• Clinical and Experimental Reproductive Medicine
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• v.30 no.1
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• pp.31-37
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• 2003

연구목적: 일반적으로 IVF-ET에서 가장 높은 임신율을 얻는 방법은 5 day ET (배반포기 배아 이식)이지만 장기간 배양이 적절하지 못한 경우에는 $2{\sim}4$일째에 ET를 실시하고 나서 $5{\sim}7$일째에 배반포기에 도달한 배아를 재이식 (SET)하여, SET의 효용성에 대하여 조사하고자 실시하였다. 연구재료 및 방법: 48주기의 환자에서 회수한 난자와 수정란은 10%와 20% hFF가 첨가한 DMEM에서 이식 직전까지 각각 공배양하였다. 채란 2일 (group I, day 2 ET), 5일째 이식 (group II, day 5 ET) 또는 재이식 (group III, SET; 2-5, 2-6, 2-7, 3-5, 4-7일)을 실시하면서 수정률, 할구분할률 및 임신율을 각각 비교하였다. 결과에 대한 통계 분석을 SAS (version 6.2)를 이용한 Duncan's Multiple Range Test를 이용하여 p값이 0.05 보다 작을 때 통계적으로 유의차가 있는 것으로 하였다. 결 과: 수정률은 group II (90.5%)가 다른 군에 비하여 높게 (p<0.05) 나타났다 (group I: 80.6%; group III: 82.9%). 할구분할률은 군간에 차이가 없었다 (수정란 당 $93.3{\sim}99.1%$). 임상적 임신율은 group II와 III (각각 58.3%)가 group I (33.3%) 보다 높게 나타났다. 그러나 처리군이 적어서 통계적인 차이는 없었다. 결 론: 배반포기 배아를 단독 이식하는 것이 임신율을 높일 수 있는 최선의 방법으로 나타났지만, 채란수가 적거나 수정률이 저조한 경우에는 $2{\sim}4$일째에 ET를 실시한 후 여분의 배아를 배반포기까지 배양한 다음 $5{\sim}7$일에 재이식 (SET)하면 blastocyst ET에서 나타날 수 있는 이식 자체의 실패를 방지할 수 있으면서 임신율을 높일 수 있는 이식 기법이 될 것이다.

• 대한생식의학회:학술대회논문집
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• 2002.05a
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• pp.63-64
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• 2002

• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.143-151
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• 2010

Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.65-72
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• 2010

Objective: To compare the respective pregnancy outcomes of cycles undergoing elective two cleavage-stage embryos transfer (2ET) and three cleavage-stage embryos transfer (3ET) in fresh in vitro fertilization and embryo transfer (IVF-ET) program. Methods: We conducted a retrospective matched case control study that included 100 women with 2ET and 100 women with 3ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and cycle characteristics. All of transferred embryos in both groups had good qualities. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with 2ET and 3ET groups were not statistically different; implantation rate (41.0% vs. 35.3%), positive pregnancy rate (58.0% vs. 60.0%), clinical PR (55.0% vs. 59.0%), ongoing PR (51.0% vs. 55.0%), respectively. However, the 3ET group showed significantly higher multiple pregnancy and triplet pregnancy rates (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036, respectively). Conclusion: In women with favorable conditions and good quality embryos undergoing IVF, 2ET can get pregnancy outcomes comparable to those of 3ET and reduce multiple pregnancy (especially, triplet pregnancy).

• Clinical and Experimental Reproductive Medicine
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• v.37 no.4
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• pp.329-338
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• 2010

Objective: This study was carried out to know whether cryopreservation of sibling 2PN zygotes could increase the cumulative delivery rates in the patients who had less than 10 fertilized zygotes. Methods: A retrospective analysis was performed in 138 in vitro fertilization-embryo transfer (IVF-ET) cycles with less than 10 fertilized zygotes during January 2003 to December 2007 in Cheil General Hospital. These cycles were divided into two groups. In Group I (n=86), all fertilized embryos were cultured to transfer on day 3 without cryopreserved embryos at the 2PN stage. In Group II (n=52), among fertilized zygotes, some sibling zygotes were frozen at the 2PN stage, the remainder were cultured to transfer. Clinical outcomes in fresh ET cycles and cumulative ongoing pregnancy rates after subsequent frozen-thawed (FT)-ET cycles were compared. Results: There were no significant differences in female mean age, number of retrieved oocytes and total fertilized embryos between two groups, Number of cultured embryos was significantly lower in Group II ($5.2{\pm}0.5$) than in Group I ($8.4{\pm}0.7$) (p<0.01). Also, number of transferred embryos was significantly lower in Group II ($3.3{\pm}0.6$) compared with Group I ($3.6{\pm}0.6$) (p<0.01). ${\beta}$-hCG positive rates and delivery rates (51.2 vs. 46.2 % and 41.9 vs. 34.6 %, respectively) after fresh ET were slightly higher in Group I than in Group II. However, the differences were not statistically significant. Also, the cumulative delivery rates after subsequent FT-ET cycles were not significantly different between Group I (48.8%) and Group II (50.0%). Conclusion: This study showed that cryopreservation of sibling 2PN zygotes from patients who had less than 10 zygotes in the fresh ET cycles did not increase cumulative delivery outcomes. But, it could provide an alternative choice for patients due to offering more chance for embryo transfers if pregnancy was failed in fresh IVF-ET cycles.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.57-64
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• 2010

Objectives: Likewise fresh cycle, it is also important to select right blastocysts for transfer in purpose of improving the pregnancy and implantation rates in frozen-thawed embryo transfer (ET) cycles. To investigate the relationship between the developmental velocity at the time of cryopreservation and pregnancy rates, we compared pregnancy rates between the day 5 cryopreservation group and the day 6 cryopreservation group. Methods: Transfers of frozen-thawed blastocysts which had been cryopreserved by vitrification on day 5 or day 6 were performed between January 2006 and June 2007. Ethylene glycol, DMSO, and pull and cut straws were used for vitrification and artificial shrinkage was done in expanded blastocysts. Thawing was performed on the day before transfer and thawed blastocysts were cultured in for 15~18 hrs in Quinn's blastocyct media. Blastocyst survival was assessed before transfer and post-thaw survival was defined as >50% of cells remaining intact and blastocoele re-expansion by the time of transfer. Results: Transfers of thawed blastocyst had been cryopreserved on day 5 were 52 cycles and 41 transfer cycles were cryopreserved on day 6. Patient characteristics, the number of transferred embryos and the survival rate of thawed blastocysts were not different in each cryopreservation day. But the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and implantation rate were significantly high in transfer of frozen-thawed blastocyst which were cryopreserved on day 5. Conclusions: The clinical pregnancy and implantation rate of day-5 blastocyst showed significantly higher than those of day-6 blastocyst in frozen-ET cycles. This result indicated that developmental rate of blastocyst at cryopreservation time in frozen-thawed cycle is discriminative marker of pregnancy outcome as like in fresh cycle.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.3
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• pp.347-353
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• 1997

This study was to test whether in vitro/in vivo survival of vitrified mouse blastocysts was influenced by culture conditions and ET method. Mouse blastocysts were obtained from in vitro fertilization and cultured for 4 days in M16 medium, and they were vitrified in EFS40 which contained 40% ethlyene glycol, 18% Ficoll and 0.5 mol sucrose in PBS. In experiment I, in vitro and in vivo survival rate of these embryos were evaluated in different culture condition after thawing. When thawed embryos were cultured in M16 medium as a control, m-CR1 medium contained 20 amino acids (2% BME amino acis and 1% MEM non-essential amino acids solution) and 4 mg/ml BSA and cumulus monolayer cell co-cultured condition in mCR1 medium (10% FBS), their in vitro survival at 24 hr after thawing was not affected by culture condition (75.6, 83.1, 82.4%). However, in vivo survival rates of implantation in m-CR1 medium (80.4%) were significantly higher than those of M16 medium (51.2%), co-culture (57.1%) condition, although there was no difference in live fetuses rates on day 15 gestation (39.0, 49.0, 38.1%). In experiment II, the in vivo development potential of embryos by ET methods was examined. When blastocysts were transferred to the day 2, 3 pseudopregnant recipient without culture soon after thawing, no pregnant recipient was obtained on the day 2 pseudopregnancy, and 50% of pregnancy rates and 15.4% of live fetus rates were obtained on the day 3 pseudopregnant recipients. These results were significantly lower than those of transferred group (day 3 pseudopregnant recipients) after culture for 16 hr post thawing (73.5, 57.1%) (p<0.05). In experiment III, to elevate usability of delayed embryos in vitro/in vivo survival of vitrified embryos (day 4 early, day 5 early and expanding blastocyst) were examined. in vivo survival rates (live fetus, total implantation) were higher in day 4 early blastocysts (33.3, 66.7%) than in day 5 expanding blastocysts (29.0, 38.7%), although the highest in vitro survival rates were obtained in the day 5 expanding brastocysts (78.3%). Therefore, these results suggest that the in vitro/in vivo survival rates of vitrified embryos could be improve by the culture condition and ET method and that the in vivo development rates of delayed embryos were decreased with longer culture duration in vitro. It means that more effective cryopreservation was obtained in day 4 early blastocysts than in day 5 expanding blastocysts.

• Korean Journal of Animal Reproduction
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• v.22 no.1
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• pp.11-17
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• 1998

This study was carried out to investigate the in vivo developmental potential of mouse zona-hatched blastocysts (HBs). The HBs were cultured in vitro until day 5 and day 6 from zygotes produced in vivo and classified to small (S-HBs), medium (M-HBs) and large (L-HBs) on the basis of embryo diameters. The results obtained in these experiments were summarized as follows ; 1) when the blastocysts at day 4 were further cultured for $24\sim48hr$, HBs obtained at day 5 and day 6 culture in vitro were 29.1% and 22.8%, respectively. 2) Also, when the total cell number of HBs were counted, cell numbers of classified HBs on day 5 and day 6 to small ($77.3\pm5.3$, $59.6\pm4.4$), medium ($83.7\pm4.0$, $66.8\pm3.5$) and large ($100.7\pm2.6$, $88.9\pm3.8$) were increased as their size increases. Especially, there were significantly different between S-HBs and L-HBs (p<0.01). 3) In addition, when the classified HBs were transferred into when the classified HBs were transferred into day 3 pseudopregnant recipients, the pregnancy and implantation rates of S-HBs (28.6%, 15.7%), M-HBs (44.4%, 30.9%) and L-HBs (62.5%, 49.1%) at day 5 were increased as their size increases. However, this pattern was not showed in embryo transfer of day 6 HBs. But, when the live fetuses formation against total implantation rates were observed, the result (87.5%) of S-HBs of day 5 was significantly higher than that of the others (p<0.01). Therefore, this study demonstrates that in vitro cultured healthy HBs can not only be developed normally with good pregnancy rates, implantation rates and live fetuses formation, but also served as a fundamental data for utility of supernumerary HBs in human blastocyst transfer.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.3
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• pp.319-326
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• 1996

The objective of this study was to investigate correlation between the morphology by microscopic assessments of surplus blastocysts produced in human IVF program and their cell number obtained by differential labelling method. For these experiments, 76 surplus human blastocysts were obtained from 36 patients on day 5 after IVF, the embryos were classified to early (ErB), early expanding (EEB), middle expanding (MEB), expanded blastocyst (EdB) according to their blastocoel expansion and zona thickness. When the ovum size and zona thickness of the classified blastocysts were measured using micrometer, although the embryos were produced in the same culture condition, there were significant variances in ovum size ($148.8 217.6{\mu}m$) and zona thickness ($1.2-14.4{\mu}m$). Total blastomere cell number counted after hoechst staining was increased by two to three fold during the transition period from ErB ($39.1{\pm}3.6$) to EdB ($(89.6{\pm}3.3)$) stage on day 5 after IVF. ICM ($11.9{\pm}1.8-22.2{\pm}4.3$) and TE ($24.5{\pm}3.6-70.0{\pm}7.7$) cell numbers using differential labelling were also showed the increased pattern according to the developmental level. Especially, EdB which showed poor ICM morphologically also indicated the low ICM cell number after differential labelling. This demonstrated that there is good correlation between the morphological assessment and the cell number. The count of ICM and TE nuclei using differential labelling can be used as an important criterion, if it is accompanied with morphological assessments, in selecting the better embryos for improving the pregnancy rates in human blastocyst transfer program.