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Lee JW, Cha JH, Shin SH, Kim YJ, Lee SK, Park CK, Pak KA, Yoon JS, Park SY. Effects of laser-assisted thinning versus opening on clinical outcomes according to maternal age in patients with repeated implantation failure. Lasers Med Sci 2019; 34:1889-1895. [PMID: 31044362 DOI: 10.1007/s10103-019-02787-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
Laser-assisted thinning (LAT) and laser-assisted opening (LAO) are performed as part of human in vitro fertilization (IVF) to increase the implantation rate in patients with a poor prognosis and in cases of repeated implantation failure. However, an insufficient number of studies have directly compared LAT and LAO using the same methods. Therefore, we compared the effects of LAT and LAO on clinical outcomes according to maternal age in patients with repeated implantation failure. This retrospective study was performed in 509 IVF cycles (458 patients). The cycles were divided based on maternal age and the method used (< 38 years LAT, n = 119 vs. LAO, n = 179 and ≥ 38 years LAT, n = 72 vs. LAO, n = 139). Cleavage-stage embryos before transfer were either thinned or opened using a 1.46-μm noncontact diode laser. We compared the implantation rates and pregnancy outcomes of cycles between LAT and LAO according to maternal age. The characteristics of patients did not differ significantly among the groups (p > 0.05), with the exception of mixed factor infertility, which was more common in the LAT group than in the LAO group among patients < 38 years of age (10.1% vs. 2.8%, p = 0.008). The LAT and LAO groups showed similar rates of biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion, implantation, singleton pregnancy, and twin pregnancy (p > 0.05). In conclusion, LAT and LAO had similar clinical outcomes. Therefore, we did not find any evidence that LAT is superior to LAO. In fact, the patients ≥ 38 years of age who underwent LAO tended to have a lower abortion rate. Further study is necessary to confirm these results in a larger population.
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Affiliation(s)
- Jung-Woo Lee
- Agaon Fertility Clinic, Seoul, 08391, South Korea.,College of Animal Life Science, Kangwon National University, Chuncheon, 24341, South Korea
| | - Jeong-Ho Cha
- Agaon Fertility Clinic, Seoul, 08391, South Korea.
| | - Sun-Hee Shin
- Agaon Fertility Clinic, Seoul, 08391, South Korea.,College of Animal Life Science, Kangwon National University, Chuncheon, 24341, South Korea
| | | | - Seul-Ki Lee
- Agaon Fertility Clinic, Seoul, 08391, South Korea
| | - Choon-Keun Park
- College of Animal Life Science, Kangwon National University, Chuncheon, 24341, South Korea
| | - Kyung-Ah Pak
- Agaon Fertility Clinic, Seoul, 08391, South Korea
| | - Ji-Sung Yoon
- Agaon Fertility Clinic, Seoul, 08391, South Korea
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Lee JW, Cha JH, Shin SH, Cha HJ, Kim JH, Park CK, Pak KA, Yoon JS, Park SY. Effect of the sexual abstinence period recommended by the World Health Organization on clinical outcomes of fresh embryo transfer cycles with normal ovarian response after intracytoplasmic sperm injection. Andrologia 2018; 50:e12964. [PMID: 29460293 DOI: 10.1111/and.12964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/28/2022] Open
Abstract
This study was to investigate whether the sexual abstinence period (SAP) recommended by the World Health Organization (WHO) affects clinical outcomes. We compared the rate of clinical outcomes between 2-7 and ≥8 days of SAP in first fresh embryo transfer after intracytoplasmic sperm injection (ICSI) in groups of young maternal age (YMA: <38 years) and old maternal age (OMA: ≥38 years). We conducted a retrospective study of 449 first ICSI cycles with a normal ovarian response. SAP was identified before collecting the semen samples. Semen analysis was performed based on the guidelines recommended by WHO (2010). Sperm preparation was made using the swim-up method. Patients' baseline characteristics in the YMA and OMA groups did not differ. The rates of fertilisation, top-quality embryos on day 3, biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion and implantation per cycle were not significantly different between 2-7 and ≥8 days of SAP in the YMA or OMA group. In conclusion, SAP beyond the recommended period by WHO was not associated with the rates of a lower fertilisation and pregnancy in human in vitro fertilisation (IVF). We think that a new criterion of SAP for clinical application in human IVF needs to be considered by WHO.
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Affiliation(s)
- J W Lee
- Agaon Fertility Clinic, Seoul, Korea
- College of Animal Life Science, Kangwon National University, Chuncheon, Korea
| | - J H Cha
- Agaon Fertility Clinic, Seoul, Korea
| | - S H Shin
- Agaon Fertility Clinic, Seoul, Korea
- College of Animal Life Science, Kangwon National University, Chuncheon, Korea
| | - H J Cha
- Agaon Fertility Clinic, Seoul, Korea
| | - J H Kim
- Agaon Fertility Clinic, Seoul, Korea
| | - C K Park
- College of Animal Life Science, Kangwon National University, Chuncheon, Korea
| | - K A Pak
- Agaon Fertility Clinic, Seoul, Korea
| | - J S Yoon
- Agaon Fertility Clinic, Seoul, Korea
| | - S Y Park
- Agaon Fertility Clinic, Seoul, Korea
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Lee JW, Cha JH, Shin SH, Kim YJ, Lee SK, Park CK, Pak KA, Yoon JS, Park SY. Efficacy of embryo transfer on day 2 versus day 3 according to maternal age in patients with normal ovarian response. Clin Exp Reprod Med 2017; 44:141-145. [PMID: 29026720 PMCID: PMC5636926 DOI: 10.5653/cerm.2017.44.3.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/05/2017] [Accepted: 08/04/2017] [Indexed: 12/02/2022] Open
Abstract
Objective Delaying embryo transfer (ET) enables us to select among the embryos available for transfer and is associated with positive effects on implantation and pregnancy outcomes. However, the optimal day for ET of human cleavage-stage embryos remains controversial. Methods A retrospective study of 3,124 in vitro fertilization/intracytoplasmic sperm injection cycles (2,440 patients) was conducted. We compared the effects of day 2 and 3 ET on rates of implantation and pregnancy outcomes between young maternal age (YMA; <38 years old, n=2,295) and old maternal age (OMA; ≥38 years old, n=829) patient groups. Results The YMA and OMA groups did not differ in terms of patient characteristics except for the proportion of unexplained factor infertility, which was significantly greater in the OMA group, and the proportion of arrested embryos, which was significantly greater in the YMA group. However, the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion, and implantation rates per cycle were not significantly different between day 2 and 3 ET in the YMA group or the OMA group. Conclusion We suggest that offering patients the opportunity to decide which day would be suitable for ET could be part of a patient-friendly protocol that takes into consideration an infertile woman's circumstances and work schedule by allowing ET to be performed on day 2 instead of the traditional transfer on day 3.
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Affiliation(s)
- Jung-Woo Lee
- Agaon Fertility Clinic, Seoul, Korea.,College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea
| | | | - Sun-Hee Shin
- Agaon Fertility Clinic, Seoul, Korea.,College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea
| | | | | | - Choon-Keun Park
- College of Animal Life Sciences, Kangwon National University, Chuncheon, Korea
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Lee JW, Cha JH, Shin SH, Kim YJ, Lee SK, Cha HJ, Kim JH, Ahn JH, Kim HY, Pak KA, Yoon JS, Park SY, Park CK. Long Cut Straw Provides Stable the Rates of Survival, Pregnancy and Live Birth for Vitrification of Human Blasotcysts. Dev Reprod 2016; 20:219-225. [PMID: 27796003 PMCID: PMC5078147 DOI: 10.12717/dr.2016.20.3.219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Most of the commercial devices for vitrification are directly immersed into the warming solution (WS) for increasing of warming rate. However, the previous modified cut standard straw (MCS) which has reported is difficult to immerse into the WS. The aim of this study was to investigate whether the long cut straw (LCS) could be useful as a stable tool for vitrified-warmed human blastocysts. A total of 138 vitrified-warmed cycles were performed between November 2013 and November 2014 (exclusion criteria: women ≥38 years old, poor responder, surgical retrieval sperm, and severe male factor). The artificial shrinkage was conducted using 29-gauge needles. Ethylene glycol and dimethyl sulfoxide (7.5% and 15% (v/v)) were used as cryoprotectants. Freezing and warming were conducted using the LCS tool. The cap of LCS was removed using the forceps in the liquid nitrogen (LN2) and then directly immersed into the first WS for 1 min at 37℃ (1 M sucrose). Only re-expanded blastocysts were transferred after it was cultured in sequential media for 18-20 h. A total of 294 blastocysts were warmed, and all were recovered (100%). Two hundred eighty-five embryos were survived (96.9%). The vitrifiedwarmed blastocysts of all patients were transferred without any cancellation. We were able to achieve a reasonable implantation (24.2%), following by clinical pregnancy (36.2%), which then continued to ongoing pregnancy (36.2%), and live birth (31.2%). Using LCS is achieved the acceptable rates of survival, pregnancy and live birth. Therefore, the LCS could be considered as a stable and simple tool for human embryo vitrificaton.
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Affiliation(s)
- Jung-Woo Lee
- 1Agaon Fertility Clinic, Seoul 08391, Korea; College of Animal Life Science, Kangwon National University, Chuncheon 24341, Korea
| | | | | | | | | | | | - Ji-Hae Kim
- 1Agaon Fertility Clinic, Seoul 08391, Korea
| | | | | | | | | | | | - Choon-Keun Park
- College of Animal Life Science, Kangwon National University, Chuncheon 24341, Korea
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