• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.174-183
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• 2021

Objective: The aim of this study was to compare the pregnancy outcomes of in vitro fertilization with embryo transfer between embryos cultured in a time-lapse monitoring system (TLS) and those cultured in a conventional incubator (CI). Methods: The medical records of 250 fertilized embryos from 141 patients undergoing infertility treatment with assisted reproductive technology at a tertiary hospital from June 2018 to May 2020 were reviewed. The study population was divided into TLS and CI groups at a 1 to 1 ratio (125 embryos per group). The primary outcome was the live birth rate. Results: The TLS group had a significantly higher clinical pregnancy rate (46.4% vs. 27.2%, p=0.002), implantation rate (27.1% vs. 12.0%, p=0.004), and live birth rate (32.0% vs. 18.4%, p=0.013) than the CI group. Furthermore, subgroup analyses of the clinical pregnancy rate and live birth rate in the different age groups favored the TLS group. However, this difference only reached statistical significance in the live birth rate in women aged over 40 years and the clinical pregnancy rate in women aged 35-40 years (p=0.048 and p=0.031, respectively). The miscarriage rate, cleavage rate, and blastocyst rate were comparable. Conclusion: TLS application improved the live birth rate, implantation rate, and clinical pregnancy rate, particularly in the advanced age group in this study, while the other reproductive outcomes were comparable. Large randomized controlled trials are needed to further explore the ramifications of these findings, especially in different age groups.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.2
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• pp.111-117
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• 2017

Objective: The aim of this study was to evaluate pregnancy outcomes and the live birth rate at 1-year age increments in women aged ${\geq}40years$ undergoing fresh non-donor in vitro fertilization (IVF) and embryo transfer (ET), and to identify predictors of success in these patients. Methods: This retrospective study was performed among women ${\geq}40years$ of age between 2004 and 2011. Of the 2,362 cycles that were conducted, ET was performed in 1,532 (73.1%). Results: The clinical pregnancy rate and live birth rate in women ${\geq}40years$ significantly decreased with each year of increased age (p<0.001). Maternal age (odds ratio [OR], 0.644; 95% confidence interval [CI], 0.540-0.769; p<0.001), basal follicle-stimulating hormone (FSH) levels (OR, 0.950; 95% CI, 0.903-0.999; p=0.047), the number of high-quality embryos (OR, 1.258; 95% CI, 1.005-1.575; p=0.045), and the number of transferred embryos (OR, 1.291; 95% CI, 1.064-1.566; p=0.009) were significant predictors of live birth. A statistically significant increase in live birth rates was seen when ${\geq}3$ embryos were transferred in patients 40 to 41 years of age, whereas poor pregnancy outcomes were seen in patients ${\geq}43years$ of age, regardless of the number of transferred embryos. Moreover, the cumulative live birth rate increased in patients 40 to 42 years of age with repeated IVF cycles, but the follicle-stimulating hormone in those ${\geq}43years$ of age rarely showed an increase. Conclusion: IVF-ET has acceptable outcomes in those < 43 years of age when a patient's own oocytes are used. Maternal age, basal FSH levels, and the number of high-quality embryos and transferred embryos are useful predictors of live birth.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.255-261
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• 2021

Objective: This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods: In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results: The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6% ±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner's age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion: Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.

• Animal Bioscience
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• v.35 no.9
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• pp.1360-1366
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• 2022

Objective: The present study analyzed the influence of co-transferring embryos with high and low cloning efficiencies produced via somatic cell nuclear transfer (SCNT) on pregnancy outcomes in dogs. Methods: Cloned dogs were produced by SCNT using donor cells derived from a Tibetan Mastiff (TM) and Toy Poodle (TP). The in vivo developmental capacity of cloned embryos was evaluated. The pregnancy and parturition rates were determined following single transfer of 284 fused oocytes into 21 surrogates and co-transfer of 47 fused oocytes into four surrogates. Results: When cloned embryos produced using a single type of donor cell were transferred into surrogates, the pregnancy and live birth rates were significantly higher following transfer of embryos produced using TP donor cells than following transfer of embryos produced using TM donor cells. Next, pregnancy and live birth rates were compared following single and co-transfer of these cloned embryos. The pregnancy and live birth rates were similar upon co-transfer of embryos and single transfer of embryos produced using TP donor cells but were significantly lower upon single transfer of embryos produced using TM donor cells. Furthermore, the parturition rate for TM dogs and the percentage of these dogs that remained alive until weaning was significantly higher upon co-transfer than upon single transfer of embryos. However, there was no difference between the two embryo transfer methods for TP dogs. The mean birth weight of cloned TM dogs was significantly higher upon single transfer than upon co-transfer of embryos. However, the body weight of TM dogs did not significantly differ between the two embryo transfer methods after day 5. Conclusion: For cloned embryos with a lower developmental competence, the parturition rate and percentage of dogs that remain alive until weaning are increased when they are co-transferred with cloned embryos with a greater developmental competence.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.3
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• pp.185-195
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• 2022

Objective: This study aimed to determine the effect of sperm DNA fragmentation (SDF) on the cumulative live birth rate (CLBR) in intracytoplasmic sperm injection (ICSI) cycles in couples with unexplained infertility. Methods: We conducted a prospective study of 145 couples who underwent ICSI cycles for unexplained infertility. Based on the SDF rate, patients were categorized into a low SDF group (SDF ≤30%, n=97) and a high SDF group (SDF >30%, n=48). SDF was assessed using the acridine orange test on density gradient centrifugation prepared samples. The CLBR was calculated as the first live birth event per woman per egg collection over 2 years. Results: The high SDF group (SDF >30%) showed a significantly lower CLBR (p<0.05) and a significantly higher miscarriage rate (p<0.05) than the low SDF group (SDF ≤30%). No significant difference was observed in the implantation and cumulative pregnancy rates between the two SDF groups. The total number of embryo transfers was stratified further into fresh and frozen embryo transfers. In the fresh embryo transfers, there were significant differences in the implantation rates, clinical pregnancy rates, and live birth rates (p<0.05) between the low SDF and high SDF groups. However, in the frozen embryo transfers, there were no significant differences in clinical outcomes between the two groups. In the multivariable logistic regression analysis, SDF was a predictor of CLBR (p<0.05) when adjusted for possible confounding factors. Conclusion: High SDF was associated with a lower CLBR and a higher miscarriage rate in the ICSI cycles of couples with unexplained infertility.

• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.106-113
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• 2022

Objectives: Herbal medicine is a worldwide health topic. Vitex agnus-castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods: Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups: control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15^th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results: We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion: VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.203-210
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• 2021

We performed a systematic review and meta-analysis to evaluate whether intralipid administration improved the outcomes of in vitro fertilization. Online databases (PubMed, Cochrane Library, Medline, and Embase) were searched until March 2020. Only randomized controlled trials (RCTs) that assessed the role of intralipid administration during in vitro fertilization were considered. We analyzed the rates of clinical pregnancy and live birth as primary outcomes. Secondary outcomes included the rates of chemical pregnancy, ongoing pregnancy, and missed abortion. We reviewed and assessed the eligibility of 180 studies. Five RCTs including 840 patients (3 RCTs: women with repeated implantation failure, 1 RCT: women with recurrent spontaneous abortion, 1 RCT: women who had experienced implantation failure more than once) met the selection criteria. When compared with the control group, intralipid administration significantly improved the clinical pregnancy rate (risk ratio [RR], 1.48; 95% confidence interval [CI], 1.23-1.79), ongoing pregnancy rate (RR, 1.82; 95% CI, 1.31-2.53), and live birth rate (RR, 1.85; 95% CI, 1.44-2.38). However, intralipid administration had no beneficial effect on the miscarriage rate (RR, 0.75; 95% CI, 0.48-1.17). A funnel plot analysis revealed no publication bias. Our findings suggest that intralipid administration may benefit women undergoing in vitro fertilization, especially those who have experienced repeated implantation failure or recurrent spontaneous abortion. However, larger, well-designed studies are needed to confirm these findings.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.3
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• pp.173-183
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• 2010

Purpose: To estimate the effect of oriental treatment on recurrent pregnancy loss, a retrospective analysis was done. Methods: Sixty-eight pregnant women at the $\bigcirc\bigcirc$ oriental clinic, Korea, from January 2005 to May 2009 diagnosed as recurrent pregnancy loss were included in this study. The sixty-eight patients received oriental treatment such as acupuncture, moxibution, herbal acupuncture and herbal prescriptions, divided into two groups: Group A- live birth(N=58) and Group B- abortion(N=10). The maternal age, parity, menstrual history, gynecological history and period of treatment were compared. To find out factors affecting the success of birth, we performed binary logistic regression analysis(SPSS ver. 14.0 for windows). Results: The live birth rate was 85.3%. The maternal age, parity, menstrual history, gynecological history and period of treatment were not different between two groups. Logistic regression analysis showed that the significant factors predicting the occurrence of miscarriage were advanced maternal age(${\geq}35$)(P=0.005, Odds Ratio[OR]=3.809, 95% Confidence Interval[95%CI]: 1.514-9.585) and suffering from gynecological problems(P=0.044, OR=4.048, 95%CI: 1.037-15.801). Conclusions: The results suggest that oriental treatment has effectiveness on recurrent pregnancy loss. Further study will be needed.

• Asian-Australasian Journal of Animal Sciences
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• v.15 no.6
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• pp.828-833
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• 2002

Thirty mature pregnant ewes of the Phan Rang breed with an initial live weight of 30 to 45 kg were used to compare the effects of three different diets in late pregnancy on ewe and lamb performance. All diets contained 20% of whole sugar cane, 16% rice bran, 26% cassava root and 6% molasses urea block. The remaining 32% of dry matter consisted of Jackfruit (JF diet), 16% each of Jackfruit and Cassava foliage (JF+CS diet) or Jackfruit and Flemingia foliage (JF+FM diet). The diets were fed at 3.5% of actual BW of the individual animal. The foliages were offered at 120% of the amount decided in the diets of the requirements. The JF+CS diet resulted in significantly higher feed intake than the JF diet, and also a higher feed intake than the JF+FM diet, but this difference was not significant. The ewe weight changes during the last 8 weeks of pregnancy, or from start to 24 h after lambing, were significantly different. The highest weight gain was obtained from the ewes fed the JF+CS diet. Diets had no effect on weight changes of ewes during 3 weeks after lambing but a significant effect on the litter birth weight, with the JF+CS diet giving the highest litter birth weight. There was, however, no effect on the litter weight at 21 days or litter growth rate from birth to 21 days due to the experimental diets.

• Clinical and Experimental Reproductive Medicine
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• v.47 no.2
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• pp.135-139
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• 2020

Objective: In the present study, we aimed to retrospectively evaluate the cumulative live birth rate (LBR) after up to three consecutive embryo transfer (ET) cycles, either fresh or frozen, in women with expected poor ovarian response (ePOR). Methods: We selected 115 women who entered the first in vitro fertilization (IVF) cycle between August 2013 and July 2016. The women were divided into an ePOR group (37 women) and a non-ePOR group (78 women). All women in the ePOR group were ≥ 40 years old or had serum anti-Müllerian hormone levels of less than 1.1 ng/mL at the time of the first IVF cycle. Live birth outcomes were monitored until December 2017. The cumulative LBR (with both conservative and optimistic estimates) was calculated according to the serial number of ET cycles. Results: After up to three ET cycles, the overall cumulative LBR was significantly lower in the ePOR group than in the non-ePOR group (conservative estimate, 10.8% vs. 44.9%, respectively; optimistic estimate, 14.7% vs. 56.1%, respectively; log-rank test, p= 0.003). Conclusion: Women with ePOR exhibited a lower cumulative LBR than women in the non-ePOR group, and this information should be provided to ePOR women during counseling before starting IVF.