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체외수정시술주기에서 배아와 난구세포의 공배양 효과에 관한 연구
허의종,이원기,Hur, Eui-Jong,Lee, Won-Ki 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.3
Despite the rapid development of assisted reproductive technologies (ART) in recent years, implantation rates after replacement of embryos into the uterine cavity remains low. Several techniques such as culture conditions based on formulations of human tubal fluid and various ART techniques as GIFT, ZIFT, TET have been adopted in recent years to improve embryo viability in vitro and implantation rates. Also, coculture of human IVF-derived embryos have been used in an effort to increase the number of viable embryos following IVF and to improve synchrony between the developing embryo and the uterine environment. The aim of this study was to evaluate whether the use of co culture with autologous cumulus cells has a significant beneficial effect on the development of embryos in vitro and its relation to the pregnancy rates in 120 patients with previous failed IVF-ET from September, 1995 to January 1998. We obtained the results from which significant improvement in the quality of viable embryos were observed using a coculture system with autologous cumulus cells, but pregnancy rates in this group of patients did not differ from the rate in the standard IVF group during the same period. Our study shows that a simplified short-term coculture system with autologous cumulus cells may help rescue moderate quality embryos to cleave regularly.
FSH/hCG호르몬투여법을 병용한 체외수정시술에 의한 중증남성불임치료에 관한 연구
허의종,이상훈 중앙대학교 의과대학 의과학연구소 1993 中央醫大誌 Vol.18 No.2
Male-factor infertility patients with severe impairment of sperm parameters often do not achieve fertilization in the in vitro fertilization(IVF) system. Different techniques of assisted fertilization such as micromanipulation have been proposed to overcome this problem, but the success rate is'still very low, and they have a high degree of complexity. Theoretically, treatment of male-factor infertility with the pure follicle-stimulating hormone(FSH) may provide adequate endocrine stimulation to the Sertoli cell to enhance its FSH-dependent functions and to support spermatogenesis, and with the human chorionic gonadotropin(hCG) may increase the concentration of intratesticular testosterone(T) and enhance promptly initiation of spermatogensis. The objective of this study is to determine the effect of the systemic pure FSH.hCG on endocrine and semen parameters and to assess the potential of this therapy to improve sperm fertilizing ability in IVF. From March 1991 to July 1992, Two groups of severe male-factor patients were evluated; patients with poor sperm parameters, indicating that fertilization would not occurred at all(group Ⅰ) and the cases with a history of total unfertilization in previous IVF attempts(group Ⅱ). The patients in both groups were administered FSH/hCG for at least 3 months. The wives of patients were performed in controlled ovarian hyperstimulation with human menopausal gonadotropins(hMG) including gonaotropin-releasing hormone agonist (GnRH-a) long protocol or modified ultrashor GnRH-a protocol. The results were as follows: 1. The rates of normal fertilization and of delayed fertilization in group Ⅰ were respectively 16.08%(32/199) and 5.03% (10/199). 2. The rate of total unfertilization cycles and of pregnancies in group Ⅰ were respectively 47.4% (9/19) and 15.8%(3/19). 3. In group Ⅱ, the rate of normal fertilization after hormonal treatment(17.4%, 27-161) was significantly higher than before hormonal treatment(8.8%, 15/170) (P<0.05). 4. In group Ⅱ, no pregnancy was in patients before hormonal treatment, but 3 pregnancies were achieved in patients after hormonal treatment.