• Clinical and Experimental Reproductive Medicine
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• v.43 no.4
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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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• v.25 no.2
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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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• v.44 no.2
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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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• v.29 no.3
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• pp.193-199
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• 2005

The cryopreservation of germ cells, sperm and embryos, has been largely used to increase the effect of artificial reproductive techniques for human infertility, but the efficiency of germ cell cryopreservation has been conkoversial till now. Thus, the effect of the cryopreservation of human sperm used for ICSI and the effect of the cryopreservation of embryos produced by ICSI on fertilizatiof development and pregnancy were investigated. Sperm freezing did not affect fertilizatiort development and pregnancy rates. Also, there was no significant difference between ejaculated and testicular sperm in ferclizatiort development and pregnancy. Embryo freezing methods, slow freezing and vitrificatior did not differ each other in viability and pregnncy rates. However, ICSI embryo freezing significantly decreased pregnancy rate compared to fresh embryos freezing (p<0.05). In conclusiof this result suggested that cryopreservation of sperm for ICSI did not affect on the resulted embryo development and pregnancy, but ICSI embryo cryopreservation would significantly inhibit pregnancy.

• The Journal of Korean Medicine
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• v.32 no.5
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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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• v.20 no.11
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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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• v.43 no.4
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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.

• Journal of Embryo Transfer
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• v.29 no.3
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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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• v.36 no.4
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• pp.301-310
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• 2009

Objective: To compare the embryonic development and pregnancy results using sperms retrieved from fresh and frozen-thawed testicular tissue in patients with obstructive (OA) and non-obstructive azoospermia (NOA). Methods: A total two hundred twenty-two cycles of TESE-ICSI were performed in OA and NOA. Sperms were retrieved from fresh and frozen-thawed testicular tissue. ICSI was performed patient's own sperm. Fertilization was assessed 16~18 hrs after ICSI. Embryo development and pregnancy rates were analysed. Results: The fertilization rates were significantly different between OA and NOA patients (75.2% vs. 56.7%, p<0.05), however, embryo development did not differ between the groups (96.9% vs. 98.0%). Likewise, OA and NOA groups had no differences in their clinical pregnancy and delivery rates, 33.9% vs. 36.0% and 28.1% vs. 28.0%, respectively. With regard to sperm retrieved from fresh testicular tissue, fertilization rates were significantly different between the OA and NOA groups (76.4% vs. 52.9%, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. For sperm retrieved from thawed testicular tissue, the fertilization rates were significantly different between the two groups (74.7% OA group vs. 65.6% NOA group, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. Conclusions: Embryo development and clinical pregnancy did not differ in patients with obstructive and non-obstructive azoospermia, whether sperm retrieved from fresh and thawed testicular tissue were used, although the fertilization rates were different. Therefore, ICSI with sperm retrieved from fresh and thawed testicular tissue could achieve relevant clinical pregnancy results in patients with azoospermia.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.3
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• pp.213-221
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• 2008

Objective: To evaluate predictor of IVF outcomes following single embryo transfer in patients with decreased ovarian reserve. Methods: A retrospective review was performed in 919 IVF cycles with elevated basal serum FSH (${\geq}12\;mIU/mL$), the number of retrieved oocytes ${\geq}4$ and serum $E_2$ concentration on hCG day <500 pg/ml between Jan. 1996 and Dec. 2006. Two hundred thirty five IVF cycles following single embryo transfer were included. Pregnancy rates and live birth rates was evaluated according to maternal age, serum $E_2$ on hCG day, basal FSH level, the number of blastomere on day 3 ET, stimulation protocol, the number of cycles of ET. Statistical analysis was used SPSS 12.0 program. Results: OPU cancellation rates were 25.6% (235 cycles), OPU failure rates were 18.5% (170 cycles), embryo transfer cancellation rates were 14.0% (129 cycles). Pregnancy rates following single embryo transfer was 8.1% (19 cycles) and live birth rates was 4.7% (11 cycles). Pregnancy rates and live birth rates of women under 35 years old was statistically higher than those of women above 35 years old (20% vs. 3.5% (p<0.0001), 12.3% vs. 1.8%, (p=0.002)). There was no difference in basal FSH, serum $E_2$ on hCG day, and the number of blastomere on ET, and stimulation protocol. Cumulative pregnancy rates according to the number of cycles of ET were $1^{st}$ 8.1%, $2^{nd}$ 9.2%, $3^{rd}$ 9.7%, $4^{th}$ 9.0%, and $5^{th}$ 9.5%. Conclusion: Pregnancy rates and live birth rates of IVF-ET cycles following single embryo transfer in patients with decreased ovarian reserve are statistically increased in women under 35 yrs old. There is no difference in cumulative pregnancy rates. These data may be helpful for counseling women with decreased ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.