• 제목/요약/키워드: implantation rate

검색결과 385건 처리시간 0.028초

인간 포배란의 유리화동결 융해 후 임신 및 분만에 관한 연구 (Clinical Study on the Successful Pregnancy and Delivery after Transfer of Human Blastocysts Cryopreserved by Vitrification)

  • 최동희;정형민;정미경;이숙환;남윤성;박찬;곽인평;윤태기
    • Clinical and Experimental Reproductive Medicine
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    • 제27권4호
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    • pp.367-372
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    • 2000
  • Objective: This study was performed to evaluate whether vitrification method could be used for the cryopreservation of human blastocysts derived from IVF program. Methods: Surplus embryos were obtained from consented IVF patients. Controlled ovarian hyperstimulation was done with midluteal GnRH agonist, gonadotropin and hCG. After oocyte retrieval and insemination, fresh embryo transfer was done at $4{\sim}8$ cell stage. The surplus embryos after ET were cultured in blastocyst medium up to 6 days after oocyte retrieval. Obtained blastocysts were cryopreserved with our vitrification method. Blastocysts were exposed to 1.5 Methylene glycol (EG) in phosphate buffered saline (PBS) for 2.5 minutes, followed by 5.5 M EG plus 1 M sucrose for 20 seconds. Then 1 to 3 blastocysts were mounted on electron microscope (EM) grid and the grid was plunged into liquid nitrogen for storage. For thawing, blastocyst-containing EM grids were sequentially transferred in 1.0 M, 0.5 M, 0.25 M, 0.125 M and 0 M sucrose solution at the intervals of2.5 minutes. And blastocysts were cultured for about 6 hours and only re-expanded blastocysts were transferred to uterus of the patients on 4 to 5 days after ovulation in natural cycle or on 18 to 19 day of artificial cycle. Results: From Oct. 1998 to Jul. 1999, 34 patients were agreed to participate in this study. The mean age and duration of infertility of the patients were 31.6 years and 4.1 years, respectively. Among 34 cycles. replacements could be done in 20 cycles (58.8%). A total 93 blastocysts were thawed and 48 (51.6%) of them survived. Thirty-eight blastocysts, mean 1.9 embryos per patient, were transferred, resulting in 5 clinical pregnancies which consisted of 1 triplet, 2 sets of twins and 2 singleton pregnancies. The pregnancy rate per transfer was 25% and implantation rate was 23.6%. Five patients delivered 7 healthy babies including 2 sets of twins at term. Conclusion: Successful pregnancies and deliveries were established after transfer of vitrified human blastocysts. Vitrification using ethylene glycol as cryoprotectant and electron microscope grid is a rapid and simple method that can be effectively applied for the cryopreservation of human blastocysts.

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불임증(不姙症) 환자(患者)의 통계적(統計的) 고찰(考察);서울대학교병원(大學校病院) 불임상담실(不姙相談室) 1872 예(例)의 분석(分析) (An Analysis of Infertility Patients)

  • 장윤석;이진용;문신용;김정구;최승헌;임용택
    • Clinical and Experimental Reproductive Medicine
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    • 제12권1호
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    • pp.47-70
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    • 1985
  • This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

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Shewanella algae BrY를 이용한 영가철 칼럼의 TCE 처리 수명연장 (Durability Extension of Fe(0) Column with Shewanella Algae BrY on TCE Treatment)

  • 채희훈;배연욱;박재우
    • 한국지반환경공학회 논문집
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    • 제8권2호
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    • pp.41-48
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    • 2007
  • 영가철은 trichloroethylene(TCE)과 같은 염소계 유기오염물질 제거에 탁월한 효과를 가지고 있어서, 반응벽체를 이용한 오염된 토양 및 지하수의 현장처리에 반응매질로 자주 사용되고 있다. 하지만 영가철의 빠른 반응성으로 인하여 반응벽체의 수명이 다하고, 탈염소화 과정 중 생성된 산화철이 영가철 표면에 침적 되어 반응표면적을 줄임으로써 반응성이 떨어지게 된다. 이러한 영가철 반응벽체의 단점을 보완하기 위한 방법이 연구되어 왔고, 그 중 철환원균을 이용한 연구가 본 연구에서 시도되었다. 실험에 사용한 Shewanella algae BrY는 철환원균의 일종으로서 Dissimilatory Iron Reducing Bacteria(DIRB)로 분류된다. 본 연구에서는 이전의 배치실험 연구결과를 바탕으로 칼럼실험을 통해 TCE의 농도를 30mg/L과 67.5mg/L의 두 가지로 비교하고, 유량을 8mL/hr, 16mL/hr의 두 가지로 비교하여 세 개의 칼럼 실험을 실시하여 영가철 반응벽체의 TCE의 제거 및 산화된 철의 철환원균을 이용한 환원과정을 칼럼실험을 통해 측정했다. 그 결과 철환원균에 의한 산화철의 환원은 오염물질의 농도가 높을 경우 처리량의 증가로 인하여 반응벽체의 수명을 단축시키는 원인이 되었고, 유량의 증가 역시 유입되는 오염물질의 증가로 인하여 수명의 단축을 가져왔다. 그러나 유량증가의 경우 유속의 증가를 가져와서 Shewanella algae BrY가 매질표면에 작용하여 산화철을 환원시킬 수 있는 시간을 감소시키고 착상되는 것을 방해하기 때문에 오염물질의 농도보다 큰 영향을 미치는 결과를 보여준다. 칼럼실험결과 Shewanella algae BrY에 의한 산화철의 환원은 TCE의 탈염소화 후 생성된 산화철의 침적에 의하여 발생되는 반응벽체의 수명감소를 줄일 수 있다는 결과를 얻었다.

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인간 체외수정술에서 배아 이식일의 자궁동맥 임피던스에 따른 임신의 예측 (Prediction of Pregnancy Outcomes by Uterine Artery Impedances on the Day of Embryo Transfer in Human IVF)

  • 정주은;조무성;김승철;주종길;최종열;이규섭
    • Clinical and Experimental Reproductive Medicine
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    • 제36권4호
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    • pp.293-300
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    • 2009
  • 목 적: 본 연구는 배아이식일의 자궁동맥혈류가 인간 체외수정술에서 임신예후의 예측인자가 될 수 있는지 알아보기 위해 시행되었다. 연구방법: 51회의 체외수정술 주기에 대해 전향적인 임상 관찰로 시행되었으며 혈청 estradiol 농도는 hCG 투여일에 측정되었고, 자궁동맥 박동율 (PI)과 저항율 (RI)은 배아이식 3일째에 측정되었다. 결 과: 51회의 주기 중 22주기에서 임상적으로 임신이 확인되었고 (43.1%), 착상률은 14.7%였다. 자궁동맥 PI와 RI는 혈청 estradiol 농도과 의미 있는 음의 상관관계 (p<0.05)를 보였으며 자궁혈류량은 임신된 그룹과 임신 되지 않은 그룹에서 차이가 없었다. 임신율은 PI가 3.0 이상인 군에서 PI가 3.0 이하인 군보다 조금 높게 측정되었으나 통계학적인 유의성은 없었다. 결 론: 배아이식일의 자궁동맥 PI와 RI는 체외수정술에서 임신의 예측인자로는 효용성이 떨어지지만 estradiol 농도와는 음의 상관관계를 보여 자궁혈류와 estradiol 농도가 상관관계가 있음을 알 수 있다.

혈소판 농축혈장이 임플랜트 주위 골결손부 재생에 미치는 영향 (The Effects of Platelet-Rich Plasma on Regeneration around Dental Implant Defects)

  • 홍기석;임성빈;정진형;이종헌
    • Journal of Periodontal and Implant Science
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    • 제33권4호
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    • pp.673-691
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    • 2003
  • The current interest in periodontal tissue regeneration has lead to research in bone graft, root surface treatments, guided-tissue regeneration, and the administration of growth factors as possible means of regenerating lost periodontal tissue. Several studies have shown that a strong correlation between platelet-rich plasma and the stimulation of remodeling and remineralization of grafted bone exists, resulting in a possible increase of 15-30% in the density of bone trabeculae. The purpose of this study was to study the histopathological correlation between the use of platelet-rich plasma and a bone xenograft used in conjunction with a non-resorbable guided-tissue membrane, e-PTFE, compared to a control group with regards to bone regeneration at the implant fixture site. Implant fixtures were inserted and graft materials placed into the left femur of in the experimental group, while the control group received only implant fixtures. In the first experimental group, platelet-rich plasma and BBP xenograft were placed at the implant fixture site, and the second experimental group had platelet-rich plasma, BBP xenograft, and the e-PTFE membrane placed at the fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2 , 4, and 8 weeks after implant fixture insertion. The results of the experiment are as follows: 1. The rate of osseointegration to the fixture threads was found to be greater in the first experimental group compared to the control group. 2. The histopathological findings of the second experimental group showed rapid resorption of BBP with subsequent new bone formation replacing the resorbed BBP. 3. The second experimental group showed new bone formation in the area adjacent to the fixture threads beginning two weeks after fixture implantation, with continued bone remodeling in the areas mesial and distal to the fixture. 4. Significant new bone formation and bone remodeling was observed in both experimental groups near the implant fixture sites. 5. The rate of osseointegration at the fixture threads was greater in the second experimental group compared to the first group, and the formation of new bone and trabeculae around the fixture site occurred after the fourth week in the second experimental group. The results of the experiment suggest that a greater degree of new bone formation and osseointegration can occur at the implant fixture site by utilizing platelet-rich plasma and bone xenografts, and that these effects can be accelerated and enhanced by concurrent use of a non-resorbable guided tissue membrane.

Skin Deiodinase Profiles after Melatonin Manipulated in Chinese Inner Mongolia Cashmere Goats

  • Yue, Chunwang;Du, Lixin;Zhu, Xiaoping;Kong, Xianghao;Zhang, Wei;Jia, Zhihai
    • Asian-Australasian Journal of Animal Sciences
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    • 제20권10호
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    • pp.1496-1502
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    • 2007
  • The roles of melatonin in the control of deiodinase (MD) activity in cashmere goat skin and associated cashmere fibre growth were investigated. Eighteen half-sib Chinese Inner Mongolia cashmere wethers were allocated randomly to two groups (n = 9/group). One group was implanted subcutaneously with melatonin (2 mg/kg BW) at three 2-monthly intervals while the other group served as a control. All goats were maintained under natural photoperiodic conditions and were grazed on natural pasture. The plasma melatonin concentration showed a significant difference (p<0.01) between the implant group (M) and the control group (C) but plasma $T_4$ (or $T_3$) showed no significant difference (p>0.05). The monodeiodinase type II (MDII) activity in skin tended to increase gradually from the summer solstice to November. During July and August, the activity of MDII for the M group was higher (p<0.05) than that of the C group; also during this period, there was a significant positive correlation between MDII activity of skin and cashmere fibre growth rate. The monodeiodinase type III (MDIII) activity and the ratio of MDIII and MDII tended to decrease from the summer solstice to November. The ratio of MDIII and MDII for the M group was lower (p<0.05) than that of the C group in July and August. The cashmere fibre growth rate of the M group was significantly greater than that of the C group in July (p<0.01), August (p<0.001) and September (p<0.05). The cashmere fibre diameter and guard hair and body weight were not influenced (p>0.05) by melatonin implantation. The results demonstrate that melatonin plays an important role in the regulation of skin MD activity. Simultaneously, the cashmere fibre elongation stimulated by melatonin may result from enhanced MDII activity during a period of two months after melatonin treatment.

GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI

  • Kim, Chung-Hoon;You, Rae-Mi;Kang, Hyuk-Jae;Ahn, Jun-Woo;Jeon, Il-kyung;Lee, Ji-Won;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • 제38권4호
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    • pp.228-233
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    • 2011
  • Objective: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP). Methods: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP. Results: There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups. Conclusion: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.

발살바동 동맥류의 외과적 치료 및 장기 결과 (Surgical Repair and Long Term Results in Sinus of Valsalva Aneurysm: Twelve Year Experience)

  • 방정희;조광현;우종수
    • Journal of Chest Surgery
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    • 제37권7호
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    • pp.578-584
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    • 2004
  • 발살바동 동맥류는 드문 심장 기형으로 수술 후 장기 생존율이 잘 알려져 있지 않다 본 연구는 발살바동 동맥류의 수술적 치료 후 장기 성적을 알아보고자 하였다. 대상 및 방법: 1991년 1991년 3월부터 2003년 11월까지 발살바동 동맥류로 수술한 35명(남자 23, 여자 12, 평균 연령 35.2세, 범위 11세∼64세)의 환자를 대상으로 하였다. 술 전 NYHA 기능적 분류는 26명(74.3%)에서 class III∼IV였다. 술 전 심초음파상 평균 심구출률은 63.32 $\pm$ 11.43%였고 9명(25.7%)의 환자는 대동맥 판막 폐쇄 부전 grade III∼IV였다. 발살바동 파열부위의 수술은 직접 봉합이 14예(46.7%), 첩포를 이용한 폐쇄는 16예 (53.3%)에서 시행되었다. 대동맥 판막 치환술은 5예에서(14.3%) 성형술은 3예에서(8.6%) 시행되었다. 그리고 3명(8.6%)의 환자에서는 Bentall's 수술을 했으며 동반된 수술은 심실 중격 결손 폐쇄 12예 (34.3%), 심방 중격 결손 폐쇄 3예(8.6%)였다. 평균 심폐체외순환 시간은 116.79 $\pm$ 38.79분이었고 평균 대동맥 차단 시간은 81.2 $\pm$ 28.97분이었다. 결과: 수술 사망은 없었다. 1예에서 완전 방실 차단으로 영구 심장 박동기를 삽입했다. 재수술은 3예에서 시행하였는데 1예는 발살바동 동맥류 재발로 직접 봉합했고 1예는 대동맥 판막 기능 부전이 악화되어 인공 판막 치환술을, 1예는 인공 판막 치환술 후 판막 열개로 Bentall's 수술을 시행했다. 평균 추적 기간은 58.55$\pm$38.38개월이었으며 만기 사망은 1예 있었다. 5 year freedom from reoperation rate는 87.1 $\pm$ 7%였다. 결론: 발살바동 동맥류의 수술적 치료는 안전하며 만족할 만한 결과를 얻었다.

임플란트 환자의 일반적 특성 및 구강관심도에 따른 기능별 만족도 연구 (Study for general characters of dental implant patients and satisfaction level of function by dental interest level)

  • 유은미;황윤숙
    • 한국치위생학회지
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    • 제9권3호
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    • pp.456-467
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    • 2009
  • For this study, self-completion survey for 149 implant patients of dental clinics and hospitals in Seoul and Kyunggi areahas been executed in order to provide basic data for increasing patient satisfaction level by effective consultation and various information for the patients who want dental implantation. The conclusion of the study is like below. 1. In terms of demographics of the study, sample size of female patients(n=85) was more than that of male patients(n=64) and patients in their 50s were major age group. When it comes to the educational level, university graduates were 85 and high school graduates were 44. And 132 were married and 6 were single. In the income level, monthly income between KRW 2~4 million was major group(n=59). 2. In the study, patients' most concern was complication or adverse events(n=41), and price(n=39) & annual dental check-up(n=49) were following it. And 80 patients responded that dental health is the most valuable(n=80) and whole body health was following(n=37). In terms of knowledge on dental implant, 100 patients responded 'know just a little', 31 and 13 answered 'generally know' and 'well know' each. 3. As a result of analyzing implant patients' satisfaction level by segment, general satisfaction rate was highest as 4.20, social satisfaction rate was 4.20, psychological function was 4.06 and masticatory function was 3.90. 4. Based on the result of comparing patient satisfaction level by general characters of dental implant patient, chewing function was the highest in the age group of 60s with score of 4.21 and in terms of social function, the group with over KRW 8 million of monthly income showed highest score with 4.54. When it comes to the psychological function, patients in their 70s showed highest satisfaction level with 4.52. In the end, patients in their 70s showed highest score with 4.81 in the overall satisfaction and it was also statistically significant. 5. In the overall satisfaction level by interest in dental health, appearance showed highest score with 4.57 and it was also significantly higher than that of whole body. In the variance by dental knowledge, 'well know' group showed highest score with 4.58, and that of 'just a little' group was 4.33. That means there are correlations between dental knowledge and satisfaction level. 6. As a result of analyzing correlations amongst variances of the study, there were strong positive correlations among them. And there were very significantly positive correlations especially between social and psychological function and between psychological and overall satisfaction level. In conclusion, higher psychological function has strong relations with both social function and overall satisfaction level(p<.001).

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Comparison of the clinical outcomes of day 4 and 5 embryo transfer cycles

  • Lee, Sun-Hee;Lee, Hyoung-Song;Lim, Chun Kyu;Park, Yong-Seog;Yang, Kwang Moon;Park, Dong Wook
    • Clinical and Experimental Reproductive Medicine
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    • 제40권3호
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    • pp.122-125
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    • 2013
  • Objective: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.