일반 배양액과 Vero cell 공배양에서의 생쥐 배아 발달에 관한 비교 연구

이유성(You Sung Lee),이창호(Chang Ho Lee),고희정(Hee Jung Go),이기숙(Ky Suk Lee),류철희(Chul Hee Rheu),김종덕(Jong Duk Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.6

목적 : 인간 체외수정에 적용하는 공배양 기법에 사용할 세포로 vero cell을 택하여 vero cell monolayers 상에서 생쥐배아를 공배양한 것과 일반배양액인 IVF-20 배양액에서만 생쥐배아를 배양하여 두군의 배아양상에서 배아 발달을 비교하여 그 차이를 밝혀보고자 하였다. 방법 : 생쥐 암컷의 난포성장을 촉진시키기 위해 6~8주 된 흰 생쥐 암컷에 PMSG 5 IU를 복강주사 한 후 48시간 후에 hCG 5 IU를 다시 복강 주사하여 암수를 합사시켰으며, 교미가 일어난 암컷으로부터 난관을 무균적으로 절취하여 배아를 채취하였고, 난할이 일어난 정상적이고 건강한 2세포기 배아만을 각 실험에 사용하였다. 생쥐 2세포기 배아를 일반 배양액인 IVF-20에서만 배양하여 보고, 또한 vero cell과 공배양하여 각각의 발달 정도를 조사하였다. 결과 : 1. 배양 초기인 48시간까지는 일반배양액인 IVF-20에서만 배양한 것이 배아발달율이 높아 4세포기 (4 cell)까지는 IVF-20에서 67.0%, 상실배 (moula)까지는 55.7% (p<0.05)의 발달율을 보였으나, vero cell 공배양에서 는 4세포기까지 47.6%, 상실배까지는 42.9%의 발달율만을 보였다. 2. 배양중기인 72시간에는 IVF-20 배양액에서 배양하였을 때에는 배반포 (blastocyst)와 확장된 배반포 (expanded blastocyst)까지 51.6% (p<0.01)의 발달을 보였으며, vero cell과 공배양하였을 때에는 25.9%의 발달을 보였다. 3. 배양후기에 들어서면서 배양 96시간에는 확장된 배반포와 부화까지 IVF-20에서 배양하였을 때에는 37.7%의 발달을 보였고, vero cell과 공배양하였을 때에는 32.6%의 발달을 보여 두군 사이에 비슷한 발달율을 보였다. 4. 배양 120시간에는 확장된 배반포와 부화까지 IVF-20에서는 36.9%, vero cell과 공배양 했을때는 37.4%를 보여 비슷한 발달을 보였다. 결론 : 배양 초기에는 vero cell 공배양에서 보다 일반 배양액인 IVF-20에서 더 빠른 그리고 더 좋은 발달율을 보이며, 배양후기에 들어 확장된 배반포와 부화까지 발달하는 율은 IVF-20에서와 vero cell 공배양에서 비슷한 배아 발달율을 보임을 알 수 있었다. Objective : To evaluate mouse embryos development in conventional medium IVF-20 versus vero cell coculture. Methods : Female ICR mice aged 6 to 8 weeks, were stimulated with 5IU PMSG and 48 hours later were injected 5IU of hCG, then female and male mice were mated. At 48 hour post-hCG injection, oviducts were dissected out and 2-cell embryos were flushed. The 2-cell embryos were cultured in IVF-20 media or media containing vero cell (African green monkey kidney epithelial cell lines) for 120 hours. Coculture techniques have been applied in mouse 2-cell embryos culture used vero cell lines. Results : 1. After 48 hours culture, 60.7% and 55.7% of 2 cell embryos developed to 4 cell and morulae stage, respectively, in IVF-20 culture medium, but significantly less embryos developed to 4 cell (47.6%, p<0.05) and momlae (42.9%, p<0.05) in vero cell coculture. 2. After 72 hours culture, 51.6% of 2 cell embryos developed to blastocyst and expanded blastocyst in IVF-20 culture medium, but significantly less embryos developed to blastocyst and expanded blastocyst (25.9%, p<0.01) in vero cell coculture. 3. After 96 hours culture, 37.7% and 32.6% of 2 cell embryos similar developed to expanded blastocyst and hatching in IVF-20 culture medium and vero cell coculture, respectively. 4. After 120 hours culture, 36.9% and 37.4% of 2 cell embryos similar developed to expanded blastocyst and hatching in IVF-20 culture medium and vero cell coculture, respectively. Conclusion : There was no difference of embryo development rates between the two culture groups. IVF-20 medium alone gives a benefit to the viability of an embryo compared with a vero cell coculture.

체외수정으로 임신된 쌍태아에서 수정방법에 따른 임신 중기 triple test의 의의

김혜옥 ( Hey Ok Kim ),송인옥 ( In Ok Song ),차선화 ( Sun Wha Cha ),한정렬 ( Jung Yeol Han ),신중식 ( Joong Sik Shin ),강인수 ( Inn Soo Kang ),궁미경 ( Mi Kyoung Koong ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11

목적: 다운증후군의 선별검사인 임신 중기의 모체 혈청을 통한 트리플 검사에서 자연 임신된 쌍태아와 보조 생식술로 임신된 쌍태아에서 차이가 있는지 알아보고, 수정방법과 이식된 배아수에 따라 triple marker의 차이가 있는지 연구하였다. 연구 방법: 2001년부터 2004까지 제일병원 아이소망센타를 방문하여 시험관 아기로 쌍태아 임신된 246예 (conventional IVF=106, ICSI=142)와 같은 시기에 제일병원을 방문한 자연임신된 쌍태아 436예를 대상으로 하였다. 연구대상 쌍태아는 본원에서 분만이 확인되었고, 모두 정상이었다. 임신 중기 모체 혈청은 임신 14-18주에 얻었고, hCG, AFP, uE3의 혈청농도는 본원의 주 수에 따른 중앙값에 기준하여 중앙값의 배수 (MoM, multiples of the median)로 나타내었다. 결과: 엄마의 평균연령 (yrs)은 IVF 쌍태아는 31.6±2.8, ICSI 쌍태아는 31.6±3.0, 자연 임신된 쌍태아는 32.1±2.1였고, 임신 중기 혈청 검사 시기는 각각 16.0±0.5주, 16.0±0.7주, 16.1±0.2주로 차이가 없었다. 모체 혈청 total hCG 농도는 세 그룹간의 차이가 없었다 (2.04 vs. 2.06 vs. 2.02; p>0.05). 모체 혈청 AFP은 IVF 쌍태아와 ICSI 쌍태아에서 통계적으로 의미 있게 자연 임신된 쌍태아 보다 증가되었다 (2.40 vs. 2.22 vs. 1.98; p<0.05). 모체 혈청 uE3는 세 그룹간의 차이 없었다 (1.78 vs. 1.72 vs. 1.83; p>0.05). 그리고, 이식된 배아의 수에 따른 total hCG, AFP, uE3의 혈청농도는 차이가 없었다. 결론: IVF 쌍태아에서 다운 증후군의 선별검사를 위한 임신 중기 모체 혈청 내 트리플 marker는 자연 임신된 쌍태아와 차이가 없고, 수정 방법이나 이식된 배아의 수와 관련이 없다. Objective: To compare the midtrimester triple marker levels for down syndrome screening between natural and IVF twin pregnancies and to evaluate the difference triple marker in IVF twin pregnancies according to the fertilization method and number of transferred embryos. Methods: The study population consisted of conventional IVF twin (n=106), ICSI twin (n=142), and natural (n=436) twin pregnancies as controls between 2001 and 2004. All pregnancies in this study were known to have normal outcome. Maternal serum samples were collected between 14-18 gestational weeks. Levels of AFP, total hCG, and uE3 were measured and were expressed as multiples of the median (MoM) based on reference medians established at Cheil Hospital. Results: The mean maternal age (31.6±2.8 vs. 31.6±3.0 vs. 32.1±2.1: conventional IVF group vs. ICSI group vs. control, respectively) and gestational weeks (16.0±0.5 vs. 16.0±0.7 vs. 16.1±0.2) for triple test were similar. There was no difference in levels of all serum markers between conventional IVF and ICSI group. The median AFP MoM for conventional IVF and ICSI group were significantly higher than that of the control group (2.40 vs. 2.22 vs. 1.98; p<0.05). However, the median uE3 MoM for conventional IVF or ICSI group were not different from that of the control group (1.78 vs. 1.72 vs. 1.83; p>0.05). Also, the median hCG MoM was not different from that of the control group (2.04 vs. 2.06 vs. 2.02; p>0.05). There was no correlation in triple marker levels according to the number of transferred embryos in conventional IVF and ICSI groups. Conclusion: Midtrimester triple marker levels of IVF twin pregnancy for down syndrome screening are similar with those of natural twin pregnancy regardless of fertilization method and number of transferred embryos.

체외수정 과배란 유도에서 hCG 주사 당일의 혈청 Progesterone과 Estradiol 농도가 수정율 및 임신율에 미치는 영향에 관한 연구

이은숙,이상훈,배도환,Lee, Eun-Sook,Lee, Sang-Hoon,Bae, Do-Hwan 대한생식의학회 1996 Clinical and Experimental Reproductive Medicine Vol.23 No.1

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. Controlled Ovarian hyperstimulation(COH) is generally used to obtain synchronous high quality oocytes in in vitro fertilization-embryo transfer(IVF-ET). Many investigators have studied the relationship between serum hormone levels and outcomes of IVF-ET because there is no accurate estimation method of oocyte quality. Early premature luteinization of follicles before oocyte retrieval is the most troublesome problem in COH for IVF-ET. Gonadotropin-releasing hormone agonists(GnRH-a) are used as adjuncts with gonadotropins for COH in patients undergoing in IVF. The possible benefits of GnRH-a pretreatment include improving oocyte quality, allowing a more synchronous cohort of follicles to be recruited, and preventing premature lueinization hormone surges. In COH of IVF cycles, we investigated whether an elevated progesterone(P4) level on the day of human chorionic gonadotropin(hCG) administration indicates premature luteinization and is associated with a lower fertilization rate. Many investigators have studied that the lower fertilization rates seen in patients with elevated P4 levels might result from an adverse effect of P4 on the oocytes. We hypothesizes that serum P4 levels around the day of hCG may be helpful prediction of out come in IVF-ET cycles. Success rates after COH of IVF-ET cycles are dependent upon many variable factors. Follicular factors including the number of follicles, follicular diameters and especially serum estradiol(E2) levels as an indirect measurement of follicular function and guality have been thought to influence the outcomes of IVF-ET. To assess whether serum P4 and E2 levels affect the fertilization and pregnancy rate, we reviewed the stimulation cycles of 113 patients (119 cycles) undergoing IVF-ET with short protocol with GnRH-a, from March 1993 to August 1994 retrospectively. The serum P4 and E2 levels were compared on the day of hCG in the pregnant group, 45 patients(47 cycles) and in the non-pregnant group, 68 patients (72 cycles) respectively. The serum E2 level in non-pregnant group was $1367{\pm}875.8$ pg/ml which was significantly lower than that of pregnant group, $1643{\pm}987.9$ pg/ml( p< 0.01 ). And the serum P4 level in non-pregnant group was $2.1{\pm}1.4$ ng/ml which was significantly higher than that of pregnant group, $1.0{\pm}0.7$ ng/ml( p< 0.001 ). The fertilization rate was $61.3{\pm}21.3%$ in pregnant group which was higher than that of non-pregnant group, $41.1{\pm}20.2%$ (p< 0.01). We suggest that the serum levels of P4 and E2 on the day of hCG administration are additional parameters that predict the outcomes of IVF-ET cycles.

체외수정시술시 5 일간의 체외배양을 이용한 포배기 배아 이식술에 관한 연구

김석현(Seok Hyun Kim),구승엽(Seung Yup Ku),지병철(Byung Chul Jee),김은경(Eun Kyung Kim),천은경(Eun Kyung Chun),김희선(Hee Sun Kim),오선경(Sun Kyung Oh),서창석(Chang Suk Suh),최영민(Young Min Choi),김정구(Jung Gu Kim),문신용(Shin Yong 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11

N/A Objective : To evaluate the clinical efficacy of human blastocyst transfer following in vitro culture for five days in vitro fertilization and embryo transfer (IVF-ET), and to compare the efficiency of P1-BL and G1-G2 media in the culture of human blastocyst. Methods : Seventy-two infertile patients undergoing blastocyst transfer in IVF-ET were classified into the conventional IVF (n=52) and ICSI (n=20) groups, and P1-BL (n=37) and G1-G2 (n=35) groups. The outcomes of blastocyst transfer cycles were evaluated and compared, respectively. Results : There were no significant differences in the outcomes of controlled ovarian hyperstimulation (COH) and IVF-ET, such as duration of COH, total dosage of gonadotropins used, serum estradiol (E2) level on hCG day, numbers of oocytes retrieved and fertilized, and number of blastocysts transferred between the conventional IVF and ICSI groups, and between P1-BL and G1-G2 groups, respectively. Total blastulation rate was significantly higher in IVF group than ICSI group (53.6% vs. 37.3%, p<0.05). Implantation, clinical pregnancy, and multiple pregnancy rates were significantly higher in IVF group than ICSI group (15.1% vs. 4.1%, p<0.05; 36.5% vs. 15.0%, p<0.05; 36.8% vs. 0%, p<0.01). There were no significant differences in total blastulation, implantation, and clinical pregnancy rates between P1-BL and G1-G2 groups. However, multiple pregnancy rate was significantly higher in G1-G2 group than P1-BL group (60.0% vs. 8.3%, p<0.05). Conclusions : In human blastocyst transfer following in vitro culture for five days in IVF-ET, conventional IVF showed better outcomes of embryo development and pregnancy than ICSI. The efficiency of P1-BL media in the culture of human blastocyst was comparable to that of G1-G2 media. Further investigation will be necessary to compare the efficiency of various media in the blastocyst culture and to confirm the risk of multiple pregnancy in cases using G1-G2 media.

Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

Na, Eun Duc,Cha, Dong Hyun,Cho, Jung Hyun,Kim, Mi Kyoung The Korean Society for Reproductive Medicine 2012 Clinical and Experimental Reproductive Medicine Vol.39 No.4

Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

Application of two different synthetic sequential media for the human IVF-ET program: a prospective, randomized, and comparative study

Yoon, Jeong,Yoon, Hye-Jin,Juhn, Kyoung-Mi,Ko, Jin-Kyung,Yoon, San-Hyun,Ko, Yong,Lim, Jin-Ho The Korean Society for Reproductive Medicine 2011 Clinical and Experimental Reproductive Medicine Vol.38 No.4

Objective: Since IVF program was first established, various types of media and culture systems have been developed either in-house or commercially. The aim of this study was to compare the efficacy of in-house Maria Research Center (MRC) media to that of commercially available Sydney IVF media in human day 3 embryo transfer cycles. Methods: Three hundred sixty nine couples were included in this prospective, randomized, and comparative study. All couples undergoing IVF treatment at the Maria Fertility Hospital were randomly assigned to either Sydney IVF (n=178) or MRC (n=191) media. Results: No difference was observed between the MRC media and Sydney IVF media groups with respect to fertilization rate (74.4% vs. 75.5%). The clinical pregnancy and implantation rates of MRC media (47.1% and 20.0%, respectively) were also similar to those of Sydney IVF media (44.4% and 19.4%, respectively). However, the proportion of embryos with good quality on day 3 was significantly higher in the MRC media group than the Sydney IVF media group (50.2% vs. 43.2%) ($p$ <0.05). Conclusion: MRC media were as effective as Sydney IVF media for sustaining embryo development and pregnancy rates. The present study implies that MRC media can be a suitable alternative to commercially available media for human IVF-ET program.

미수정 및 저수정율의 기왕력을 지닌 체외수정시술 환자에서의 난자 세포질내 정자 주입술을 이용한 미세보조 수정술에 관한 연구

문신용,김석현,채희동,김광례,이재훈,김희선,류범용,오선경,서창석,최영민,김정구,이진용,Moon, Shin-Yong,Kim, Seok-Hyun,Chae, Hee-Dong,Kim, Kwang-Rye,Lee, Jae-Hoon,Kim, Hee-Sun,Ryu, Buom-Yong,Oh, Sun-Kyung,Suh, Chang-Suk,Choi, Young-Min,Kim, 대한생식의학회 1997 Clinical and Experimental Reproductive Medicine Vol.24 No.1

Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many infertile couples with normal semen parameters, and certain couples cannot be accepted for standard IVF-ET due to unfertilization or extremely low fertilization rate of oocytes. Recently, several procedures of microassisted fertilization (MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after partial zona dissection (PZD), subzonal insertion (SUZI), and intracytoplasmic sperm injection (ICSI). This clinical study was performed to develop and establish ICSI as an effective procedure of MAF in infertile couples who could not undergo standard IVF-ET repetitively because of failure in fertilization or extremely low fertilization rate of oocytes with the conventional fertilization technique in the previous IVF-ET cycles. From March, 1995 to May, 1996, 27 cycles of IVF-ET with ICSI in 19 infertile patients were included in study group, and the outcomes of ICSI were analyzed according to fertilization rate, cumulative embryo score (CES), and pregnancy rate. The number of oocytes retrieved after controlled ovarian hyperstimulation (COH) was $10.50{\pm}6.13$ in 30 previous cycles, and $10.57{\pm}5.53$ in 27 ICSI cycles. In ICSI cycles, the number of oocytes optimal for ICSI procedure was $7.89{\pm}4.30$, and the fertilization rate of $67.9{\pm}20.2%$ could be obtained after ICSI. The number of embryos transferred was $1.43{\pm}2.40$ in previous cycles, and $4.36{\pm}1.77$ with the mean CES of $41.8{\pm}27.4$ in ICSI cycles. In ICSI cycles, the overall pregnancy rate was 29.6% (8/27) per cycle and 42.1% (8/19) per patient with the clinical pregnancy rate of 22.2% (6/27) per cycle and 31.6% (6/19) per patient. In conclusion, MAF of human oocytes with ICSI is a promising fertilization method for IVF-ET patients, especially with the past history of failure in fertilization or low fertilization rate of oocytes in the previous IVF-ET cycles, and ICSI using micromanipulation procedures applied to human oocytes will provide a range of novel techniques which may dramatically improve the pregnancy rate in IVF-ET program and contribute much to effective management of infertile couples.

고식적 체외수정시술과 난자 세포질내 정자주입술에 의해 태어난 아이의 주산기 결과 및 선천성 기형 발생빈도의 비교 연구

임정은,유근재,이종표,이문섭,현우영,전진현,홍수정,송지홍,송인옥,백은찬,최범채,손일표,궁미경,강인수,전종영,박인서,Lim, Jeong-Eun,Yoo, Keun-Jai,Lee, Jong-Pyo,Lee, Moon-Seob,Hyun, Woo-Young,Jun, Jin-Hyun,Hong, Soo-Jeong,Song, Ji-Hong,Song, In-Ok,Paik, 대한생식의학회 1998 Clinical and Experimental Reproductive Medicine Vol.25 No.3

The safety of ICSI as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestational age $({\pm}SEM)$ and birth weight in singleton pregnancy were $38.8{\pm}1.9$ weeks and $3209.7{\pm}501.9gm$ in IVF group, $39.0{\pm}2.2$ weeks and $3289.9{\pm}479.5gm$ in ICSI group, respectively. Mean gestational age and birth weight in twins were $36.8{\pm}2.1$ weeks and $2512.8{\pm}468.0gm$ in IVF group, $36.5{\pm}2.8$ weeks and $2492.7{\pm}537.1gm$ in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twins; for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.

난자 세포질내 정자 주입술을 이용한 체외수정시술시 누적임신율에 관한 연구

김석현(Seok Hyun Kim),심순섭(Soon Sup Shim),지병철(Byung Chul Jee),최성미(Sung Mi Choi),김희선(Hee Sun Kim),류범용(Buom Yong Ryu),오선경(Sun Kyung Oh),서창석(Chang Suk Suh),최영민(Young Min Choi),배광범(Kwang Bum Bai),김정구(Jung Gu 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Objective : To evaluate the cumulative pregnancy rate(CPR) of in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). Methods : Medical records of 260 infertile patients undergoing 519 cycles of IVF-ET with ICSI from January, 1994 to December, 1999 were retrospectively reviewed. The CPR beyond 12 weeks of gestation was estimated by Kaplan-Meier method. The CPRs were compared by log-rank test between groups divided by age of patients, indication of ICSI, and method of sperm retrieval for ICSI. Results : As 70 patients achieved an on-going pregnancy after IVF-ET with ICSI, the PR was 26.9% per patient and 13.5% per cycle. The overall CPR was 54.9% after 6 cycles of IVF-ET with ICSI. As expected, age had a significant strong effect on the CPR; CPRs afer 4 cycles of ICSI were 61.8% in the age group of 30 years(n=81), 43.7% in 31-35 years(n=106), and 15.3% in 36 years(n=73). There was no significant difference in the CPR between abnormal semen analysis group(n=184) and prior low fertilization rate group(n=66). In abnormal semen analysis group, the CPR of surgically retrieved sperm subgroup(n=60) was not significantly different from that of ejaculated sperm subgroup(n=124). Conclusions : The CPR of IVF-ET with ICSI was presented, and it could be of much help in the clinical counseling of IVF-ET patients. ICSI technique could be used successfully for IVF-ET in infertile couples who had the male factor infertility or the past history of low fertilization rate in the previous cycles.

새로운 임신 기술과 '위험', 그리고 아픈 아이들 : 보조생식술 결과의 국제비교를 중심으로

하정옥(Ha, Jung-Ok) 한국가족학회 2012 가족과 문화 Vol.24 No.2

이 논문은 새로운 임신 기술이 수반하는 '위험'에 대해, 특히 체외수정(IVF) 기술로 태어난 아이들 건강 조사 연구를 중심으로 살펴본다. 흔히 시험관아기로 불리는 이 기술은 불임부부에게 자신의 아이를 가질 수 있는 희망을 준 기술로 찬사를 받았고 전 세계에 널리 확산 되었다. 그런데 이로부터 태어난 아이들의 건강에 대한 우려가 유럽과 북미를 중심으로 제기 되었다. 이러한 우려는 아이들에 대한 추적조사 자료와 함께 실증적으로 제기되었고, 이에 대한 대책으로 체외수정 시술에서 한 번에 이식하는 배아의 수에 대한 규제가 이루어졌다. 그런데 한국을 비롯하여 아시아 국가에서는 이러한 추적조사가 거의 이루어진 바 없고 한번에 이식하는 배아의 수도 그동안 별 변화가 없었다. 이와 함께 전체 출생 인구에서 다태아가 차지하는 비율은 급격히 증가하고 있다. 또 다른 한편, 전 세계적으로도 아이들에 대한연구는 많이 이루어진 반면 이 기술이 여성에 미치는 영향에 대해서는 소수의 연구가 있을뿐이다. 이러한 점에서 이 기술 '위험'의 인지와 대책 마련에서 지구적 불균등을, '위험' 문제구성에서 성별 정치의 일면을 읽을 수 있다. 또한 무엇이 '위험'으로 간주되고 어떤 대책이 마련되는가를 보면 기술 위험의 사회적 구성 또한 발견할 수 있다. This paper intends to study the risks of technology, particularly in terms of the health outcome surveys and follow-up of children born through IVF (in vitro fertilization, also known more colloquially as test-tube babies). From the early stage of IVF's development, the disabilities of children born through IVF was the key target for risk management practices, and the follow-up studies of the children born through IVF have been working through samples or complete enumeration surveys in mostly European countries. The results showed that the overall health outcomes of IVF children were relatively poorer than for other children, and the multiple pregnancies and births from multiple embryo implantations was pointed out as the main cause for this. Such an analysis result was followed by legislative or administrative regulation of the number of embryos allowed to be transferred in actual IVF practice. Risk management status differs from country to country. Since the first 'test tube baby' was born in Korea in 1985, 235,000 cases were accumulated between 1992, when official reporting began, and 2007. However, no follow-up study of the children has been conducted nor has the official regulation of the number of embryos been transferred along with the technology. Even today, the rate of transferring 4 or more embryos in an IVF procedure is more than 50% in Korea, and the ratio of multiple-births to the total number of babies born began rapidly increasing in the 2000's. I suggest that the risk of technology should be considered not just as a side effect of technological development but as an essential part of those processes. Furthermore, the social construction of the risks, which considers risk according to the locality's status of technological development, can also be observed.