• Clinical and Experimental Reproductive Medicine
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• 제16권2호
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• pp.153-160
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• 1989

The effect of antisperm antibodies (ASA) on the human in vitro fertilization (lVF) process was evaluated by analyzing the IVF data between October and December 1988 at Seoul National University Hospital prospectively. The immunobead test (IBT) was used to identify Ig G, Ig A, and Ig M in the serum, semen, and follicular fluid from 93 couples undergoing in vitro fertilization-embryo transfer (lVF-ET ) . The fertilization rate in couples with ASA to sperm head of at least one isotype in female serum (n= 10) was significantly less than that in couples without ASA to sperm head (n=83; 28.5% versus 45.3% , p=0.028). The presence of ASA to sperm head in follicular fluid (n=8) also reduced fertilization rate from 45.3% to 24.4% (p=O.0l3). However, ASA binding to sperm head in male serum and semen did not predict fertilization. Similarly, ASA binding to sperm tail and tail-tip did not reduced the oocyte fertilization rate significantly in any of the fluids tested. The zygote cleavage rate was not reduced in the presence of ASA. These results suggest that the presence of ASA to sperm head in female serum and follicular fluid is associated with reduced fertilization in IVF-ET. Another observation is that the oocyte that do fertilize in the presence of antisperm antibodies can subsequently proceed with normal cleavage. The results of this investigation therefore suggest that the IBT is a useful test forscreening of women participat.ing IVF-ET program.

• Clinical and Experimental Reproductive Medicine
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• 제38권1호
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• pp.10-17
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• 2011

Objective: To explore potential relationships between sperm DNA integrity and both semen parameters and clinical outcomes. Methods: Semen analysis of 498 samples was performed according to the 2010 criteria of the World Health Organization. The sperm DNA fragmentation Index (DFI) of the semen samples was assessed using a neutral comet assay. Results: Sperm DFI showed a significant correlation with semen parameters, including the patient's age, sperm viability, motility, morphology, and number of leukocytes (p<0.05). The sperm DFI values for asthenozoospermic (15.2%), oligoteratozoospermic (18.3%), asthenoteratozoospermic (17.5%), and oligoasthenoteratozoospermic semen samples (21.3%) were significantly higher than that observed in normozoospermic semen samples (10.5%, p<0.05). A sperm DFI value of 14% was used as a threshold of sperm DFI in assessing whether DNA was highly damaged. In 114 IVF-ET cycles, the fertilization rate of the sperm DFI <14% group (70 cycles, 61.7%) was significantly higher than that observed for the ${\geq}14%$ group (44 cycles, 55.3%), but there was no difference in the other clinical outcomes between the two groups. In the ${\geq}14%$ group, the pregnancy rates of the ICSI cycles (40.0%) and half-ICSI (44.0%) were higher than conventional IVF cycles (30.7%), but the difference was not statistically significant. Conclusion: Along with the conventional semen analysis, the sperm DFI assessed using the comet assay was shown to improve the quality of the semen evaluation. To evaluate the precise effect of ICSI on pregnancy rates in the patients who demonstrate high sperm DFI values, further study is necessary.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.51-59
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• 1996

체외수정 시술을 위해 중앙대학교부속병원 산부인과학 교실 불임크리닉을 방문한 환자중 1993년 3월부터 1994년 8월까지 난관폐쇄로 인하여 불임이 된 환자 113명(119주기)을 대상으로 GnRH-a 병합요법 중 Short protocol 방법으로 과배란시 임신된 45명(47주기)과 임신이 되지 않은 68명(72주기)에서 hCG 투여 당일 혈청내 E2 및 P4 수치를 측정하여 임신의 결과를 비교하였다. 1. 환자의 평균 연령 및 불임기간은 임신군에서 $33.2{\pm}14.8$세 및 $4.2{\pm}3.4$년이었으며 비 임신군에서는 $34.5{\pm}21.7$세 및 $3.9{\pm}2.8$년으로 연령 및 불임기간의 차이는 없었다. 2. hGC 투여 당일 측정한 혈중 E2치는 임신군에서는 $1643{\pm}987.9$ pg/ml, 비임신군에서는 $1367{\pm}875.8$ pg/ml로 임신군에서 유의하게 높았다(P<0.01). 또한 혈중 LH치는 인신군 에서는 $16.7{\pm}10.4$ ng/ml, 비임신군에서는 $18.3{\pm}8.3$ ng/ml로 임신군에서 유의하게 낮았다 (P<0.01). 혈중 P4치는 임신군에서는 $1.0{\pm}0.7$ ng/ml이었고 비임신군에 서는 $2.1{\pm}1.4$ ng/ml로서 임신군에서 유의하게 낮았다(P<0.001). 3. hCG 투여당일 E2/P4 비는 임신군에서 $1865.6{\pm}318.1$, 비임신군에서는 $1324{\pm}377.7$ 로서 유의한 차이가 있었다(P<0.01)(Table 3). 4. 주기당 수정율은 임신군에서 $61.3{\pm}21.3%$, 비임신군에서는 $41.1{\pm}20.3%$로 임신군에서 의미있게 높았고(P<0.01) 이식된 배아의 수는 임신군 47주기에서 $4.2{\pm}2.2$개, 비임신군 72주기에서는 $2.3{\pm}1.2$개로 두 군간의 차이는 없었다(Table 4). 이상에서 임신이 된 군은 임신이 안된 군보다 혈중 progesterone 치가 의미있게 낮았고 혈중 estradiol 치는 의미있게 높았음을 알 수 있었다. 혈중 progesterone 및 estradiol치는 과배란 유도 후 체외수정시술에 있어서 수정율 및 임신율에 영향을 줄 수 있다고 생각되며 이는 체외수정시술시 과배란후 임신의 예후판정에 효용성이 있을것으로 사료된다.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 1995년도 추계 학술대회 및 정기총회
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• pp.50-51
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• 1995

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2002년도 제42차 춘계학술대회
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• pp.70-71
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• 2002

• Clinical and Experimental Reproductive Medicine
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• 제39권1호
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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.

• Clinical and Experimental Reproductive Medicine
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• 제40권1호
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• pp.23-28
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• 2013

Objective: The aim of the present study was to examine the relationship among male age, strict morphology, and sperm chromatin structure and condensation. Methods: Sperm samples from a total of 100 men underwent semen analysis, and sperm chromatin structure and condensation were assessed with toluidine blue (TB) and aniline blue (AB) tests. Results: Prevalence of strict morphology of less than 4%, and abnormal sperm chromatin structure and condensation did not show any statistically significant differences according to male age (p=0.605, p=0.235, and p=0.080). No significant correlation was demonstrated among age of male partners, strict morphology, and abnormal sperm chromatin structure using TB and AB tests. However, abnormal sperm chromatin condensation was positively associated with sperm chromatin structure (r=0.594, p=0.000) and showed negative correlation with strict morphology (r=-0.219, p=0.029). Conclusion: The tests for sperm chromatin condensation showed a significant association with strict morphology. Further study is needed to elucidate the relationship between clinical outcome and sperm chromatin tests.

• Clinical and Experimental Reproductive Medicine
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• 제20권2호
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• pp.101-105
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• 1993

This study was carried out to improve pregnancy rate in IVF-ET program through Assisted Hatching (AH) by the use of micromanipulation technique. Among 72 IVF patient, randomized 29 IVF patients were performed for AH by Partial Zona Dissection(PZD). Two to eight cell embryos were micromanipulated just before uterine transfer. The results were as follows: 1. The implantation rates of embryos between PZD group and control group were 10.0%, 4.9%, respectively. 2. The clincal pregnancy rates of both groups were 34.5%,20.9%, respectively. 3. Among 131 PZD embrys, only 2 embryos were damaged mechanically. Although there were no statistical difference in the rates of implantation and pregnancy between PZD group and control group due to small sample size, the PZD group had increasing trend in the rates of implantation and pregnancy. In conclusion, it would be thought that PZD could be adequately used to improve implantation rate and pregnancy rate in IVF-ET program as an assisted technique if much more studies were done. Also the risks resulting from this study can be reduced because of technical stability, which showed the low rate of damaged embryos.

• Clinical and Experimental Reproductive Medicine
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• 제38권4호
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• pp.210-215
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• 2011

Objective: This study was performed to identify whether growth and differentiation factor-9 (GDF-9) and transforming growth factor-${\beta}1$ (TGF-${\beta}1$) expressions would be lower in the follicular fluid (FF) of those over age 35 who underwent IVF than under age 35. Methods: A total of 24 IVF cycles (20 patients) were included in this study. All of patients were stimulated for IVF by the GnRH short protocol and divided into two groups for analysis, according to their age: <35 group (14 cycles, 11 patients) vs. ${\geq}35$ group (10 cycles, 9 patients). The expression levels of GDF-9 and TGF-${\beta}1$ were determined by western blotting and quantitative enzyme-linked immunosorbent assay. Results: The numbers of retrieved oocytes and metaphase II oocytes were significantly lower in the ${\geq}35$ group. Lower expression of GDF-9 and TGF-${\beta}1$ by western blotting in the ${\geq}35$ group were observed as well. The mean GDF-9 and TGF-${\beta}1$ levels by enzyme-linked immunosorbent assay were lower in the ${\geq}35$ group. The values were $6,850.5{\pm}928.4$ ng/L vs. $3,333.3{\pm}1,089.2$ ng/L of GDF-9 ($p$ <0.05) and $3,844.1{\pm}571.1$ ng/L vs. $2,187.7{\pm}754.0$ ng/L of TGF-${\beta}1$ ($p$ <0.05). A negative correlation between GDF-9 and age was observed (r=-0.546, $p$=0.006). Conclusion: GDF-9 and TGF-${\beta}1$ production from stimulated ovaries during IVF appears to decrease with age.

• Clinical and Experimental Reproductive Medicine
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• 제13권2호
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• pp.101-112
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• 1986

It is now common practice to attempt ovarian hyperstimulation in vitro fertilization and embryo transfer (IVF-ET) to promote the development of multiple preovulatory follicles and to maximize the number of mature egg available. There are several drugs for hyperstimulation such as clomiphene citrate only, clomiphene citrate and human menopausal gonadotropin (HMG) and HMG only. Accumlated experience has shown that the hyperstimulation of the ovary in IVF-ET results in high pregnancy rate. But the hyperstimulation of the ovary in IVF-ET may cause the hyperandrogenism, so we must consider the adverse effect on pregnancy rate of the hyperandrogenism. Little is known about the functional significance of androgen for the follicular growth, however, the hyperandrogenism might interfere with oocyte maturation. The aim of the present investigation was to determine the serum profiles of estradiol, androstenedione and testosterone during the hyperstimulated menstrual cycles in IVF. The results were summarized as follows: 1. There was a gradual increase in the mean levels of serum estradiol, androstenedione, and testosterone approaching follicular maturation. 2. The mean serum estradiol levels in the hyperstimulated groups were significantly higher than that in the control group in late follicular phase and ovum retrieval (ovulation) day (p<0.01). 3. The mean serum androstenedione levels in the clomiphene citrate groups were significantly higher than that in the control group in late follicular phase (p<0.01). There was no statistically significant different in the mean serum androstenedione levels between the control group and the HMG group (p>0.05). 4. There was no statistically significant difference in the mean levels of testosterone among each group (p>0.05). 5. There was no statistically significant different in the mean levels of estradiol, androstenedione and testosterone between the fertilized patients and non-fertilized patients in clomiphene citrate and HMG group (p>0.05).