• Title/Summary/Keyword: In vitro fertility

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A Case Report of Unexplained Secondary Infertility (원인불명으로 진단받은 속발성 불임환자 1례의 임상보고)

  • Jeong, A-Rong;Kim, Kyeong-Hye;Kim, Hyun-Jin;Jung, Eun-A
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.4
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    • pp.234-243
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    • 2007
  • Purpose: The purpose of this paper is to report the effect of oriental medicine to unexplained secondary infertility. Methods: The patient was 40 years-old female whose case was diagnosed as unexplained secondary infertility. On purpose to pregnant, she had being treated with IVF(in vitro fertilization) and oriental medicine at once. But she had failed IVF in twice, who was treated with oriental medicine only constantly. Results: On course of failing IVF again, the patient was treated with Oriental medicine constantly. After she had stopped IVF who was treated only oriental medicine. And she became pregnant. Conclusion: According to this result, we concluded that oriental medicine could improve fertility rate. After this paper, futher study and clinical approach based on oriental medicine will be needed about unexplained infertility.

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The Optimal Time for Embryo Transfer in Fresh IVF: Comparison between Day 3 and Day 5 on Pregnancy Outcomes (체외수정술 후 난할단계 배아와 포배기단계 배아를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Kim, A-Ri;Seok, Hyun-Ha;Kim, You-Shin;Lee, Woo-Sik;Yoon, Tae-Ki;Won, Hyung-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.143-151
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    • 2010
  • Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

Clinical Outcome of Elective Single Embryo Transfer Compared to Elective Double Embryo Transfer Performed at the Cleavage Stage (2개 대비 1개의 난할기 선발배아 이식에 따른 임상 결과)

  • Kang, Sang-Min;Lee, Sang-Won;Jeong, Hak-Jun;Chae, Soo-Jin;Yoon, San-Hyun;Lim, Jin-Ho;Lee, Seong-Goo
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.349-359
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    • 2010
  • Objective: This study was performed to compare the clinical outcome of elective single embryo transfer (eSET) performed at the cleavage stage to that of elective double embryo transfer (eDET). Methods: Of the women less than 36 years old who visited Daegu Maria from January 2008 to April 2009, the only women (n=330) with more than 8 mm of endometrial thickness and at least one good quality embryo, who were treated with GnRH agonist long protocol, were included in this study. After information about complications that can arise by multiple embryo transfer, either eSET or eDET was conducted by their request (167 and 163, respectively).Results: The implantation rate of eSET group was significantly higher than that of eDET group (53.9% vs. 40.2%, p<0.01). The twin pregnancy rate of eSET group was significantly lower than that of eDET group (1.1% vs. 32.3%, p<0.001). However, there were no significant differences between two groups in the clinical pregnancy (53.3% vs. 60.7%, p=0.172), ongoing pregnancy (47.3% vs. 54.6%, p=0.185) and live birth rates (44.9% vs. 50.9%, p=0.275). The number of the surplus embryos which developed to the blastocyst stage and cryopreserved at that stage was significantly higher in eSET group than that of eDET group ($3.2{\pm}2.6$ vs. $2.1{\pm}2.4$, p<0.001). Conclusion: These results suggest that eSET should reduce significantly the multiple baby pregnancy without decreasing the whole pregnancy rate in women with less than 36 years old.

Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes

  • Choi, Hwa Young;Kim, Seul Ki;Kim, Seok Hyun;Choi, Young Min;Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.224-231
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    • 2017
  • Objective: We studied the association between sperm DNA fragmentation (SDF) and several clinical in vitro fertilization outcomes. Methods: We retrospectively analyzed 169 consecutive fresh IVF cycles. Semen was collected on the day of oocyte retrieval, and we assessed standard semen parameters and the SDF level (by terminal deoxynucleotidyl transferase dUTP nick-end labeling). Poor ovarian response (POR) was defined as the collection of three or fewer mature oocytes. Oocytes were inseminated by the conventional method or intracytoplasmic sperm injection. Results: SDF did not affect the fertilization or pregnancy rate, but did have a significant effect on the miscarriage rate. In the miscarriage group (n = 10), the SDF level was significantly higher (23.9% vs. 14.1%) and number of mature oocytes was significantly lower (4.3 vs. 7.6) than in the live birth group (n = 45). Multiple regression analysis showed that SDF was an independent predictor of miscarriage (odds ratio, 1.051; 95% confidence interval, 1.001-1.104). The cutoffs for the SDF level and number of mature oocytes that could predict miscarriage were > 13% and ${\leq}3$, respectively. In the low-SDF group (${\leq}13%$), the miscarriage rate was similar in POR patients and those with a normal ovarian response (NOR; 14.2% vs. 4.3%). In the high-SDF group ( > 13%), the miscarriage rate was significantly higher in the POR group than in the NOR group (60.0% vs. 13.3%, p= 0.045). Conclusion: Our study demonstrated that a high SDF level ( > 13%) was associated with a high miscarriage rate, and that it mainly contributed to miscarriage in the POR group. The results suggest that SDF measurements should be considered in couples with POR in order to predict the prognosis of the pregnancy.

Effects of sperm insemination on the final meiotic maturation of mouse oocytes arrested at metaphase I after in vitro maturation

  • Yoon, Jeong;Juhn, Kyoung-Mi;Yoon, San-Hyun;Ko, Yong;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.15-21
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    • 2017
  • Objective: The aims of this study were to investigate whether fertilization could induce the resumption of meiosis in mouse oocytes arrested at metaphase I (MI) after in vitro maturation (IVM), and to investigate the effect of $Ca^{2+}$ chelator treatment at the time of fertilization on the transition from MI to metaphase II (MII). Methods: MII-stage and arrested MI-stage mouse oocytes after IVM were fertilized, and then embryonic development was monitored. Blastocysts from each group were transferred into 2.5 days post-coitum pseudo-pregnant ICR mice. MI oocytes after IVM were treated with a $Ca^{2+}$ chelator to investigate the effect of $Ca^{2+}$ oscillations on their maturation. Results: As insemination time increased, the number of oocytes in the MI group that reached the MII stage also increased. The blastocyst rates and total cell numbers in the MII group were significantly higher than in the MI group. No pregnancy occurred in the MI group, but 10 pregnancies were achieved (10 of 12) in the MII group. The proportion of MI oocytes that matured to MII oocytes after fertilization was significantly higher in the non-treated group than in the $Ca^{2+}$ chelator-treated group. Conclusion: The findings that a higher proportion of MI-arrested oocytes progressed to MII after fertilization and that the MI-to-MII transition was blocked by $Ca^{2+}$ chelator treatments before fertilization indicate that the maturation of MI oocytes to MII oocytes is associated with intracellular $Ca^{2+}$ oscillations driven by fertilization.

Combined Tubal and Interstitial Pregnancies after IVF-ET: a Case Report (체외수정 및 배아 이식 후 난관과 반대편 간질 부위에 동시에 생긴 복합성 자궁외 임신 1예)

  • Oh, Yoe-Un;Kim, Mi-Kyoung;Lee, Seo-Yeong;Kim, You-Shin
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.2
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    • pp.129-136
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    • 2009
  • The incidence of ectopic pregnancy is increased since in vitro fertilization-embryo transfer (IVF-ET) has started. And because of the possibility of combined pregnancy after IVF-ET, bilateral adnexal area and other portion of pelvis should be examined carefully by transvaginal ultrasonography during follow-up period. The rate of combined pregnancy after IVF is estimated to be as high as 0.2~1%. Since the incidence of combined pregnancies is markedly higher with IVF, special attention to this possibility after ET is warranted. According to a recent report, the occurrence of interstitial pregnancy is estimated to be 1:3600 for all pregnancies achieved with IVF. The prevalence of interstitial pregnancies is 2~4% of ectopic pregnancies. Interstitial pregnancies tend to be diagnosed later than most other ectopic pregnancies, and if uterine rupture occurs, the resulting hemorrhage can be severe. Currently, about 2% to 3% of interstitial pregnancies are thought to carry a maternal death, which is twice that of other tubal gestations. We report a case of simultaneous left tubal and right interstitial pregnancies after IVF-ET with a brief review of literature.

High efficiency of homemade culture medium supplemented with GDF9-β in human oocytes for rescue in vitro maturation

  • Mohsenzadeh, Mehdi;Khalili, Mohammad Ali;Anbari, Fatemeh;Vatanparast, Mahboubeh
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.2
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    • pp.149-158
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    • 2022
  • Objective: Optimizing culture media for the incubation of immature oocytes is a vital strategy to increase the oocyte maturation rate during in vitro maturation (IVM) programs. This study evaluated the IVM and fertilization rates of human germinal vesicle (GV) and metaphase I (MI) oocytes using two different maturation media (commercial and homemade) with or without growth differentiation factor 9-β (GDF9-β). supplementation. Methods: Immature oocytes from intracytoplasmic sperm injection (ICSI) cycles were collected and assigned to one of two IVM culture media (commercial or homemade; cleavage-stage base). After maturation, MII oocytes were examined under an inverted microscope for the presence of the polar body, zona pellucida (ZP) birefringence, and meiotic spindle (MS) visualization after maturation in four conditions (commercial or homemade medium, with or without GDF9-β. ICSI was done for matured oocytes, and fertilization was confirmed by the visualization of two distinct pronuclei and two polar bodies. Results: No significant differences were found between the two culture media in terms of the time and rate of oocyte maturation or the rate of fertilization (p>0.05). Growth factor supplementation increased the 24-hour maturation rate for both GV and MI oocytes only in homemade medium. The maturation rate after 24 hours was higher for MI oocytes (p<0.05). Similar results were observed for MS visualization and ZP structure in both types of media (p>0.05). Conclusion: Higher rates of oocyte maturation and fertilization were observed after application of homemade medium supplemented with GDF9-β. Therefore, this combination may be recommended as an alternative for clinical IVM programs.

Factors influencing serum progesterone level on triggering day in stimulated in vitro fertilization cycles

  • Park, Ju Hee;Jee, Byung Chul;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.2
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    • pp.67-71
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    • 2015
  • Objective: Elevated serum progesterone (P) levels on triggering day have been known to affect the pregnancy rate of in vitro fertilization (IVF). This study aimed to identify the possible factors influencing serum P levels on triggering day in stimulated IVF cycles. Methods: Three hundred and thirty consecutive fresh IVF cycles were included in the study. All cycles were first attempts and were performed in a single infertility center. The indications for IVF were male factor infertility (n=114), ovulatory infertility (n=84), endometriosis (n=61), tubal infertility (n=59), unexplained infertility (n=41), and uterine factor infertility (n=39). A luteal long protocol of a gonadotropin-releasing hormone (GnRH) agonist (n=184) or a GnRH antagonist protocol (n=146) was used for pituitary suppression. Ovarian sensitivity was defined as the serum estradiol level on triggering day per 500 IU of administered gonadotropins (OS[a]) or the retrieved oocyte number per 500 IU of administered gonadotropins (OS[b]). Results: Univariate analysis revealed that the serum P level on triggering day was associated with the serum estradiol level on triggering day (r=0.379, p<0.001), the number of follicles ${\geq}14mm$ (r=0.247, p<0.001), the number of retrieved oocytes (r=0.384, p<0.001), and ovarian sensitivity (OS[a]: r=0.245, p<0.001; OS[b]: r=0.170, p=0.002). The woman's age, body mass index, antral follicle count, and basal serum follicle stimulating hormone and estradiol levels were not associated with serum P level on triggering day. The serum P level on triggering day did not show significant variation depending on the type or cause of infertility, pituitary suppression protocol, or the type of gonadotropins used. Conclusion: The serum P level on triggering day was closely related to the response to ovarian stimulation.

In vitro Selection of Acifluorfen-tolerant Solanum ptycanthum and Phenotypic Variation in Regenerated Plants

  • Yu, Chang-Yeon;Lim, Jeong-Dae;Kim, Myong-Jo;Kang, Won-Hee;Hyun, Tae-Kyoung
    • Korean Journal of Medicinal Crop Science
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    • v.10 no.4
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    • pp.263-268
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    • 2002
  • Acifluorfen-tolerant callus lines of Solanum ptycanthum were isolated by stepwise selection. Growth of the unselected line was completely inhibited at 0.5 uM. while some selected lines grew at 8 uM acifluorfen. Twenty-two of twenty-five acifluorfen-tolerant callus lines regenerated shoots. Many of the regenerated somaclones were variants, differing in leaf shape, leaf color, number of flower parts, flower color, and fertility. The acifluorfen tolerant S. ptycanthum callus lines differed.

Percentage Motility before and after Processing by a Sperm Washing and Swim-up Method : Relationship to Outcome of Intrauterine Insemination (정자 세정후 Swim-up 처치가 정자의 운동성에 미치는 영향)

  • Lee, Yu-Il
    • Clinical and Experimental Reproductive Medicine
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    • v.18 no.1
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    • pp.89-94
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    • 1991
  • Thirty five couples were treated by intrauterine insemination with sperm prepared by a washing and swim-up method. Fifteen women conceived(42.9%). Sperm washing and swim-up was found to significantly improve sperm motility for men of infertile couples and the increment of percent sperm motility after sperm preparation allowed significant differentiation of pregnant and nonpregnant patients in asthenozoospermia(submotile) group (p<0.01). The author suggest that the increment of percent sperm motility after sperm washing and swim-up could be a useful screening tool for in vitro procedure proposed to improve fertility in the intrauterine insemination of asthenozoospermia.

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