Effect of Dual Trigger In Vitro Fertilization and Intracytoplasmic Sperm Injection During the Gonadotropin-releasing Hormone-Antagonist Cycle on Final Oocyte Maturation and Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve

Objective It is well known that a dual trigger treatment can improve clinical outcomes of in vitro fertilization(IVF)in high or normal ovarian responders.However,it is not clear whether dual triggering also benefits patients with diminished ovarian reserve(DOR).The aim of this study was to investigate whether a dual trigger treatment of gonadotropin-releasing hormone(GnRH)agonist combined with human chorionic gonadotropin(hCG)for final follicular maturation improves the cumulative live birth rate(CLBR)during the GnRH-antagonist cycle in patients with DOR.Methods This retrospective study included patients with DOR who received a GnRH-antagonist protocol during IVF and intracytoplasmic sperm injection(IVF-ICSI)cycles at Peking University People’s Hospital from January 1,2017 through December 31,2017.Oocyte maturation was triggered by GnRH combined with hCG(n=110)or hCG alone(n=71).Embryos were transferred on the third day after oocyte retrieval or during a subsequent freeze-thaw cycle.Patients were followed up for 3 years.Results The dual trigger treatment did not affect CLBR,which is an overall determinant of the success rate of assisted reproductive technology(ART).Women in the dual trigger group had significantly higher rates of fertilization than those in the hCG group(90.1%vs.83.9%,P=0.040).Conclusion Dual trigger with GnRH agonist and hCG did not improve CLBR in patients with DOR,but did slightly improve fertilization rate,oocyte count,and embryo quality.

Cumulative live birth rates of in vitro fertilization/intracytoplasmic sperm injection after multiple complete cycles in China

There were few studies of cumulative live birth rates(CLBRs) based on multicenter reproductive clinical data from the general Chinese population.Here we report a retrospective cohort study,including 14 311 women with17 315 cycles,in three reproductive centers to evaluate two estimated parameters of CLBRs with multiple transfer cycles of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) in a Chinese population.We found that CLBRs were related to female age and endometrial thickness.By the fourth transfer cycle,the conservative and optimal estimates of CLBRs were 52.95% and 77.30% in women under 30 years of age,and 18.17% and26.51% in those 37 years of age or older,respectively.The two estimates were 44.70% and 63.15% in women with endometrial thickness more than 7 mm,and 32.05% and 46.18% in those with less than 7 mm,respectively.In addition,body mass index(BMI),duration of infertility,and infertility diagnoses may also be related to CLBRs on certain conditions.The findings from this study on CLBRs after multiple transfer cycles of IVF/ICSI treatment on different conditions in the Chinese population should be beneficial to both infertile couples and clinicians.

Relationship between Living Rate of Bud and Emergence Rate of Ratoon Rice and Characteristics of the First Cropping Mid-season Hybrid Rice

[Objective] The aim was to study the relationship of plant characters with bud living rate and mother stem emergence rate of ratoon rice before harvest. [Method] Eighteen mid-season hybrid rice cultivators approved recently were taken as materials and relationship of plant characters including bud living rate and moth- er stem emergence rate of ratoon rice before harvest was explored, based on relat- ed data. [Result] The shorter rice with lower harvesting index is the main character of high emergence rate for first cropping rice; decline of plant height and increase of ear-bearing percentage would improve emergence of regenerative seedlings. [Conclusion] The research provided scientific reference for breeding of rice cultivars with high regenerative capacity.

Pregnancy outcomes following supplementation of single dose GnRH agonist to sustain the luteal phase in antagonist fresh embryo transfer cycles:A multicentric prospective cohort study

Objective:To determine whether a single dose of gonadotropin-releasing hormone(GnRH)agonist administered subcutaneously in addition to the regular progesterone supplementation could provide a better luteal support in antagonist protocol fresh embryo transfer cycles.Methods:This prospective,multicentric,cohort study included total 140 women,70 in each group.Controlled ovarian stimulation was carried out as per fixed GnRH antagonist protocol.The trigger was given with hCG.In vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)was performed and day-3 embryos were transferred.Patients were divided into groups 1 and 2 based on computer generated randomization sheet.Six days following oocyte retrieval,group 1 received 0.2 mg decapeptyl subcutaneously in addition to regular progesterone support while group 2 received progesterone only.Luteal support was given for 14 days to both groups;if pregnancy was confirmed luteal support was continued till 12 weeks of gestation.The clinical pregnancy rate was the primary outcome.The implantation rate,miscarriage rate,live birth delivery rate,and multiple pregnancy rates were the secondary outcomes.Results:A total of 140 patients were analysed,70 in each group.Clinical pregnancy rates(47.1%vs.35.7%;P=0.17),implantation rates(23.4%vs.18.1%,P=0.24),live birth delivery rates(41.4%vs.27.1%,P=0.08),and multiple pregnancy rates(21.2%vs.16.0%,P=0.74)were higher in group 1 than in group 2.Group 1 had a lower miscarriage rate than group 2(5.7%vs.8.6%;P=0.75).However,these differences were not statistically significant between the two groups.Conclusions:Administration of a single dose of GnRH agonist in addition to regular natural micronized vaginal progesterone as luteal support in GnRH antagonist protocol cycles marginally improves implantation rates,clinical pregnancy rates,and live birth delivery rates.However,more studies with higher sample sizes are needed before any conclusive statements about GnRH agonist as luteal phase support can be made.

A retrospective analysis of the safety and efficacy of low dose tacrolimus (FK506) for living donor liver transplant recipients

We sought to evaluate the efficacy and effects of low-dose tacrolimus （FK506） to recipients with living donor liver transplantation （LDLT）. A total of 66 patients who underwent LDLT between 2001 and 2007 were enrolled in this study. According to different doses of tacrolimus, the recipients were randomly divided into two groups： the low-dose tacrolimus group （group A） and the normal-dose tacrolimus group （group B）. The blood concentration of tacrolimus and its side effects including infection, hyperglycemia, hypertension, high blood creatinine and jaundice were monitored once a week at the perioperative period, and once a month thereafter. Besides, the survival rates of the recipients were analyzed at the 1and 3-year time point after operation. Among these patients, no significant acute rejection was detected after LDLT. The incidences of infection, hyperglycemia, liver dysfunction and renal impairment in group A were markedly lower than those in group B. However, no significant differences were detected in the incidence of hypertension between the two groups. Moreover, the recipients in each group had a similar survival rate according to the results of 1and 3-year follow-up. The incidence of side effects that associated with tacrolimus positively correlated with tacrolimus blood concentration. In conclusion, long-term and low-dose administration of tacrolimus is a safe and effective treatment for LDLT recipients.

Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic male patients

Objective:To know whether sperm DNA fragmentation(SDF)affects the clinical outcomes in the cumulative transfers of an intracytoplasmic sperm injection(ICSI)cycle along with blastocyst transfers in couples with normozoospermic males.Methods:The study included 252 couples who underwent their first ICSI cycles along with blastocyst transfer and whose male partner semen samples were normozoospermic according to the World Health Organization 2010 criteria.All the couples were classified into two groups based on the SDF:the low SDF group(SDF≤30%,n=162)and the high SDF group(SDF>30%,n=90).Clinical as well as laboratory outcomes were correlated between the two groups.Sperm DNA fragmentation was assessed on the post-wash semen samples by acridine orange test.The main outcome measures were the live birth rate and miscarriage rate.Results:A significant decrease in the live birth rates was observed in the high SDF group compared to the low SDF group in fresh embryo transfer cycles(P<0.05).However,no significant difference was observed in the clinical outcomes either in the frozen embryo transfer cycles or in the overall cumulative transfer cycles(P>0.05).No significant difference was observed in the laboratory outcomes between the two SDF groups.A remarkable decrease in sperm motility was observed in the high SDF group compared to the low SDF group(P<0.05).Conclusions:Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic males.

Observation on Sperm Penetration Rate of Infertile Men with Varicocele at 1.5 to 2 Years after Varicolectomy

Objective To observe the sperm penetration rate among treated but 'unsuccessful' infertile men with varicocele Material & Methods Twenty nine infertile males with II°(n=17) or III°(n=12) varicocele were enrolled into this study. They underwent a varicolectomy, but their spouses had not achieved a pregnancy after 1.5~2 years of treatment. The sperm zona-free hamster oocyte penetration assay (SPA) was used to compare the sperm penetration rate (PR) before treatment and 1.5~2 years after treatment. Results After varicolectomy, enhanced PR were observed in 7 cases of the II°group and in 1 case of the III°group. However, the PR values of these 8 cases were still below 20% PR-level. Conclusion Among the treated but 'unsuccessful' men, some patients could obtain improvements on PR after varicolectomy. But PRs of men with III°grade varicele would still remain a low PR-level which indicate varicolectomy is ineffective in increasing PR among part of sever varicocele patients. SPA is a useful test for evaluating the fertilizing potential of treated infertile males with varicocele.

Study on the Diagnostic Value of Combined Detection of Sperm Quality, Sex Hormone and Ovulation in Infertility

Objective: To analyze the application value of combined detection of sperm quality, sex hormone and ovulation in the diagnosis of infertility. Methods: The study was conducted from June 2021 to June 2022. Sixty infertile couples who received IVF cycle treatment in our hospital during this period were selected as the observation group, and 60 couples with good sperm quality and follicle number ≥ 5 who conceived naturally after gynecological disease treatment were selected as the control group during the same period. The sperm quality, sex hormones and ovulation of the two groups were observed, and the change of positive rate was detected by the combined detection method. Results: Compared with the control group, the observation group had less semen (2.82 ± 0.12) ml, lower concentration (69.17 ± 1.28) × 106/ml, normal sperm morphology rate (2.92% ± 0.11%), lower survival rate (70.25% ± 1.16%), higher deformed sperm index (1.39 ± 0.11), and significant differences between groups (P < 0.05);The levels of FSH (7.15 ± 1.33) U/L, LH (5.13 ± 0.53) mU/ml, E2 (72.34 ± 5.11) ng/L, AMH (3.87 ± 0.67) ng/ml and AFC (7.15 ± 0.76) in the control group were significantly better than those in the observation group (P < 0.05). Compared with the single detection method of the three groups, the positive detection rate of the combined diagnosis method was higher, and the difference between the groups was significant (P < 0.05). Conclusion: For the diagnosis of infertility, the combined detection method of sperm quality, sex hormone and ovulation can effectively clarify the problems existing in the couple, significantly improve the detection rate of the cause of the patient, and is more conducive to guiding clinical symptomatic treatment, which is worthy of promotion and reference.

F-Actin Visualization in Generative and Sperm Cells of Living Pollen of Rice Using a GFP-Mouse Talin Fusion Protein

Green fluorescent protein (GFP) fused to the F-actin binding domain of mouse talin labels the actin cytoskeleton in the living generative and sperm cells of a third generation transgenic rice (Oryza sativa L.) plant, A005-G-T-1-2. Observations were made on pollen at four major developmental stages, viz. I. uni-nucleate microspore stage; II. early bi-cellular pollen stage; III. late bi-cellular pollen stage; and IV. tri-cellular pollen stage. At each of these developmental stages vegetative nucleus, generative nucleus/ cell, and sperm cells were seen undergoing continuous and coordinated motion and migration. These movements seemed to be influenced by associated microfilament networks existing in the pollen. Based on these observations we propose that it is the interaction between the microfilament networks (usually one existing in the central cytoplasm and another in the cortex) that controls the dynamic movement of the vegetative nucleus, generative nucleus/cell and sperm cells. Furthermore, we have also observed that there is an array of microfilaments (oriented mostly parallel to the long axis of the cell) existing in the generative and sperm cells. As far as we are aware, this is the first report showing the existence of microfilaments in living generative and sperm cells of rice pollen. The implication and significance of the existence of microfilaments in generative and sperm cells in rendering self-propelled motion of these cells in relation to their passage and movement in the pollen tube and embryo sac for fertilization were discussed.

Effects of Magnetic Field on the Quality of Chicken Semen Stored at Low Temperature

[ Objective] The study aimed to explore the effects of magnetic treatment on the quality of chicken semen stored at low temperature. [ Method] 5 ml fresh chicken semen was divided into five groups equally, each of which was diluted at the volume ratio 1：4. With the group without magnetic treatment as the control, the other four groups were magnetized for 6, 12, 24 and 48 min in the self-made magnetizer, respectively. Subsequently, all the five groups were stored at 2 -4 ℃, and the sperm motility, survival time, survival index and deformity rate were observed regularly. [ Result] Comparing with the control group, the magnetic groups showed higher sperm motilities and effective survival indices as well as lower deformity rates. The effective survival index of the group magnetized for 24 min was the highest and increased by 7.75% in con- trast to the control. [ Conclusion] Magnetic treatment can effectively enhance the quality of chicken semen stored at low temperature.

The evolution and refinement of vasoepididymostomy techniques

Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy （VE）. Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE （LIVE） in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. This technique has been widely referenced in the recent literature including robotic-assisted microsurgery. The history of the development of different VE approaches, the oreoDerative evaluation along with the techniaues of various VE will be described in this article.

Role of ICSI in Non-male Factor Cycles as the Number of Oocytes Retrieved Decreases from Four to One

This study aimed to investigate whether intracytoplasmic sperm injection（ICSI） shows an advantage over in vitro fertilization（IVF） in non-male factor cycles as the number of oocytes retrieved decreases from four to one.We undertook a retrospective analysis of 1305 IVF/ICSI cycles of non-male factor in which four or fewer oocytes were retrieved.Comparisons were made between conventional IVF（CI） and ICSI when one,two,three or four oocyte（s） were retrieved.Primary outcomes including normal fertilization rate,proportion of embryos per obtained oocyte,cycle cancellation rate,implantation rate,clinical pregnancy rate（PR）,live birth rate（LBR）,cumulative PR and cumulative LBR were evaluated.The results showed that the normal fertilization rate（72.5% vs.50.0%） and the proportion of embryos per obtained oocyte（72.5% vs.55.0%） were significantly increased in one oocyte retrieved cycles in ICSI group as compared with CI group.However,the proportion of embryos per obtained oocyte was markedly decreased in ICSI group when three（52.3% vs.61.3%） or four（56.9% vs.64.0%） oocytes were retrieved.The implantation rates,clinical PRs,LBRs,cumulative PRs and cumulative LBRs in CI group were comparable to those in ICSI group when one,two,three or four oocyte（s） were retrieved.In conclusion,ICSI doesn＇t show advantages over IVF in low oocyte yield cycles of non-male factors,even when only one oocyte was retrieved.Key words

Predictors of patient survival following living donor liver transplantation

BACKGROUND: Living donor liver transplantation (LDLT) is considered to be the alterative choice in light of the great shortage of cadaveric donors. However, the characteristics of the patients who will benefit from LDLT have not been well identified. The aim of this study was to define the pre- and intra-operative factors that may influence patient outcome. METHODS: The data from 102 LDLT patients who had operations between 2002 and 2009 were collected and analyzed retrospectively. Data were analyzed using uni- and multi-variate analysis according to factors that are known to be associated with outcome in these patients. RESULTS: Overall, the accurate survival rate of recipients at 1, 3, and 5 years was 84%, 76%, and 70%, respectively. The independent risk factors, preoperative renal dysfunction, intraoperative red blood cell transfusions of greater than 5 units, and female to male match (donor to recipient matching), were identified by Cox regression analysis. The pre-transplant model for end-stage liver disease score and a graft to recipient weight ratio of less than 0.8% were not predictive of outcome. The overall 1-, 3-, and 5-year survival of patients with one or no risk factors and two or more risk factors were 91%, 86%, and 83% and 67%, 56%, and 47%, respectively (P<0.0001). CONCLUSIONS: In our retrospective study, preoperative renal dysfunction, intraoperative red blood cell transfusions of greater than 5 units, and female to male gender match were independent risk factors for LDLT recipient outcome. Two or more of these risk factors may contribute to poor outcome.

Developmental Potential and Clinical Value of Embryos with Abnormal Cleavage Rate

To investigate the developmental potential and clinical value of embryos with abnormal cleavage rate,a retrospective analysis was performed on 66 635 2-prokaryotic(2PN)and 1-pronuclear(1PN)embryos.The embryos were given conventionally in vitro fertilization(IVF)treatment and continuously cultured on the day 3(D3)at the Reproductive Medicine Center,Tongji Medical College,Huazhong University of Science and Technology from January 2016 to December 2017.The embryos were separated into the day-2(D2)undivided group with 106 cases,the arrested development group with 3482 cases,the blastomere reduction group with 541 cases,and the control group with 62 506 cases,respectively.The blastocyst utilization rates of these three abnormal groups were 2.83%,10.86%and 6.84%,respectively,which were significantly different from that in control group(39.46%).Furthermore,2 cases of anabiosis and 1 case of live birth were found in D2 undivided group.In arrested development group,there were 55 cases of anabiosis,11 cases of clinical pregnancy in single-embryo transplantation(including 6 cases of live birth),and 25 cases of clinical pregnancy in combination with one normal embryo transplantation(including 23 cases of live births and 15 cases of dizygotic twins under B-ultrasound).There were 13 case of anabiosis in blastomere reduction group:there was 1 case of single embryo transplantation and clinical pregnancy was obtained;there were also 6 cases of clinical pregnancy in combination with one single normal embryo transplantation(including 5 cases of live births and 2 cases of di2ygotic twins under B-ultrasound).In conclusion,embryos with abnormal cleavage rate still have the potential to continue to develop,and have certain blastocyst utilization rate and live birth.

Effects of Clindamycin on Sperm Function in Mice

[ Objective] To study the effects of clindamycin on germ cells of male mice. [Method] A total of 48 healthy adult male mice were randomly divided into group A, group B, group C and control group, 12 mice in each group. The mice in the group A, group B and group C were respectively administrated with clindamycin at doses of 15, 30 and 60 mg/kg.d via intraperitoneai injection, and those in the control group were trea- ted with normal saline. On Day 29 after administration, the mice were killed by dislocation, and the sperm motility rate, sperm deformity rate and the percentage of sperm having swollen tail membrane were determined, respectively. [ Result] The sperm motility rate and the percentage of sperm having swollen tail membrane of the group B and group C were lower than those of the control group; and the sperm deformity rate of the group B and group C was higher than that of the control group. The sperm motility rate, sperm deformity rate and percentage of sperm having swollen tail membrane had no significant difference between the group A and control group. [ Conclusion] The clindamycin at a dose equal to or more than that used for severe infection affects the normal function of sperm in mice.

Pregnancy Outcomes for Day 5 Versus Day 6 Single Frozen-thawed Blastocyst Transfer with Different Qualities of Embryos: A Large Matched-cohort Study

Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6.

Human circBOULE RNAs as potential biomarkers for sperm quality and male infertility

Reliable molecular biomarkers to predict fertility remain scarce.The current study investigated the potential of testis-specific circBOULE RNAs as biomarkers for male infertility and sperm quality.Using reverse transcription-PCR and real-time reverse transcription-PCR assays,we identified seven circular RNAs from the human BOULE gene in human sperm.We observed that the expression level of circEx3-6 was significantly reduced in asthenozoospermia,while the expression levels of both circEx2-6 and circEx2-7 were decreased in terato-zoospermia,compared with the controls.Furthermore,we demonstrated that the expression level of circEx2-6 was negatively correlated with the sperm DNA fragmentation index,and the expression level of circEx2-7 was correlated with both fertilization and cleavage rates in those treated with the assisted reproductive technologies.Further functional analyses in a transgenic fly model supported the roles of circBOULE RNAs in sperm development and human male fertility.Collectively,our findings support that sperm circBOULE RNAs may serve as diagnostic biomarkers for assessing sperm motility and DNA quality.Therefore,clinical application and significance of sperm circBOULE RNAs in the assisted reproductive technologies warrant further investigation.

Acupuncture improves the live birth of patients with repeated implantation failure: a retrospective cohort study

OBJECTIVE:To explore the therapeutic efficacy of acupuncture treatment on repeated implantation failure(RIF)patients with cryo-thawed embryo transfer(CET).METHODS:In a retrospective cohort study,all eligible women undergoing RIF were recruited in our center from January 1,2018 to December 31,2021.The patients were grouped by whether an acceptance of acupuncture treatment before CET,including the acupuncture group(Acu-group,55 cycles)and control group(Con-group,244 cycles).Data were analyzed by using binary logistic regression to explore the relationship of acupuncture treatment with pregnancy outcomes.RESULTS:The Acu-group had higher live-birth rate(LBR)[54.5%vs 41.0%,respectively;odds ratio(OR)=1.105,95%confidence interval(CI)(1.029,1.187),P=0.006]and ongoing pregnancy rate(OPR)[56.4%vs 43.0%,respectively;OR=1.100,95%CI(1.025,1.181),P=0.008]than the Con-group.There were no significant between-group differences in the rates of implantation[OR=1.070,95%CI(0.996,1.149),P=0.064],clinical pregnancy[OR=1.065,95%CI(0.997,1.138),P=0.061],biochemical pregnancy[OR=1.002,95%CI(0.903,1.112),P=0.967],or miscarriage[OR=0.778,95%CI(0.551,1.099),P=0.155].Perinatal outcomes did not differ significantly between the two groups.CONCLUSIONS:Acupuncture treatment could improve the LBR and OPR in RIF patients with CET cycles,suggesting a potential adjuvant therapy of acupuncture to improve the pregnancy outcomes in RIF patients.

Studies on Rate Enhancement of Polymerization in NMRP

In NMRP, the polymerization of MMA, the polymerization of St and the copolymerization of MMA with St were distinctly accelerated by the addition of a small amount of MN. The polymerization proceeds in a living fashion as indicated by the increase in molecular weight with the increase of time and conversion and a relatively low polydispersity. It has been found that the addition of MN results in a nearly one hundred times higher rate of the polymerization of MMA, a nearly twenty times higher rate of the polymerization of St and a nearly fifteen times higher rate of the copolymerization of St and MMA.

Can apoptosis analysis of cumulus granulosal cell evaluatethe potential vitality of replaced embryo?

Objective: We evaluated the relationships between the incidence of the apoptotic cell of human granulose cell (GC) from the oocytes during intracytoplasmic sperm injection (ICSI) and the pregnancy rate. Methods: 275 oocytes were retrieved from 29 patients with aging between 23 - 38 years, who underwent ICSI (21), percutanious sperm aspiration (PESA-ICSI)and testicular sperm extraction (TESE-ICSI) (7), only one case came from conventional IVF. The patients were divided into two groups based on pregnancy or not. The cumulus cells were collected to measure the number of apoptotic cell by using flow cytometer. The degree of cumulus GC apoptosis and clinic pregnancy rate were assessed, and compared with embryo morphology and number of blastomere. Results: The apoptosis value in pregnancy gruop (9 cases) were lower than the nonpregnancy group (19 cases) (P<0. 05). In pregnancy group, the apoptosis value in the GC obtained from replaced embryos (37) were significantly lower than that of the nonreplaced embryos (78) (P<0. 02). Conclusion: The results indicated that the embryos with lower apoptosis value would have the potency of increase pregnancy rate. It will be possible to elevate the clinic pregnancy rate by selecting the replaced embryos bases on the apoptosis value of GC from oocytes in addition to the morphological score.