• Journal of Embryo Transfer
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• v.18 no.2
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• pp.125-134
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• 2003

본 연구는 사람의 시험관아기 프로그램에서 체외 수정란의 질을 향상시키는 한 방법으로 난포액으로 처리된 정자를 체외 수정에 사용하여 생산된 체외 수정란의 전핵 등급과 발달 능력을 조사하였다. 정상적인 시험관 아기 시술을 시행한 실례 환자를 대상으로 과배란을 유기하여 배란 직전의 난자를 채취하여, 난포액으로 처리된 정자와 체외 수정시킨 후 사람 체외 수정란의 전핵 등급과 체외발달율을 조사하였다. 체외수정을 위한 정자의 처리 방법으로 synthetic serum substitute (SSS)를 15% 첨가한 modified human total fluid (m-hTF) 혹은 난포액에서 정자를 2시간 동안 swimming-up 처리 후 각각 체외수정에 사용한 결과, 수정율은 75.3 및 82.1%를 나타내어 유의적인 차이는 없었으나, 1등급 전핵란은 각각 48.0 및 65.5%를 나타내어 난포액에서 유의적으로 (P<0.05) 높았고, 배양 후 3일째에 수정란의 등급을 조사한 결과, 1등급 체외수정란은 각각 44.9 및 60.5%를 나타내어 난포액에서 유의적으로 (P<0.05) 높았다. 또한 체외수정란을 배양 후 3일째에 수정란의 발달 단계를 조사 한 결과, 5-세포기 단계 이상을 발달하는 비율은 각각 51.0 및 70.5%를 나타내어 난포액에서 유의적으로 (P<0.05) 높았다.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.41-48
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• 2010

Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF). Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks. Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was $8^{+4}$ gestational weeks ($46{\pm}5.8$ days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at $9^{+4}$ weeks, $11^{+3}$ weeks and $11^{+4}$ weeks. Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients' discomfort induced by multiple injections.

• 대한생식의학회:학술대회논문집
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• 2001.06a
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• pp.41.1-41.1
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• 2001

• 대한생식의학회:학술대회논문집
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• 1999.11a
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• pp.104.2-105
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• 1999

• Clinical and Experimental Reproductive Medicine
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• v.34 no.3
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• pp.189-196
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• 2007

Objectives: The purpose of this study is to investigate the clinical significance of age and basal serum FSH in predicting the outcomes of in vitro fertilization (IVF) in patients with poor-ovarian response. Methods: From January 2000 to December 2004, 85 second IVF cycles of 85 poor-ovarian response patients under the age of 42 with a back-ground of the first IVF cycles at our infertility center and 5 or less oocytes were retrieved and their basal serum FSH levels of 15$\sim$25 mIU/ml were enrolled in this study. Exclusion criteria were patients with a male factor for the etiology of infertility and undergoing genetic diagnosis of embryo such as PGD. Flare-up protocol was used for ovarian stimulation in all cases. Results: When we stratified the study groups by patient's age, the younger age group (age<35, n=35) showed significantly higher implantation rate (19.0% versus 4.0%, p<0.05) and higher ongoing pregnancy rate (100% versus 14.3%, p<0.05) than the older age group (age$\geq$35, n=50). And then, when we stratified the study populations by basal serum FSH level, the lower FSH group (basal serum FSH<20 mIU/ml, n=58) showed significantly higher number of retrieved oocytes (4.6$\pm$0.7 versus 2.2$\pm$0.5, p<0.05) and lower cancellation rate (19.0% versus 55.6%, p<0.05) than higher FSH group (basal serum FSH$\geq$20 mIU/ml, n=27). Conclusions: In conclusion, it was suggested that the patient's age could predict the IVF outcomes in respect to its potency of pregnancy and ongoing pregnancy. Serum basal FSH levels could predict more accurately the ovarian response of cycle, but not clinical outcomes.

• 대한생식의학회:학술대회논문집
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• 2004.11a
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• pp.90-90
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• 2004

• 대한생식의학회:학술대회논문집
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• 1997.11a
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• pp.59-59
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• 1997

• 대한생식의학회:학술대회논문집
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• 2001.06a
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• pp.48-48
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• 2001

• 대한생식의학회:학술대회논문집
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• 2003.12a
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• pp.90-90
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• 2003

• Clinical and Experimental Reproductive Medicine
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• v.35 no.3
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• pp.193-202
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• 2008

Objective: To evaluate efficacy of assisted hatching by laser (AHL) and acidified Tyrode solution (AHA) in selected groups of IVF-ET patients who have a poor prognosis. Methods: From February 2006 to September 2006, total of 328 IVF-ET cycles with advanced female age (${\geq}38$ years), recurrent implantation failure (${\geq}3$ cycles), thick zona (${\geq}17{\mu}m$), and/or poor quality of embryo were randomly divided into assisted hatching by acidified Tyrode solution (AHA, n=180) and the assisted hatching using the ZILOS-tk laser (AHL, n=148) groups. Clinical outcomes were analyzed and compared between AHA and AHL group based on the patient characteristics. Results: In all AHL and AHA group, there were no significant differences in pregnancy (42.6%, 63/148 vs. 33.3%, 60/180) and implantation rates (17.4%, 82/470 vs. 16.0%, 89/556) However, in advanced female age group (Group 1), pregnancy (37.0%, 20/54 vs. 18.7%, 14/75) and implantation rates (14.4%, 23/160 vs. 7.1%, 15/210) in AHL group were significantly (p<0.05) higher than those of AHA, although there was no difference in patient parameters of both groups. And, the clinical outcome of groups with recurrent implantation failure (Group 2), thick zona pellucida (Group 3) and poor quality embryo (Group 4) were improved in AHL compared to those of AHA: 43.8% (21/48) and 31.6% (25/79) in Group 2, 43.8% (32/73) and 34.1% (28/82) in Group 3, 25.0% (7/28) and 14.6% (6/41) in Group 4, but no significance. Conclusion: The AHL improved the pregnancy and implantation rates in patients with advanced female age and recurrent implantation failure when compared to outcomes achieved from AHA. Therefore, this AHL technique may be a efficient and safe method for patients with poor prognosis.