• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.221-227
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• 2016

Objective: The aim of this study was to evaluate the influence of maternal age on fertilization, embryo quality, and clinical pregnancy in patients undergoing intracytoplasmic sperm injection (ICSI) using testicular sperm from partners with azoospermia. Methods: A total of 416 ICSI cycles using testicular spermatozoa from partners with obstructive azoospermia (OA, n = 301) and non-obstructive azoospermia (NOA, n = 115) were analyzed. Female patients were divided into the following age groups: 27 to 31 years, 32 to 36 years, and 37 to 41 years. The rates of fertilization, high-quality embryos, clinical pregnancy, and delivery were compared across maternal age groups between the OA and NOA groups. Results: The rates of fertilization and high-quality embryos were not significantly different among the maternal age groups. Similarly, the clinical pregnancy and delivery rates were not significantly different. The fertilization rate was significantly higher in the OA group than in the NOA group (p< 0.05). Age-group analysis revealed that the fertilization and high-quality embryo rates were significantly different between the OA and NOA groups in patients aged 27 to 31 years old, but not for the other age groups. Although the clinical pregnancy and delivery rates differed between the OA and NOA groups across all age groups, significant differences were not observed. Conclusion: In couples using testicular sperm from male partners with azoospermia, pregnancy and delivery outcomes were not affected by maternal age. However, women older than 37 years using testicular sperm from partners with azoospermia should be advised of the increased incidence of pregnancy failure.

• Clinical and Experimental Reproductive Medicine
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• 제25권2호
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• pp.189-198
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• 1998

Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than 5 years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% (p<0.01, p<0.01). Patency and pegnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence (p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vas (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively (p>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and vasal ooze with surgical skills.

• Clinical and Experimental Reproductive Medicine
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• 제44권2호
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• pp.105-110
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• 2017

Objective: The purpose of this study was to evaluate the efficacy of frozen mixed double-embryo transfer (MDET; the simultaneous transfer of day 3 and day 5 embryos) in comparison with frozen blastocyst double-embryo transfer (BDET; transfer of two day 5 blastocysts) in patients with repeated implantation failure (RIF). Methods: A total of 104 women with RIF who underwent frozen MDET (n = 48) or BDET (n = 56) with excellent-quality embryos were included in this retrospective analysis. All frozen embryo transfers were performed in natural cycles. The main outcome measures were the implantation rate, clinical pregnancy rate, multiple pregnancy rate, and miscarriage rate. These measures were compared between the patients who underwent MDET or BDET using the chi-square test or the Fisher exact test, as appropriate. Results: The implantation and clinical pregnancy rates were significantly higher in patients who underwent MDET than in those who underwent BDET (60.4% vs. 39.3%, p=0.03 and 52.1% vs. 30.4%, p=0.05, respectively). A significantly lower miscarriage rate was observed in the MDET group (6.9% vs. 10.7%, p=0.05). In addition, the multiple pregnancy rate was slightly, but not significantly, higher in the MDET group (27.1% vs. 25.0%). Conclusion: MDET was found to be significantly superior to double blastocyst transfer. It could be regarded as an appropriate approach to improve in vitro fertilization success rates in RIF patients.

• Reproductive and Developmental Biology
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• 제29권3호
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• pp.193-199
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• 2005

인간의 불임을 극복하기 위한 번식공학 기술의 효율성을 증가시키기 위해 성세포의 동결이 널리 수행되고 있으나 동결 기술의 효율성에 있어서 논란의 여지가 있다. 본 연구에서는 체외수정란을 생산하기 위한 난자세포질내 정자미세주입(ICSI) 시술에 사용되는 정자와 이들 기술을 이용 생산한 체외수정란의 동결이 배 발생 및 임신에 미치는 효과를 조사하였다. ICSI방법으로 체외수정란을 생산하는 경우 정자의 동결이 체외수정, 발생 및 임신에 영향을 미치지 않았으며, 특히 동결융해한 사출 및 정소정자에 의한 체외수정율과 발생율 및 임신율도 차이가 없었다. 한편 체외수정란을 동결하는 경우 완만동결과 초자화동결에 의한 체외수정란의 생존율과 임신율은 차이가 없었으나, 동결수정란은 신선수정란에 비하여 임신율이 유의하게 낮았다(p<0.05). 결론적으로 ICSI에 사용되는 정자와 달리 ICSI에 의해 생산된 수정란을 동결하는 경우 임신율을 저하시킬 수 있다.

• 대한한의학회지
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• 제32권5호
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• pp.25-40
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• 2011

Objectives: This study was performed to assess whether herbal medicine and acupuncture before in vitro fertilizationembryo transfer (IVF-ET) is effective on clinical pregnancy. Methods: From May 2010 to January 2011, a prospective analysis study was performed in 38 patients planning to undergo IVF-ET after taking herb medicine and acupuncture treatment. This study investigated the pregnancy rate and analyzed the change of dysmenorrhea by visual analog scale (VAS), body heat and condition of premenstrual syndrome (PMS), vaginal discharge and menstruation status. Results: 1. During herbal medicine and acupuncture treatment, five patients (13.16%) naturally became pregnant and six patients (15.79%) withdrew. After treatment, 15 patients (39.47%) received IVF-ET, 12 patients (31.58%) did not. 2. The biochemical pregnancy rate was 26.67%, the clinical pregnancy rate 26.67%, miscarriage rate 25% and ectopic pregnancy rate was 0%. 3. After treatment, PMS, dysmenorrhea and dysmenorrhea VAS was significantly decreased and the overall menstrual status improved. 4. After treatment, temperature difference of CV17-CV12 and CV4-CV12 increased, but it was not a statistically significant difference. 5. After treatment, decrease of hemoglobin and protein and increase of total bilirubin and creatinine were statistically significant. All the blood test results were within normal levels which proves safety of treatment. Conclusions: This study suggests that herbal medicine and acupuncture treatment before IVF-ET shows similar pregnancy rates with existing rates, but contributes to increasing the possibility of natural pregnancy.

• Asian-Australasian Journal of Animal Sciences
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• 제20권11호
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• pp.1670-1676
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• 2007

Fifty repeat breeder (RB) Friesian cows were allocated to five groups of 10 cows each, to determine the effect of progesterone (P4) supplement on P4 concentrations and pregnancy rates during the periods of corpus luteum (CL) formation and development between days 2-7 and 7-12 following a spontaneous or $PGF_{2{\alpha}}$-induced estrus. Cows were artificially inseminated during $PGF_{2{\alpha}}$-induced (PGF-P4-d2 and PGF-P4-d7 groups) or spontaneous (S-P4-d2, S-P4-d7, and control groups) estrus. Progesterone-releasing intravaginal device (PRID) devoid of estrogen capsule were inserted either on d 2 (PGF-P4-d2 and S-P4-d2 groups) or d 7 (PGF-P4-d7 and S-P4-d7 groups) post-insemination and left in place for 5 days. Control cows did not receive any treatment. Blood samples were collected for progesterone analysis from all cows once daily for 4 days starting on the day of estrus (d 0) and once every 3 days thereafter until d 22. Progesterone treatment by day interaction accounted for higher plasma P4 in treated than non-treated control cows. Progesterone concentrations differed significantly (p<0.05) during metestrus (d 2 to d 7) but not during diestrus (d 7 to d 12). $PGF_{2{\alpha}}$ treatment, lactation number, service number or their interactions did not affect progesterone concentrations and pregnancy rates. Therefore, cows were grouped according to the day of P4 supplement irrespective of the $PGF_{2{\alpha}}$ treatment. Progesterone supplement on d 7 but not d 2 significantly increased (p<0.03) pregnancy rates in repeat breeding cows with four or more previous services but not in cows in their third service. In conclusion, post-insemination P4 supplement to repeat breeding cows with four or more previous services improved pregnancy rates and should be advocated when no specific reason for infertility is diagnosed. Further studies with larger numbers of repeat breeding cows under field conditions are needed to ascertain the findings of this study.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.247-252
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• 2016

Objective: Heparin can modulate proteins, and influence processes involved in implantation and trophoblastic development. This study aimed to assess the improvement of clinical pregnancy and implantation rates after local intrauterine injection of low-molecular-weight heparin (LMWH) in patients undergoing intracytoplasmic sperm injection (ICSI). Methods: A randomised case/control design was followed in women scheduled for ICSI. The study arm was injected with intrauterine LMWH during mock embryo transfer immediately following the ovum pickup procedure, while the control arm was given an intrauterine injection with a similar volume of tissue culture media. Side effects, the clinical pregnancy rate, and the implantation rate were recorded. Results: The pregnancy rate was acceptable (33.9%) in the LMWH arm with no significant reported side effects, confirming the safety of the intervention. No statistically significant differences were found in the clinical pregnancy and implantation rates between both groups (p= 0.182 and p= 0.096, respectively). The odds ratio of being pregnant after intrauterine injection with LMWH compared to the control group was 0.572 (95% confidence interval [CI], 0.27-1.22), while the risk ratio was 0.717 (95% CI, 0.46-1.13; p= 0.146). No statistical significance was found between the two groups in other factors affecting implantation, such as day of transfer (p= 0.726), number of embryos transferred (p= 0.362), or embryo quality. Conclusion: Intrauterine injection of LMWH is a safe intervention, but the dose used in this study failed to improve the outcome of ICSI. Based on its safety, further research involving modification of the dosage and/or the timing of administration could result in improved ICSI success rates.

• 한국수정란이식학회지
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• 제29권3호
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• pp.257-264
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• 2014

Recently, several approaches have been used to measure the oxygen consumption rates of individual embryos, but relationship between oxygen consumption and pregnancy rates of Hanwoo following embryo transfer has not yet been reported. In this study, we investigated the correlation between oxygen consumption rate and pregnancy rates of Hanwoo embryo using a SECM. In addition to, the expression of apoptosis-related genes was determined using real-time PCR by extracting RNA according to the oxygen consumption of in vivo embryo. First, we found that the oxygen consumption significantly increased in blastocyst-stage embryos (blastocyst) compared to early blastocyst stage embryos, indicating that oxygen consumption reflects the embryo quality (Grade I). The oxygen consumption or GI blastocysts were significantly higher than those of GII blastocysts ($10.2{\times}10^{14}/mol\;s^{-1}$ versus $6.4{\times}10^{14}/mol\;s^{-1}$, p<0.05). Pregnant rate in recipient cow was 0, 60 and 80% in the transplantation of embryo with the oxygen consumption of below 10.0, 10.0~12.0 and over $12.0{\times}10^{14}/mol\;s^{-1}$, respectively. Apoptosis regulatory genes, Hsp-70.1 were significantly increased in over-10.0 group than below 10.0 group but in Caspase-3, Bax and P53 gene, there was no significant difference. In conclusion, These results suggest that measurement of oxygen consumption maybe help increase the pregnant rate of Hanwoo embryos.

• Clinical and Experimental Reproductive Medicine
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• 제36권4호
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• pp.301-310
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• 2009

목 적: 폐쇄성과 비폐쇄성 무정자증 환자에서 신선고환조직 정자와 융해고환조직 정자를 이용한 배발달과 임신결과를 비교 분석하였다. 연구방법: 폐쇄성과 비폐쇄성 무정자증 환자에서 총 222 주기의 TESE-ICSI를 시행하였다. 정자는 신선 또는 융해 고환조직으로부터 회수하였다. 수정은 ICSI 후 16~18시간째 확인하였으며, 배발달률과 임신율을 분석하였다. 결 과: 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 수정률은 유의하게 차이가 났으나 (75.2% 대 56.7%, p<0.05), 배발달률에서는 차이가 나지 않았다 (96.9% 대 98.0%). 마찬가지로 임상적 임신율 (33.9% 대 36.0%)과 분만율 (28.1% 대 28.0%)에서도 차이가 나지 않았다. 신선고환조직 정자의 경우, 수정률은 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 유의하게 차이가 났으나 (76.4% 대 52.9%, p<0.05), 배발달률, 임상적 임신율, 분만율에서는 차이가 나지 않았다. 융해고환조직 정자의 경우에서도 수정률은 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 유의하게 차이가 났으나 (74.7% 대 65.6%, p<0.05), 배발달률, 임상적 임신율, 분만율에서는 차이가 나지 않았다. 결 론: 폐쇄성과 비폐쇄성 무정자증 환자에서 신선고환조직 정자와 융해고환조직 정자를 이용하였을 경우 수정률에서는 차이가 있으나, 배발달과 임상적 임신 결과에는 차이를 보이지 않았다. 그러므로, 폐쇄성 또는 비폐쇄성 여부와는 관계없이 무정자증 환자에서 신선고환조직 정자 그리고 융해고환조직 정자를 이용하여 ICSI를 시행하면 적절한 임신 성적을 거둘 수 있다.

• Clinical and Experimental Reproductive Medicine
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• 제35권3호
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• pp.213-221
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• 2008

목 적: 난소기능이 저하된 저반응군 불임 여성에서 한 개의 배아를 이식할 때 임신율에 영향을 주는 요인에 대해 알아보고자 한다. 연구방법: 본원에서 1996년 6월부터 2006년 4월까지 시험관 시술을 받은 환자 중, basal FSH가 12 mIU/mL 이상, 획득된 난자가 4개 이하, hCG 투여일에 혈청 $E_2$가 500 pg/ml 미만인 저반응군 총 919주기에서 한 개의 배아만을 이식한 235주기를 대상으로 하였다. 여성의 연령, hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법, 이식 횟수에 따른 임신율과 생존아 출생률을 비교하였으며, 통계학적인 방법은 Chi-square를 이용하여 p-value 0.05 이하인 경우를 유의하게 평가하였다. 결 과: 총 919주기 중 난자채취 취소율은 25.6% (235주기), 난자채취 실패율은 18.5% (170주기), 배아 이식 취소율은 14.0% (129주기)였다. 한 개의 배아를 이식한 군의 전체 임신율은 8.1% (19주기), 생존아 출생률은 4.7% (11주기)였고, 35세 미만의 여성에서 35세 이상의 여성보다 임신율과 생존아 출생률이 통계적으로 유의하게 높았다 (20% vs. 3.5% p<0.0001, 12.3% vs. 1.8%, p=0.002). hCG 투여일에 혈청 $E_2$, basal FSH, 3일째 배아 이식 시 할구수, 과배란 유도 방법에 따른 임신율과 생존아 출생률은 차이가 없었다. 이식 횟수에 따른 누적 임신율은 1회에 8.1%, 2회에 9.2%, 3회에 9.7%, 4회에 9.0%, 5회에 9.5%였다. 결 론: 저반응군의 체외수정에서 한 개의 배아를 이식할 때, 불임 여성의 연령이 35세 미만에서 임신율과 생존아출생률이 유의하게 증가함을 확인하였고, 이식 횟수에 따른 누적 임신율은 차이가 없었다. 이는 체외수정을 시도하려고 하는 난소기능 저하의 불임 여성에서 구체적인 상담 자료로 사용할 수 있겠다.