• Clinical and Experimental Reproductive Medicine
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• v.47 no.3
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• pp.227-232
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• 2020

Objective: The aim of this study was to compare in vitro fertilization outcomes between fresh day 3 or day 4 embryo transfer cycles with dual progesterone (P) administration (intramuscular and vaginal) and cycles with single intramuscular P administration for luteal support. Methods: We selected 124 cycles from 100 women (under age 40 years) who underwent oocyte pick-up (number of trials ≤ 3, 4-14 oocytes obtained) and transfer of two or three day 3 or day 4 embryos at two infertility centers from January 2014 to June 2019. Dual P (intramuscular P [50 mg] daily+vaginal P) was used in 52 cycles and a single intramuscular administration of P (50 mg daily) was used in 72 cycles. Results: Women's age, infertility factors, number of oocytes retrieved, number of transferred embryos, and mean embryo score were similar between the dual P group and the single P group. Although the number of trial cycles was significantly higher (1.9 vs. 1.5), and the mean endometrial thickness on the trigger day (10.0 mm vs. 11.0 mm) was significantly lower in the dual P group, the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate for both day 3 and day 4 transfers were similar between the two groups. Conclusion: In fresh day 3 or day 4 embryo transfer cycles, dual P administration did not demonstrate any clinical advantages. Intramuscular P alone appears to be sufficient for luteal support.

• Journal of Embryo Transfer
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• v.33 no.2
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• pp.75-84
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• 2018

The cryopreservation has been extensively applied in many cells including spermatozoa (semen) during past several decades. Especially, the canine spermatozoa cryopreservation has contributed on generation of progeny of rare/genetically valuable dog breeds, genome resource banking and transportation of male germplasm at a distant place. However, severe and irreversible damages to the spermatozoa during cryopreservation procedures such as the thermal shock (cold shock), formation of intracellular ice crystals, osmotic shock, stress of cryoprotectants and generator of reactive oxygen species (ROS) have been addressed. According as a number of researches have been conducted to overcome these problems and to advance cryopreservation technique, several analytical methods have been employed to evaluate the quality of the fresh or cryopreserved canine spermatozoa in regards to the motility, morphology, integrity of membrane and DNA, mitochondrial activity, ROS generation, binding affinity to oocytes, in vitro fertilization potential and fertility potential by artificial insemination. Because the study designs with certain application of analytical methods are selective and varied depending on each experimental objective and laboratory condition, it is necessary to establish the normal reference data of the fresh or cryopreserved canine spermatozoa for each analytical method to monitor experimental procedure, to translate raw data and to discuss results. Here, we reviewed the recent articles to introduce various analytical methods for the canine spermatozoa as well as to establish the normal reference data for each analytical method in the fresh or cryopreserved canine spermatozoa, based on the results of the previous articles. We hope that this review contributes to the advancement of cryobiology in canine spermatozoa.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.3
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• pp.141-145
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• 2017

Objective: Delaying embryo transfer (ET) enables us to select among the embryos available for transfer and is associated with positive effects on implantation and pregnancy outcomes. However, the optimal day for ET of human cleavage-stage embryos remains controversial. Methods: A retrospective study of 3,124 in vitro fertilization/intracytoplasmic sperm injection cycles (2,440 patients) was conducted. We compared the effects of day 2 and 3 ET on rates of implantation and pregnancy outcomes between young maternal age (YMA; < 38 years old, n = 2,295) and old maternal age (OMA; ${\geq}38years\;old$, n = 829) patient groups. Results: The YMA and OMA groups did not differ in terms of patient characteristics except for the proportion of unexplained factor infertility, which was significantly greater in the OMA group, and the proportion of arrested embryos, which was significantly greater in the YMA group. However, the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion, and implantation rates per cycle were not significantly different between day 2 and 3 ET in the YMA group or the OMA group. Conclusion: We suggest that offering patients the opportunity to decide which day would be suitable for ET could be part of a patient-friendly protocol that takes into consideration an infertile woman's circumstances and work schedule by allowing ET to be performed on day 2 instead of the traditional transfer on day 3.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.163-173
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• 2021

Objective: This study aimed to characterize a validated model for predicting oocyte retrieval in controlled ovarian stimulation (COS) and to construct model-based nomograms for assistance in clinical decision-making regarding the gonadotropin protocol and dose. Methods: This observational, retrospective, cohort study included 636 women with primary unexplained infertility and a normal menstrual cycle who were attempting assisted reproductive therapy for the first time. The enrolled women were split into an index group (n=497) for model building and a validation group (n=139). The primary outcome was absolute oocyte count. The dose-response relationship was tested using modified Poisson, negative binomial, hybrid Poisson-E_max, and linear models. The validation group was similarly analyzed, and its results were compared to that of the index group. Results: The Poisson model with the log-link function demonstrated superior predictive performance and precision (Akaike information criterion, 2,704; λ=8.27; relative standard error (λ)=2.02%). The covariate analysis included women's age (p<0.001), antral follicle count (p<0.001), basal follicle-stimulating hormone level (p<0.001), gonadotropin dose (p=0.042), and protocol type (p=0.002 and p<0.001 for short and antagonist protocols, respectively). The estimates from 500 bootstrap samples were close to those of the original model. The validation group showed model assessment metrics comparable to the index model. Based on the fitted model, a static nomogram was built to improve visualization. In addition, a dynamic electronic tool was created for convenience of use. Conclusion: Based on our validated model, nomograms were constructed to help clinicians individualize the stimulation protocol and gonadotropin doses in COS cycles.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.2
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• pp.28-41
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• 2022

Objectives: The purpose of this study is to investigate the effectiveness of moxibustion in infertility with In Vitro Fertilization and Embryo Transfer (IVF-ET). Methods: We searched 8 databases (Embase, PubMed, CiNii, CNKI, OASIS, ScienceOn, KMBASE, KISS)to identify eligible studies published before 2021 Oct. We included randomized controlled clinical trials (RCTs) using moxibustion in infertility with IVF-ET. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results: Two RCT studies were eligible in our review. The overall risk of bias was evaluated as unclear. The meta-analysis of 2 trials indicated that favorable results for the use of moxibustion with IVF-ET. Conclusions: This systematic review and meta-analysis of clinical trials suggests that moxibustion with IVF-ET can effect on Infertility patients. However, because of studies included analysis was biased due to unclear risk of bias and unreliable study design, future RCT studies and additional Meta-Analysis are needed to judge the supplementary treatment role of moxibustion in infertility with IVF-ET.

• Development and Reproduction
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• v.3 no.1
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• pp.39-44
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• 1999

In the present study, we investigated the effect of maturity and motility of spermatozoa on the formation of pronuc-leus and subsequent developmental capacity of the human embryo in vitro. The fertilization was performed by means of intracytoplasmic sperm injection (ICSI) in HEPES-buffered m-TCM-199 medium. In the first part of the experiment, motile or im-motile human spermatozoa ejaculated were injected into cumulus-enclosed human oocytes matured in vivo. Significantly (p<0.002) higher proportion of oocytes that was injected with motile spermatozoa formed 2 pronuclei than the oocytes injected with immotile spermatozoa (79.8% vs 51.7%). In the second part of the experiment, cumulus-enclosed human oocytes matured in vivo were injected with motile or immotile spermatozoa collected from testes. There was no difference between motile and immotile spermatozoa. In the third part of the experiment, using modified Tyrode's medium containing 10.0 mM lactate, 0.5 mM pyruvate, 0.2 mM taurine, 1.0 mM glutamine, 2.22 mM MEM amino acids, vitamin and 10% human follicular fluid, we found that the development of oocytes that formed 2 pronuclei were able to develop to 9-16 cells regardless of maturity and motility of spermatozoa.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.9
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• pp.1245-1252
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• 2017

Objective: Phellodendron amurense (P. amurense) and Humulus japonicus (H. japonicus) are closely involved in anti-oxidative response and increasing antioxidant enzymes activities. However, the effects of their extracts on development of preimplantation bovine embryos have not been investigated. Therefore, we investigated the effects of P. amurense and H. japonicus extracts on developmental competence and quality of preimplantation bovine embryos. Methods: After in vitro fertilization, bovine embryos were cultured for 7 days in Charles Rosenkrans amino acid medium supplemented with P. amurense ($0.01{\mu}g/mL$) and H. japonicus ($0.01{\mu}g/mL$). The effect of this supplementation during in vitro culture on development competence and antioxidant was investigated. Results: We observed that the blastocysts rate was significantly increased (p<0.05) in P. amurense ($28.9%{\pm}2.9%$), H. japonicus ($30.9%{\pm}1.5%$), and a mixture of P. amurense and H. japonicus ($34.8%{\pm}2.1%$) treated groups compared with the control group ($25.4%{\pm}1.6%$). We next confirmed that the intracellular levels of reactive oxygen species (ROS) were significantly decreased (p<0.01) in P. amurense and/or H. japonicus extract treated groups when compared with the control group. Our results also showed that expression of cleaved caspase-3 and apoptotic cells of blastocysts were significantly decreased (p<0.05) in bovine blastocysts derived from both P. amurense and H. japonicus extract treated embryos. Conclusion: These results suggest that proper treatment with P. amurense and H. japonicus extracts in the development of preimplantation bovine embryos improves the quality of blastocysts, which may be related to the reduction of ROS level and apoptosis.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.3
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• pp.73-84
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• 2013

Objectives: This study aims to identify associated factors in female infertility treatment using herbal medicine, acupuncture and moxibustion. Methods: Acupuncture and moxibustion treatments were performed with intake of herbal medicines (Jokyungjongoktanggagam-bang, Sutaehwangagam-bang) for six menstrual cycles in 32 subfertile women. The variables selected for initial analysis were age, duration and type of infertility, frequency of previous In Vitro Fertilization (IVF) and live births, weekly frequency of sexual intercourse, number of treatment cycles, endometrial thickness on MCD15 and hormonal parameter (anti-mullerian hormone, follicle-stimulating hormone, luteinizing hormone, estrone). Results: Six patients became pregnant (18.75%) and seven patients withdrew. Factors influenced pregnancy were age (${\leq}35$ years), a shorter duration of infertility (<6 years), frequency of IVF (${\leq}3$), anti-mullerian hormone level (>1 ng/ml), and number of treatment cycles(${\leq}3$ cycles). Conclusions: Korean medicine is a useful and optimized treatment option for women with younger age, fewer previous IVF cycles, shorter infertile duration and normal anti-mullerian hormone level at first 3 cycles of treatment.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.1
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• pp.69-76
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• 1994

The survival and pregnancy rates were compared between non-frozen embryos and cryopreserved embryos at either pronucleate or 2-4 cell stages using the freezing and thawing techniques being identical in both groups were compared with fresh embryos. 496 embryos were frozen with 1, 2-propanediol and sucrose and 117 2-4 cell stages embryos had been thawed and 79.6 and 66.0% of them respectively were survival. Clinical pregnancy rate was 19.2% for embryos frozen at the pronucleate stage and 19.0% for embryos frozen at the 2-4 cell stages while the pregnancy rate of non-frozen embryos was 21.3%. There were no significant difference in the survival and pregnancy rates of embryos frozen at pronucleate and 2-4 cell stages. The current cumulative pregnancy rate per retrieval in all cycles with frozen zygotes is 35.4 %, consid~ erably higher than observed in single transfers of embryos without cryopreservation(21.3%); predicted pregnancy rate after transfer of all frozen embryos is 43.3 %. It is concluded that firstly, the survival and pregnancy rate of cryopreserved embryos at pronucleate or 2-4 cell stages are very similar to those from their fresh embryos and non-frozen embryos and secondly, cryopreservation substantially enhances pregnancy attainment from in vitro fertilization.

• Clinical and Experimental Reproductive Medicine
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• v.39 no.1
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• pp.28-32
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• 2012

Objective: This study was performed to assess the prognostic value of serum hCG, progesterone, and inhibin A levels measured at 11 days post-ET for predicting pregnancy outcome in women participating in IVF. Methods: Between May 2005 and April 2008, sera were obtained from 70 infertile women who underwent IVF-ET at 11 days post-ET and stored. HCG, progesterone, and inhibin A levels were measured by commercial enzyme-linked immunosorbent assay kits. The predictive accuracy of hCG, progesterone, and inhibin A levels for establishment of intrauterine pregnancy and ongoing pregnancy was calculated by receiver-operating characteristic curve analysis. Results: For the prediction of intrauterine and ongoing pregnancy, serum hCG was better than progesterone and inhibin A. The predictive performance of progesterone and inhibin A was similar. The serum progesterone and inhibin A levels were significantly correlated each other (r=0.915, p=0.010). Conclusion: A single measurement of the serum hCG level is sufficient to predict pregnancy outcome in IVF-ET patients.