• Clinical and Experimental Reproductive Medicine
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• 제36권1호
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• pp.55-61
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• 2009

목 적: 폐쇄성 무정자증 (obstructive azoospermia) 환자와 정자형성저하증 (hypospermatogenesis) 환자의 고환 정자를 이용한 체외수정 및 배아이식술의 결과를 비교, 분석하고자 하였다. 연구방법: 2003년 1월부터 2006년 12월까지 체외수정 및 배아이식술을 위해 고환조직 정자채취술을 시행한 폐쇄성 무정자증 환자 155명 (241주기)과 정자형성저하증 환자 28명 (34주기)을 대상으로 하였다. 고환조직 정자채취술과 세포질내 정자주입술을 실시한 후 수정률, 착상률, 임신율, 출산율을 비교하였으며, 통계적 분석은 t-test와 ${\chi}^2$-test를 사용하였다. 결 과: 정자형성저하증 환자의 고환정자 회수 결과, 신선고환을 사용한 21주기 중 1주기에서는 정자를 회수하지 못하였으나, 정자를 확인하고 고환조직 동결보존 후 융해한 13주기에서 모두 정자를 회수할 수 있었다. 수정률은 정자형성저하증 환자보다 폐쇄성 무정자증 환자에서 통계적으로 유의하게 높았다 (75.6 % vs. 62.6%, p<0.001). 난할 배아 발생률도 정자형성저하증 환자보다 폐쇄성 무정자증 환자에서 통계적으로 유의하게 높았다 (66.8% vs. 54.8% p<0.001). 그러나 우수배아 형성률, 임상적 임신율, 착상률, 출산율에는 차이가 없었다. 결 론: 정자형성저하증 환자의 고환정자를 사용하여 세포질내 정자주입술을 실시할 경우 수정률과 초기 난할율은 폐쇄성 무정자증 환자보다 낮지만, 정상적으로 발달한 배아를 이식할 경우 임신율, 착상률, 그리고 출산율에는 영향을 미치지 않는 것으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제50권4호
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• pp.230-243
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• 2023

Objective: High temperatures can trigger cellular oxidative stress and disrupt spermatogenesis, potentially leading to male infertility. We investigated the effects of retinoic acid (RA), chitosan nanoparticles (CHNPs), and retinoic acid loaded with chitosan nanoparticles (RACHNPs) on spermatogenesis in mice induced by scrotal hyperthermia (Hyp). Methods: Thirty mice (weighing 25 to 30 g) were divided into five experimental groups of six mice each. The groups were as follows: control, Hyp induced by a water bath (43 ℃C for 30 minutes/day for 5 weeks), Hyp+RA (2 mg/kg/day), Hyp+CHNPs (2 mg/kg/72 hours), and Hyp+RACHNPs (4 mg/kg/72 hours). The mice were treated for 35 days. After the experimental treatments, the animals were euthanized. Sperm samples were collected for analysis of sperm parameters, and blood serum was isolated for testosterone measurement. Testis samples were also collected for histopathology assessment, reactive oxygen species (ROS) evaluation, and RNA extraction, which was done to compare the expression levels of the bax, bcl2, p53, Fas, and FasL genes among groups. Additionally, immunohistochemical staining was performed. Results: Treatment with RACHNPs significantly increased stereological parameters such as testicular volume, seminiferous tubule length, and testicular cell count. Additionally, it increased testosterone concentration and improved sperm parameters. We observed significant decreases in ROS production and caspase-3 immunostaining in the RACHNP group. Moreover, the expression levels of bax, p53, Fas, and FasL significantly decreased in the groups treated with RACHNPs and RA. Conclusion: RACHNPs can be considered a potent antioxidative and antiapoptotic agent for therapeutic strategies in reproductive and regenerative medicine.

• Clinical and Experimental Reproductive Medicine
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• 제35권4호
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• pp.293-301
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• 2008

목 적: 비폐쇄성 무정자증 환자에서 고환의 조직병리학적 진단에 따라 고환조직내 정자채취술 (Testicular sperm extraction, TESE) 후 난자세포질내 정자주입술 (Intracytoplsmic sperm injection, ICSI)의 체외수정시술 결과를 알아보고자 하였다. 연구방법: 비폐쇄성 무정자증으로 고환조직내 정자채취술 후 난자세포질내 정자주입술을 이용하여 배아 이식을 시행한 122주기를 분석하였다. 고환의 조직병리학적 진단에 따라 Germ-cell aplasia (GA, 40주기), Maturation arrest (MA, 32주기) and severe hypospermatogenesis (S-HS, 50주기)로 구분하여 체외수정시술 결과를 비교하였으며, 이들 결과를 난자세포질내 정자주입술을 이용한 폐쇄성 무정자증 환자의 체외수정시술 결과와 비교하였다. 결 과: 고환조직내 정자채취술 후 난자세포질내 정자주입술시 수정율은 각각 58.1% in GA, 42.2% in MA and 48.0% in S-HS로 조직병리학적 진단에 따른 차이는 없었으며, 폐쇄성 무정자증 환자의 72.9%에 비해 유의하게 낮은 수정율을 보였다 (p<0.001). 고환조직내 정자채취술시 채취된 정자 (spermatozoa, 94주기)로 난자세포질내 정자주입술을 시행한 주기의 배아 이식 후 임신율은 각각 22.6% in GA, 29.4% in MA와 26.1% in S-HS이었으며, 출생률은 각각 16.1%, 29.4%와 19.6%로 조직병리학적 진단에 따른 차이는 없었다. 정자세포 (spermatid, 16주기)를 사용하여 난자세포질내 정자주입술을 시행한 주기의 임신율은 각각 0.0% (0/3 주기), 9.1% (1/11주기)와 0.0% (0/2주기)이었으며, 출생률은 각각 0.0%이었다. 정모세포 (spermatocyte, 12주기)를 사용한 주기의 임신율은 각각 0.0% (0/6주기), 0.0% (0/4주기)와 0.0% (0/2주기)이었으며, 출생률도 각각 0.0%이었다. 결 론: 비폐쇄성 무정자증환자의 배아이식을 시행한 주기에서 고환의 조직병리학적 진단에 따른 난자세포질내 정자주입술시 수정율은 차이가 없었으며, 폐쇄성 무정자증 환자에 비해 유의하게 낮은 수정율을 보였다. 비폐쇄성 무정자증환자에서 고환조직내 정자채취술시 정자를 채취하여 난자세포질내 정자주입술을 시행한 주기의 체외수정시술 결과는 고환의 조직병리학적 진단에 따라 차이를 보이지 않는다.

• 디지털융복합연구
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• 제12권6호
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• pp.433-438
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• 2014

본 연구는 흰쥐의 정소에 방사선을 조사하였을 때 시간이 경과함에 따라 나타나는 정소세포 및 정자의 변화를 현미경학적으로 얻은 영상을 기초로 영상처리에 의한 정량분석을 통하여 정자의 변화에 대한 결과를 정량화함으로써 더 정확하고 객관적인 결과를 얻고자 하는데 그 목적을 두고 있다. 연구에는 8주 수령의 흰쥐를 대상으로 하였으며, 6 MV의 X선을 1회 2 Gy를 전신 조사하였다. 총 30 마리의 흰쥐를 대상으로 방사선을 조사하지 않은 정상대조군과 실험군을 조사 즉시, 조사 2시간, 4시간, 8시간, 24시간 후에 각 실험군 마다 5마리의 정소를 각각 적출하였다. 적출 후 Periodic acid Schiff 염색을 시행하여 정상대조군과 실험군에서의 정소세포와 정자의 상태를 관찰하였다. 방사선조사 후 24시간까지, 정소세포수와 정자수가 점차 감소하는 것을 정성적 및 정량적으로 유의함을 확인하였다.

• Clinical and Experimental Reproductive Medicine
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• 제25권3호
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• pp.349-353
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• 1998

It has been well known that infertile women experience not only emotional disturbance but also stress. But there is no concern about male infertility patients. So phychiatric symptoms were studied with SCL-90 (Symptom Check List-90) in 30 infertile men who was operated testicular sperm extraction (TESE) in Samsung Cheil Hospital and in age matched 31 fertile men from Jan. 1998 to Aug. 1998. In 5 symptom dimensions (Obcessive-Compulsive, Interpersonal Sensitivity, Depression, Phobic anxiety, Psychoticisim) scores. The Infertile group scored significantly higher than the control group. The result revealed that infertile men also experienced substantially more psychiatric symptoms than fertile men. Considering this results, psychiatric evaluation and tender care by infertility specialist are necessary for infertile men during and after evaluation and treatment.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2005년도 제49차 추계학술대회
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• pp.123.1-123.1
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• 2005

• Clinical and Experimental Reproductive Medicine
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• 제48권4호
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• pp.283-294
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• 2021

A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.

• Clinical and Experimental Reproductive Medicine
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• 제31권4호
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• pp.253-260
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• 2004

Objectives: Klinefelter syndrome is the most common genetic cause of male infertility and presents with 47, XXY mainly or 46, XX/47, XXY mosaicism. It is characterized by hypogonadism and azoospermia due to testicular failure, however, sporadic cases of natural pregnancies have been reported. With the development of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI), sperm can be retrieved successfully and ART is applied in these patients for pregnancy. It has been suggested that the risk of chromosome aneuploidy for both sex chromosome and autosome is increased in the sperms from 47, XXY germ cells. Considering the risk for chromosomal aneuploidy in the offspring, preimplantation genetic diagnosis (PGD) could be applied as a safe and more effective treatment option in Klinefelter syndrome. The aim of this study is to assess the outcome of PGD cycles by using FISH for sex chromosome and autosome in patients with Klinefelter syndrome. Materials and Methods: From Jan. 2001 to Dec. 2003, PGD was attempted in 8 cases of Klinefelter syndrome but TESE was failed to retrieve sperm in the 3 cases, therefore PGD was performed in 8 cycles of 5 cases (four 47, XXY and one 46, XY/47, XXY mosaicism). In one case, ejaculated sperm was used and in 4 cases, TESE sperm was used for ICSI. After fertilization, blastomere biopsy was performed in $6{\sim}7$ cell stage embryo and the chromosome aneuploidy was diagnosed by using FISH with CEP probes for chromosome X, Y and 17 or 18. Results: A total of 127 oocytes were retrieved and ICSI was performed in 113 mature oocytes. The fertilization rate was $65.3{\pm}6.0%$ (mean$\pm$SEM) and 76 embryos were obtained. Blastomere biopsy was performed in 61 developing embryos and FISH analysis was successful in 95.1% of the biopsied blastomeres (58/61). The rate of balanced embryos for chromosome X, Y and 17 or 18 was $39.7{\pm}6.9%$. The rate of aneuploidy for sex chromosome (X and Y) was $45.9{\pm}5.3%$ and $43.2{\pm}5.8%$ for chromosome 17 or 18, respectively. Embryo transfer was performed in all 8 cycles and mean number of transferred embryos was $2.5{\pm}0.5$. In 2 cases, clinical pregnancies were obtained and normal 46, XX and 46, XY karyotypes were confirmed by amniocentesis, respectively. Healthy male and female babies were delivered uneventfully at term. Conclusion: The patients with Klinefelter syndrome can benefit from ART with TESE and ICSI. Considering the risk of aneuploidy for both sex chromosome and autosome in the sperms and embryos of Klinefelter syndrome, PGD could be offered as safe and more effective treatment option.

• Clinical and Experimental Reproductive Medicine
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• 제45권1호
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• pp.48-51
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• 2018

We report the case of a 46-year-old Chinese male patient who visited our clinic complaining of infertility. Semen analysis revealed azoospermia, and azoospermia factor c region partial deletion (b1/b3) was detected using Y chromosome microdeletion analysis. Testicular sperm extraction was performed after genetic counseling. The bilateral ductus deferens and a portion of the epididymis were absent, whereas the remaining epididymis was expanded. Motile intratesticular spermatozoa were successfully extracted from the seminiferous tubule. On histopathology, nearly complete spermatogenesis was confirmed in almost every seminiferous tubule. To our knowledge, this is the first case report of b1/b3 deletion with a congenital bilateral absence of the vas deferens and almost normal spermatogenesis.

• Clinical and Experimental Reproductive Medicine
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• 제30권3호
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• pp.207-215
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• 2003

Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.