developmental capability when fertilized in vitro, and especially it had better have been avoided to administer a large dose of hCG.

ICR female mice aged 3 to 4 weeks, were stimulated with 7.5 IU PMS injection. At 48-52h post-PMS injection, ovaries were dissected out and oocytes-cumulus complexes(OCCs) were divided into three groups, cumulus-free oocytes(O), cumulus-free oocyte cocultured with cumulus cells(O+C) and OCC. The oocyte were cultured in TCM199 containing various protein sources, FCS, BSA or PVP with gonadotropins(Gns) for 24h. Spermatozoa were collected from cauda epididymis and capacitated in T6 + BSA for 2h. After oocyte maturation in vitro(IVM) in different experimental groups, matured oocytes were inseminated with the capacitated spermatozoa in T6 + BSA for 6h. In the groups of IVM in TCM + BSA or PVP, fertilization(IVF) did not occur efficiently. However, increased fertilization was found in TCM+ FCS group. The oocytes groups, with cumulus cells showed decreased polyspermy in FCS group (O; 31.8 %, O + C; 12.2 %, OCC; 16%), the addition of Gns did not prevent polyspermy in all three groups. The rates of fertilization increased in zona-free oocytes in PVP group. This results showed that culture system for IVM and IVF could be improved. Furthermore, PVP can be used for the substitution of protein source during maturation, and its low rate of fertilization has been found due to zona hardening which occurred in FCS-free medium.

Purpose of the present study was to find the optimal culture conditions for the maturation and fertilization of immature oocytes by the use human body fluids and gonadotropins (Gn) in the mouse model. Cumulus-enclosed mouse immature oocytes were incubated in the medium containing various human body fluids with or without Gn in vitro, and examined to confirm nuclear maturation (NM) and fertilization. Female ICR mice were stimulated with 7.5 IU pregnant mares' serum gonadotropin (PMSG). Cumulus-enclosed immature oocytes were isolated at 48-52 hr post PMSG injection and cultured in TCM 199 supplemented with various concentrations (20, 50, and 70%) of human body fluids such as fetal cord serum (hCS), follicular fluid (hFF), peritoneal fluid (hPF) and amniotic fluid (hAF) in the presence or absence of 10 IU/ml PMSG and 10 IU/ml human chorionic gonadotropin (hCG) for 18 hr. Fetal calf serum (FCS) was used as a control for the supplements. Matured oocytes were fertilized with sperm collected from the epididymis of male mice. Fertilization was conducted in T6 medium containing 15 mgl ml bovine serum albumin, and confirmed at 6 hr post-insemination. Evaluation of nucler maturation and fertilization was carried out by rapid staining using fuchin. There was no significant difference between the effects of human body fluids and FCS supplements on nuclear maturation of cumulus enclosed mouse immature oocytes. When maturation medium was supplemented with 20% hPF or 20% hAF, fertilization rates were significantly (P<0.01) lower than that of 20% FCS, hCS and hFF groups. However, higher concentrations of body fluids during IVM were not more beneficial on fertilizability of oocytes. The addition of Gn significantly increased the fertilization rates in hPF and hAF groups (hPF without Gn; 51.5%, compared with 85.1% for addition of Gn, and hAF without Gn; 30.1% compared with 85.8% for addition of Gn) at 20% concentration. These results suggest that human body fluids at 20% concentration and gonadotropins can be used as supplements for the maturation of mouse immature oocytes in vitro. When gonadotropins supplemented with the human body fluids in the maturation medium, fertilizability of mouse immature oocytes was increased in hPF and hAF groups. These results can be applied to maturation of human immature oocytes in vitro.

The influence of hypoxanthine and ovarian steroids on the meiotic maturation process of mouse oocytes was investigated for the qualified application of culture medium in in vitro fertilization(IVF). Mouse oocytes were cultured in hypoxanthine and various ovarian steroids(progesterone, estradiol-17${\beta}$ and testosterone) and their effects on the oocyte maturation had been observed. When mouse oocytes were cultured in the various concentration(1-4mM) of hypoxanthine, meiotic maturation of cumulus cell-enclosed oocytes was inhibited by presence itself, which was a dose-dependent effect in meiotic arrest of mouse oocytes. The presence of progesterone, estradiol-17${\beta}$ and testosterone have made the mouse oocyte mature properly. Meanwhile maturation of cumulus cell-enclosed oocyte was severely inhibited by 3 hoursculture in the media of progesterone supplemented with hypoxanthine. However the continuous presence lasting 24 hours of progesterone even supplemented with hypoxanthine had got rid of the inhibition of oocytes maturation. Not only estradiol-17${\beta}$ supplemented with hypoxanthine but also testosterone supplemented with hypoxanthine exert the severe inhibition of the maturation of cumulus cell-enclosed oocytes for 3-hours culture. However the continuous presence lasting 24 hours of estradiol-17${\beta}$ and testosterone even supplemented with· hypoxanthine had relieved the inhibition of oocytes maturation. These results make us suggest that hypoxanthine inhibits the mouse oocyte maturation, particularly markedly in conjunction with ovarian steroids for short period, which indicated some sort of the synergistic inhibitory retationship between the ovarian steroids and hypoxanthine.

Down syndrome is one of the major chromosomal anomalies in Korea. To decrease incidence of Down syndrome, antenatal diagnosis is essential. At present, antenatal diagnosis of Down syndrome is done by karyotyping from chorionic villus sampling, amniocentesis, and cordocentsis. All these methods have some problems such as a risk of abortion, a long waiting time, difficulties in sampling, and so on. The aim of study was to confirm that PCR(Polymerase Chain Reaction) using D21S11 primer could be a diagnostic tool for Down syndrome. PCR using D21S11 primers with $^{32}P$ labeling at 5' end was done in 21 cases of DNA from 21 Trisomy and 20 cases of DNA from normal karyotype. PCR product was running for 10 hours on the 6% polyacrylamide gel under 1,000 V or for 8 hours under 1,500 V. After X-ray film exposure, it was read by densitometry. Normal group showed 1: 1 band or single band. 21 Trisomy group showed 1.3-2: 1 band or 2.3 times of density compared to normal single band or 3 bands. This method gave the result within 24 hours. It can be an useful diagnostic tool to detect 21 Trisomy antenatally, especially in late pregnancy, and in preimplantation diagnosis.

This study was carried out to develop the methodology of chromosome preparation from blood cultures in mammals which included human, mouse, cattle and pig. For karyotyping, 0.5-5.0ml of peripheral blood were collected and cultured. The satisfactory results were obtained from macroculture and microculture in all species. In culture, the patterns of cell growth were no difference among media except serum concentration and mitogen supplement. The presence of mitogen and fetal bovine serum in medium significantly affected the mitotic index. The optimal culture condition was 37$^{\circ}C$ for 3 days. And the concentration of colcemid and reincubation time also affected the chromosome morphology. In harvest, chromosome patterns were mainly affected on hypotonic treatment which included treated time and temperature, dropwise of fixative solution, and drying after slide preparation.

We have reviewed the pregnancy rate and outcome of 130 patients who underwent tubocornual anstomosis for correction of proximal tutal occlusion at Dong San Medical Center between September 1983 to May 1994. Tubal occlusion was the result of previous tubal sterilization in 115 patients(99 laparoscopic electrocautery, 16 laparoscopic ring, 1 tubal ligation with partially segmental resection and previous tubal infection in 14. Sixty four of the patients conceived(61.5%). Viable pregnancy was achieved in fifty patients (48%), tubal pregnancy in six (5.7%) and spontaneous abortion in eight(6.1%). No significant difference in pregnancy rates was found between patients with diseased cornua and those previously sterilized by either electrocautery or tubal ligation. We conclude that tubocornual anastomosis still remains the treatment of choice for patients with proximal tubal obstruction.

Copper T 380A intrauterine devices were inserted to nine thousand and nine hundred twenty women by 51 KAVS-member physicians since January 1, 1993 through December 31, 1993. This study was undertaken for the clinical analysis on a total of 9,920 women wearing Copper T 380A to grasp the effectivness as well as the expulsion rate due to a various side effects. The following features were the results of the study: 1. During the twelve months period, from January 1993 to December 1993, the largest number of IUD insertion per one physician is 740 cases and the smallest number 60 cases, the mean 195 cases. 2. After insertion of Copper T 380A, a total of 117 cases were removed the IUD;81 cases(0.8%) were due to extensive bleeding and 36 cases(O.36%) were due to pain. The pregnancy failure rate represented comparatively lower rate, 0.08% (8 cases) and the expulsion rate was 0.06%(6 cases). 3. The removal rate of Copper T 380A was different by physicians. The highest removal rate for bleeding was 3.13% and 13 physicians(25.5%) did not experience any bleeding cases. 4. For the removal rate for pain, 30 physicians(58.8%) did not experience any removal of IUD due to pain while 21 physicians(41.2%) removed IUD due to pain: 17 physiciansC33.4 %) had 0.1-1.5% of removal rate and 4 physiciansC7.0%) had 1.6-2.1% of removal rate. 5. A total of 43 physicians(84.3 %) did not experience any pregnancy failure case while 8 (15.7%) physicians was experienced pregnancy failure rate. Four physicians(7.8%) had 0.1-0.5% of pregnancy failure rate and 4 physicians had 0.6-1.0% of pregnancy failure rate. 6. Expulsion rate showed comparatively lower, 0.06% in this study. A total of 45 physicians (88.2%) did not experience any expulsion cases while 6 physicians(11.7%) had expulsion rate with the highest expulsion rate of 2.0%.