Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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The Clinical Outcomes after Embryo Transfer (ET) on Day 2 and Day 5 or Subsequent ET on Day 2-5, 2-6, 2-7, 3-5 and 4-7 in In Vitro Fertilization-ET Cycles

체외수정술에서 배아 이식 시기와 방법 (2일과 5일 및 2-5, 2-6, 2-7, 3-5, 4-7일 연속 이식)에 관한 연구

  • Kim, Dae-Won (Department of OB/Gyn, Kyungpook National University) ;
  • Park, Kee-Sang (Department of OB/Gyn, Kyungpook National University) ;
  • Song, Hai-Bum (Devision of Life Resources, Daegu University) ;
  • Lee, Taek-Hoo (Department of OB/Gyn, Kyungpook National University) ;
  • Chun, Sang-Sik (Department of OB/Gyn, Kyungpook National University)
  • 김대원 (경북대학교 산부인과학교실) ;
  • 박기상 (경북대학교 산부인과학교실) ;
  • 송해범 (대구대학교 생명자원학부) ;
  • 이택후 (경북대학교 산부인과학교실) ;
  • 전상식 (경북대학교 산부인과학교실)
  • Published : 2003.03.30
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Abstract

연구목적: 일반적으로 IVF-ET에서 가장 높은 임신율을 얻는 방법은 5 day ET (배반포기 배아 이식)이지만 장기간 배양이 적절하지 못한 경우에는 $2{\sim}4$일째에 ET를 실시하고 나서 $5{\sim}7$일째에 배반포기에 도달한 배아를 재이식 (SET)하여, SET의 효용성에 대하여 조사하고자 실시하였다. 연구재료 및 방법: 48주기의 환자에서 회수한 난자와 수정란은 10%와 20% hFF가 첨가한 DMEM에서 이식 직전까지 각각 공배양하였다. 채란 2일 (group I, day 2 ET), 5일째 이식 (group II, day 5 ET) 또는 재이식 (group III, SET; 2-5, 2-6, 2-7, 3-5, 4-7일)을 실시하면서 수정률, 할구분할률 및 임신율을 각각 비교하였다. 결과에 대한 통계 분석을 SAS (version 6.2)를 이용한 Duncan's Multiple Range Test를 이용하여 p값이 0.05 보다 작을 때 통계적으로 유의차가 있는 것으로 하였다. 결 과: 수정률은 group II (90.5%)가 다른 군에 비하여 높게 (p<0.05) 나타났다 (group I: 80.6%; group III: 82.9%). 할구분할률은 군간에 차이가 없었다 (수정란 당 $93.3{\sim}99.1%$). 임상적 임신율은 group II와 III (각각 58.3%)가 group I (33.3%) 보다 높게 나타났다. 그러나 처리군이 적어서 통계적인 차이는 없었다. 결 론: 배반포기 배아를 단독 이식하는 것이 임신율을 높일 수 있는 최선의 방법으로 나타났지만, 채란수가 적거나 수정률이 저조한 경우에는 $2{\sim}4$일째에 ET를 실시한 후 여분의 배아를 배반포기까지 배양한 다음 $5{\sim}7$일에 재이식 (SET)하면 blastocyst ET에서 나타날 수 있는 이식 자체의 실패를 방지할 수 있으면서 임신율을 높일 수 있는 이식 기법이 될 것이다.

Keywords

References

  1. Gardner DK, Lane M. Culture and selection of viable blastocysts: a feasible proposition for human IVF? Hum Reprod 1997; 3: 367-82
  2. Ashkenazi J, Yoeil R, Orvieto R, Shalev J, Ben-Rafael Z, Bar-Hava I. Double(consecutive) transfer of early embryos and blastocysts: aims and results. Fertil Steril 2000; 74: 936-40 https://doi.org/10.1016/S0015-0282(00)01549-1
  3. Shapiro BS, Harris DC, Richter KS. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development. Fertil Steril 2000; 73: 582-6 https://doi.org/10.1016/S0015-0282(99)00586-5
  4. Richter KS, Harris DC, Dandeshmand T, Shapiro BS. Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. Fertil Steril 2001; 76: 1157-67 https://doi.org/10.1016/S0015-0282(01)02870-9
  5. Lee HJ, Park KS, Song HB, Lee TH, Cho YL, Chun SS. Comparison of embryonic developmental capa-city by different co-culture time of oocytes in IVFET cycles. Kor J Fertil Steril 2002; 29: 21-8
  6. Park KS, Park YK, Song HB, Lee TH, Chun SS. A new sperm preparation method for testicular sperm extraction - intracytoplasmic sperm injection (TESEICSI) cycles: simple, effective and rapid method. J Mamm Ova Res 2002; 19: 110-20 https://doi.org/10.1274/jmor.19.110
  7. Park KS, Song HB, Lee TH, Chun SS. Subsequent embryo transfer (SET) on day 2 and day 5: it's safety and effectiveness. Kor J Fertil Steril 2000; 27: 165-72
  8. Park KS. A study on mouse and human germ cell culture for improvement of pregnancy rates in in vitro fertilization-embryo transfer technique (dissertation). Daegu (KOREA): Daegu University, 2003
  9. Bongso A, Ng SC, Sathanathan H, Lian NP, Rauff M, Ratnam S. Improved quality of human embryos when co-cultured with human ampullary cell. Hum Reprod 1989; 4: 706-13 https://doi.org/10.1093/oxfordjournals.humrep.a136971
  10. Schillaci R, Ciriminna R, Cefalu E. Vero cell effect on in-vitro human blastocyst development: preliminary results. Hum Reprod 1994; 9: 1131-5 https://doi.org/10.1093/oxfordjournals.humrep.a138645
  11. Dokras A, Sargent IL, Barlow DH. Human blastocyst grading: an indicator of developmental potential? Hum Repord 1993; 12: 2119-27
  12. Huisman GJ, Verhoeff A, Alberda AT, Zeilmaker GH, Leerentveld RA. A comparison of in vitro fertilization results after embryo transfer after 2, 3, and 4 days of embryo culture. Fertil Steril 1994; 61:970-1 https://doi.org/10.1016/S0015-0282(16)56715-6
  13. Beauchamp P, Acevedo C, Alvarez C, Cortes M, Crespo M. Double embryo transfer (DET) improve accuracy of embryo replacement and pregnancy rates. Fertil Steril 1998; 70 (Suppl. 1): P-637, S326-7
  14. Jung BJ, Kim JS, Song HJ. Effect of sequential embryo transfer in in vitro fertilization. Kor J Fertil Steril 2000; 27: 75-81
  15. World Health Organization. Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. Cambridge: Cambridge University Press, 1992
  16. Ouhibi N, Menezo Y, Benet G, Nicollet B. Culture of epithelial cells derived from the oviduct of different species. Hum Reprod 1989; 4: 229-35 https://doi.org/10.1093/oxfordjournals.humrep.a136877
  17. Veeck LL. Atlas of the human oocyte and early conceptus. 2nd ed. Maryland: Williams and Wilkins Press; 1991. p.121-3 (preembryo grading)
  18. Bolton VN, Wren ME, Parsons JH. Pregnancies after in vitro fertilization and transfer of human blastocysts. Fertil Steril 1991; 55: 830-2 https://doi.org/10.1016/S0015-0282(16)54257-5
  19. Menezo Y, Hazout A, Dumont M, et al. Coculture of embryos on Vero cells and transfer of blastocysts in humans. Hum Reprod 1992; 7 (Suppl. 1): 101-6
  20. Menezo Y, Nicollet B, Heraut N, Andre A. Freezing cocultured human blastocysts. Fertil Steril 1992; 58:977-80 https://doi.org/10.1016/S0015-0282(16)55445-4
  21. Janny L, Menezo YJR. Evidence for a strong paternal effect on human preimplantation embryo development and blastocyst formation. Mol Reprod Dev 1994; 38: 36-42 https://doi.org/10.1002/mrd.1080380107
  22. Olivennes F, Hazout A, Lelaidier C, Freitas S, Fanchin R, de Ziegler D, et al. Four indicators for embryo transfer at the blastocyst stage. Hum Reprod 1994; 9: 2367-73 https://doi.org/10.1093/oxfordjournals.humrep.a138454
  23. Alves da Motta EL, Alegretti JR, Baracat EC, Olive D, Serafini PC. High implantation and pregnancy rates with transfer of human blastocysts developed in preimplantation stage one and blastocyst media. Fertil Steril 1998; 70: 659-63 https://doi.org/10.1016/S0015-0282(98)00263-5
  24. Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla JA. Prospective randomized trial of blastocyst culture and transfer in in vitro fertilization. Hum Reprod 1998; 13: 3434-40 https://doi.org/10.1093/humrep/13.12.3434
  25. Gardner DK, Vella P, Lane M, Wagley L, Schlenker T, Schoolcraft WB. Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfer. Fertil Steril 1998; 69: 84-8 https://doi.org/10.1016/S0015-0282(97)00438-X
  26. Jones GM, Trounson AO, Gardner DK, Kausche A, Lolatgis N, Wood C. Evolution of a culture protocol for successful blastocyst development and pregnancy. Hum Reprod 1998; 13: 169-77 https://doi.org/10.1093/humrep/13.1.169
  27. Jones GM, Trounson AO, Lolatgis N, Wood C. Factors affecting the success of human blastocysts development and pregnancy following in vitro fertilization and embryo transfer. Fertil Steril 1998; 70:1022-9 https://doi.org/10.1016/S0015-0282(98)00342-2
  28. Egbase PE, Al-Sharham M, Al-Othman S, Al-Mutawa M, Udo EE, Grudzinskas JG. Incidence of microbial growth from the tip of the embryo transfer catheter after embryo transfer in relation to clinical pregnancy rate following in vitro fertilization and embryo transfer. Hum Reprod 1996; 11: 1687-9 https://doi.org/10.1093/oxfordjournals.humrep.a019470
  29. Rijuders PM, Jansen CAM. The predictive value of day 3 embryo morphology regarding blastocyst formation, pregnancy and implantation rate after day 5 transfer following in vitro fertilization or intracy-toplasmic sperm injection. Hum Reprod 1998; 13: 2869-73 https://doi.org/10.1093/humrep/13.10.2869
  30. Ben-Schlomo I, Golan J, Eyali V, Wiemer-Megnagi Z, Geslevich J, Shalev E. Double embryo transfer (48-72 hours + blastocysts) vs. single embryo transfer (48-72 hours) in ART. Fertil Steril 1999; 72 (Suppl. 1): P-209, S156-7