Since the introduction of intracytoplasmic sperm injection (ICSI) using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with p...Since the introduction of intracytoplasmic sperm injection (ICSI) using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with poor semen quality, there have been concerns that this might have adverse effects on the offspring compared to conventional in vitrofertilisation (IVF) and natural conceptions. ICSI is done for reasons other than male factor infertility, and on the whole has not been shown to have any more negative effects than those seen with IVF. There have however, been very few studies of ICSI with a focus on, or large enough numbers to examine, the specific outcomes associated with male factor infertility. From the limited information available in relation to the source of the sperm and aetiology of infertility in the presence of ICSI, there appears to be no increased risk of congenital malformations. There is, however, a small increase in both de novoand inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect. The origin of the sperm used in ICSI does not have a major influence on the early life outcomes for the offspring, but transgenerational and epigenetic effects remain unknown. When the male factor infertility is known or thought to be due to a Y-chromosome deletion, this information should be given to the young male offspring at a time that will ensure his own reproductive health and plans are optimized.展开更多
Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer...Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer from fresh and cryopreserved cycles were analyzed. Results From January to December, 2002, in a total of 628 thawing cycles in which 1 876 embryos were thawed, the embryo survival rate was similar between the IVF and ICSI group (88.09% and 88.95%, respectively). There was no significant difference in implantation rates both between the frozen and fresh IVF groups (19.19% and 21.07%, respectively) and between the frozen and fresh ICSI groups (15.22% and 15.64%, respectively), but there were significant differences either between frozen IVF and frozen ICSI groups (P<0.05) or between fresh IVF and fresh ICSI groups (P<0.01). The clinical preg- nancy rates in the frozen and fresh IVF groups were 45.86% and 43.43%, respec- tively (P>0.05). The clinical pregnancy rate of the frozen ICSI group was 42.07%, slightly higher than that of fresh ICSI (35.43%), but the difference was not significant (P>0.05). The clinical pregnancy rate between fresh IVF and fresh ICSI was signifi- cantly different (P<0.05). Conclusion The present study indicated that frozen-thawed embryos at early cleavage stage had equivalent pregnancy rates as that of fresh embryos.展开更多
Objective:To determine the correlation of different serum estradiol levels on the trigger day with the clinical and laboratory outcomes of in-vitro fertilization(IVF)cycles comprising a single fresh top-quality blasto...Objective:To determine the correlation of different serum estradiol levels on the trigger day with the clinical and laboratory outcomes of in-vitro fertilization(IVF)cycles comprising a single fresh top-quality blastocyst transfer.Methods:This was a retrospective observational study performed in Morula IVF Clinic Jakarta.Five hundred forty-two women were recruited and grouped according to their serum estradiol levels on the trigger day of follicular maturation as follows:<2000 pg/mL,2000-2999 pg/mL,3000-3999 pg/mL,and≥4000 pg/mL.Clinical pregnancy and miscarriage rates were evaluated as the primary outcomes and embryology laboratory results as the secondary outcomes which consisted of the number of retrieved,mature,and fertilized oocytes,the total sum of derived embryos,and top-quality embryos at cleavage and blastocyst stage.Results:Clinical pregnancy and miscarriage rates did not differ among the groups(P>0.05).Nonetheless,the study demonstrated a positive correlation of the serum estradiol levels with the overall laboratory outcomes including the number of retrieved,mature,and fertilized oocytes,the total sum of derived embryos,and top-quality embryos at cleavage and blastocyst stage(P<0.001).The subject group with estradiol level of≥4000 pg/mL was superior to the other groups in its respective median number of retrieved,mature,fertilized oocytes,total derived embryos,and top-quality cleavage-and blastocyst-stage embryos.Conclusions:Although an apparent positive correlation is observed between estradiol levels and laboratory outcomes,serum estradiol level on hCG trigger day is not associated with the clinical outcomes of IVF.展开更多
文摘Since the introduction of intracytoplasmic sperm injection (ICSI) using single sperm isolated from testicular tissue in men with obstructive and non-obstructive azoospermia, or using ejaculated sperm in those with poor semen quality, there have been concerns that this might have adverse effects on the offspring compared to conventional in vitrofertilisation (IVF) and natural conceptions. ICSI is done for reasons other than male factor infertility, and on the whole has not been shown to have any more negative effects than those seen with IVF. There have however, been very few studies of ICSI with a focus on, or large enough numbers to examine, the specific outcomes associated with male factor infertility. From the limited information available in relation to the source of the sperm and aetiology of infertility in the presence of ICSI, there appears to be no increased risk of congenital malformations. There is, however, a small increase in both de novoand inherited chromosome abnormalities. In terms of growth and neurodevelopment, there are very few studies, and so far, no adverse outcomes have been found in young children whose fathers have a sperm defect. The origin of the sperm used in ICSI does not have a major influence on the early life outcomes for the offspring, but transgenerational and epigenetic effects remain unknown. When the male factor infertility is known or thought to be due to a Y-chromosome deletion, this information should be given to the young male offspring at a time that will ensure his own reproductive health and plans are optimized.
文摘Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer from fresh and cryopreserved cycles were analyzed. Results From January to December, 2002, in a total of 628 thawing cycles in which 1 876 embryos were thawed, the embryo survival rate was similar between the IVF and ICSI group (88.09% and 88.95%, respectively). There was no significant difference in implantation rates both between the frozen and fresh IVF groups (19.19% and 21.07%, respectively) and between the frozen and fresh ICSI groups (15.22% and 15.64%, respectively), but there were significant differences either between frozen IVF and frozen ICSI groups (P<0.05) or between fresh IVF and fresh ICSI groups (P<0.01). The clinical preg- nancy rates in the frozen and fresh IVF groups were 45.86% and 43.43%, respec- tively (P>0.05). The clinical pregnancy rate of the frozen ICSI group was 42.07%, slightly higher than that of fresh ICSI (35.43%), but the difference was not significant (P>0.05). The clinical pregnancy rate between fresh IVF and fresh ICSI was signifi- cantly different (P<0.05). Conclusion The present study indicated that frozen-thawed embryos at early cleavage stage had equivalent pregnancy rates as that of fresh embryos.
文摘Objective:To determine the correlation of different serum estradiol levels on the trigger day with the clinical and laboratory outcomes of in-vitro fertilization(IVF)cycles comprising a single fresh top-quality blastocyst transfer.Methods:This was a retrospective observational study performed in Morula IVF Clinic Jakarta.Five hundred forty-two women were recruited and grouped according to their serum estradiol levels on the trigger day of follicular maturation as follows:<2000 pg/mL,2000-2999 pg/mL,3000-3999 pg/mL,and≥4000 pg/mL.Clinical pregnancy and miscarriage rates were evaluated as the primary outcomes and embryology laboratory results as the secondary outcomes which consisted of the number of retrieved,mature,and fertilized oocytes,the total sum of derived embryos,and top-quality embryos at cleavage and blastocyst stage.Results:Clinical pregnancy and miscarriage rates did not differ among the groups(P>0.05).Nonetheless,the study demonstrated a positive correlation of the serum estradiol levels with the overall laboratory outcomes including the number of retrieved,mature,and fertilized oocytes,the total sum of derived embryos,and top-quality embryos at cleavage and blastocyst stage(P<0.001).The subject group with estradiol level of≥4000 pg/mL was superior to the other groups in its respective median number of retrieved,mature,fertilized oocytes,total derived embryos,and top-quality cleavage-and blastocyst-stage embryos.Conclusions:Although an apparent positive correlation is observed between estradiol levels and laboratory outcomes,serum estradiol level on hCG trigger day is not associated with the clinical outcomes of IVF.