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폐쇄성 정로장애로 인한 무정자증 환자에서 미세수술적 부고환 정자흡입술과 세포질내 정자주입술을 이용한 수정율 및 임신율 증진에 관한 연구
손일표,홍재엽,이유식,전진현,박용석,이호준,강인수,전종영,Son, I.P.,Hong, J.Y.,Lee, Y.S.,Jun, J.H.,Park, Y.S.,Lee, H.J.,Kang, I.S.,Jun, J.Y. 대한생식의학회 1994 Clinical and Experimental Reproductive Medicine Vol.21 No.3
We studied the role of assisted fertilization(subzonal insemination, intracytoplasmic sperm injection) in enhancing fertilization and pregnancy rate in obstructive azoospermia. MESA was performed in the patients with congenital absence of the vas deferens and unreconstructable obstructive azoospermia. Sperm were aspirated microsurgically from various sites along the epididymal stump. Sperm were then washed on a mini-PercoH gradient or swim-up method and treated by 2-deoxyadenosine and pentoxifylline. Conventional IVF(group I, 14 cycles), SUZI(group II, 13 cycles) and ICSI(gruop III, 28 cycles) were carried out in 55 treatment cycles. The clinical results are as follows: 1. Fertilization rates for group I, II and III were 16.1 %,31.4% and 48.6%, retrospectively (p<0.05). 2. Clinical pregnancy rates for group I, II and III were 7.1 %,7.7%, and 32.1 'Yo, retrospectively. 3. In 5 of MESA-ICSI cycles, epididymal sperm from alloplastic spermatocele were used and 2 clinical pregnancies (40%) were obtained. According to our results the combined MESA-ICSI procedure is highly effcient in improving fertilization and pregnancy rate in congenital absence of the vas deferens and unreconstructable obstructive azoospermia.
폐쇄성 무정자증 환자의 신선고환조직 정자와 동결고환조직 정자의 운동성이 임신율에 미치는 영향
박용석,이형송,변혜경,염혜원,송상진,임천규,이유식,윤종민,서주태,송지홍,강인수,궁미경,Park, Yong-Seog,Lee, Hyoung-Song,Byun, Hye-Kyung,Youm, Hye-Won,Song, Sang-Jin,Lim, Chun-Kyu,Lee, You-Sik,Yun, Jong-Min,Seo, Ju-Tae,Song, Ji-Hong,Kang, I 대한생식의학회 2001 Clinical and Experimental Reproductive Medicine Vol.28 No.2
Objective: ICSI with testicular sperm could achieve optimal fertilization and pregnancy. This study was performed to observe the influence on fertilization and pregnancy of motility of fresh testicular sperm and sperm extracted from frozen-thawed seminiferous tubules in obstructive azoospermia. Materials and Methods: We analysed clinical outcome of ICSI using fresh testicular sperm and sperm extracted from thawed seminiferous tubules. The presence of motility were compared to determine the factor for optimal fertilization and pregnancy rates. Results: In 316 cases of TESE-ICSI in obstructive azoospermia, ICSI with fresh testicular sperm (fresh sperm group) were 163 cases and ICSI with sperm testicular sperm extracted from frozen-thawed seminiferous tubule (thawed sperm group) were 153 cases. The fertilization rates were 71.3% and pregnancy rates were 32.5% in fresh sperm group, in thawed sperm group, 65.1% and 33.3% respectively. The fertilization and pregnancy rates of motile and non-motile testicular sperm were 72.9% and 33.6%, 50.0% and 18.2%, respectively (p<0.05). The fertilization and pregnancy rates of motile and non-motile sperm extracted from the thawed seminiferous tubule were 67.8% and 34.7%, 55.1% and 28.1%, respectively (p<0.05). The comparative of the results of ICSI using motile fresh testicular sperm and motile sperm extracted from thawed seminiferous tubule, fertilization and pregnancy rates were not significantly different (72.9% and 33.6%, 67.8% and 34.7%, respectively). Conclusion: These results suggest that successful pregnancy in TESE-ICSI treatment is influenced by the motility of fresh testicular sperm and sperm extracted from thawed seminiferous tubule in obstructive azoospennic patients.
자궁내막증 또는 자궁선근증에 의한 불임환자에서 장기간 GnRH analogue ( Long - term Down DRegulation ) 사용 후 과배란 및 체외 수정 시술의 결과
양광문(K . M . Yang),유근재(K . J . Yoo),최범채(B . C . Choi),김계현(K . H. Kim),이홍복(H . B . Lee),이재훈(J . H . Lee),송인옥(I . O . Song),송지홍(J . H . Song),궁미경(M . K . Koong),전종영(J . Y . Jun),강인수(I . S . Kang) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
목적 : 자궁내막증 또는 자궁선근증을 가진 불임 환자의 치료에 있어 GnRH analogue를 사용한 LTDR의 과배란 유도시 그 효과를 알아보았다. 방법 및 재료 : 복강경과 질식 초음파를 이용하여 자궁내막증 또는 자궁선근증을 진단 받은 불임 여성 43명의 47 LTDR cycles이 연구 대상이 되었다. GnRH analogue를 3개월 이상 장기간 사용하여 down regulation 시킨 후 gonadotropin을 이용하여 과배란 유도를 시행한 경우를 LTDR로 정의하였으며 임신을 위해 자궁강 내 정자 주입술 또는 체외 수정 및 배아 이식이 시행되었다. 결과 : 환자의 평균 연령(meanSD)은 33.83.8이었고 자궁선근증이 10cycles였으며 자궁내막증은 34cycles(1기:12cycles, 2기:9cycles, 3기 :5cycles, 4기:8cycles)이었다. 체외 수정 시 이식된 배아는 평균(meanSD) 3.70.3개였다. 자궁내막증을 가진 34cycles중 17.6%(6/34), 자궁선근증을 가진 10cycles중 40.0%(4/10)의 임신율을 보였다.결론 : 이 연구에서 LTDR은 자궁내막증과 자궁선근증에 의한 불임 환자의 치료에 효과적인 것으로 보이나 연구 대상군의 확대 조사가 필요하리라 사료된다. Objective : To assess the clinical efficacy of long term down regulation (LTDR) for in vitro fertilization (IVF) in infertile patients with endometriosis or adenomyosis.Materials and methods : Analysis were made from data collected from 45 paients who had endometriosis or adenomyosis diagnosed using pelvic laparoscopy and ultrasonography and had undergone intrauterine insemination or in vitro fertilization. LTDR was defined as long term, as long as three months down regulation of ovarian function followed by induction of ovulation using gonadotropins. Of these patients, 43 had undergone LTDR followed by IVF-ET, whereas 30patients in control group had undergone short or long protocol as an ovarian stimulation regimen.Results : The multiple independent parameters such as plasma basal estradiol (E2), plasma E2 level on day of hCG administration, number of oocytes retrived, number of good quality oocytes, number of embryo and number of transfered embryos were not significantly different between LTDR treated group and other control group. The clinical pregnancy rate in women treated with LTDR (17.6% in endometriosis, 40% in adenomysis, and 33.3% in endometriosis combined with adenomyosis) were comparable with those of control group (15.4% in endometriosis, 33.3% in adenomyosis and 40% in endometriosis combined with adenomyosis). Conclusions : In this study the LTDR as a ovarian stimulation regimen for IVF does not seems efficienct in infertile patients having endometriosis or adenomyosis than other protocols such as short or long, however further study with large number may be needed.