卵细胞质精虫显微注射及电刺激后的临床报告.doc

O01卵細胞質精蟲顯微注射及電刺激後的臨床報告 Clinical outcome following ICSI and electrical oocyte activation: A preliminary report王家瑋* 王美莉 林傑瑜 王薔惠 李玫玟 陳俊凱 黃泓淵 王馨世 宋永魁 林口長庚醫院 婦產部 Chia-Woei Wang*, Mei-Li Wang, Chieh-Yu Lin, Chiang-Hui Wang, Mei-Wen Lee, Chun-Kai Chen, Hong-Yuan Huang, Hsin-Shih Wang, Yung-Kuei Soong Department of Obstetrics and Gynecology, Chang Gung Memorial HospitalIntroduction: Poor fertilization or complete fertilization failure after ICSI, although rare, is one of the most frustrating events for patients as well as for the fertility center. Failure of oocyte activation was proposed to play a major role in such cases. Recent reports had suggested that when unfertilized oocytes after ICSI were properly activated, the activated oocytes could develop normally. Assisted oocyte activation seems to be the method of choice to resolve the difficulties of previous poor fertilization or complete fertilization failure. Herein we present our preliminary report on clinical outcome of such cases. Successful pregnancy and delivery have been achieved after ICSI and electrical oocyte activation.Materials: A total of four couples between 2003 and 2004 were enrolled in this preliminary report, including two couples of previous complete fertilization failure and two couples of previous very poor fertilization (15% HDS had higher IVF abortion rates significantly. There was a statistically insignificant trend toward an increased abortion rate in the high DFI (>27%) group. The DFI was negatively correlated with sperm motility, and HDS was negatively correlated with sperm morphology and concentration.Conclusions: Neither DFI nor HDS scores can provide independent information about embryo quality, fertilization, and pregnancy rates to infertility patients using ART. Sperm DNA fragmentation affects sperm motility. The relationship between HDS and IVF abortion rates provides preliminary evidence that ICSI may be indicated in men with >15% HDS. The potential adverse effect of sperm DNA damage on the post- implantation embryo quality and spontaneous abortion should be concerned.O16基礎期抗穆氏管荷爾蒙濃度對於小於 35 歲的 IVF 病人是懷孕的重要預測指 標 Basel serum AMH level is an important predictor of pregnancy for women younger than 35 years old in IVF program.施養澤*1 李宗賢1 劉崇賢1 黃俊嘉2,3 陳忠義2 吳宜玲1 楊東川4 李茂盛1,2,41 中山醫學大學附設醫院婦產科 2 李茂盛婦產科不孕症研究室 3 中台科技大學生 物技術系 4 中國醫藥大學醫學系 Yang-Tse Shih*1, Tsung-Hsien Lee1, Chung-Hsien Liu1, Chun-Chia Huang2,3, Chung-I Chen2, Yi-Ling Wu1, Tung-Chuan Yang4, Maw-Sheng Lee2,4 1Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 2Division of Infertility Clinic, Lee Women’s Hospital, 3Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, 4Department of Medicine, China Medical UniversityIntroduction: Both age and basal FSH are generally considered as predictors of ovarian reserve and pregnancy in IVF cycle. However, for young age women, previous reports revealed that embryo quality was the sole factor correlated with pregnancy rate. This retrospective study was to evaluate whether indicator of ovarian reserve; including age, baseline AMH and FSH could predict pregnancy in young age women undergoing assisted reproductive technology (ART).Material and method: A total of 779 patients who underwent IVF from Aug 2006 to May 2007 were collected in the study. All patients younger than 35 years old were recruited in this analysis. Baseline hormone profile, including AMH, FSH, LH and estradiol, were determined on the day3 of the pre-stimulation cycle. Estradiol, progesterone and LH were analyzed from blood samples obtained on the day of hCG administration. Subsequent to oocyte retrieval, all mature oocytes were fertilized by insemination or ICSI. The outcomes of IVF and basal serum data were analyzed using One-way ANOVA test and logistic regression analysis as appropriate.Result: Women were recruited and divided into four groups according to quartiles of AMH concentration: AMH3.58 (group D, n=74). A significantly lower pregnancy rate (36.4%, 28/77) were observed in group A. As expected, the number of oocytes, follicles and good embryos in group A were also significantly lower than other three groups. Basal serum FSH levels in group A were significantly higher than the other group. The lowest body mass index (BMI) was observed in group A. There were no differences regarding fertilization rates and implantation rates in all group. Number of good embryo revealed significantly relationship with pregnancy outcome (odds ratio: 1.127, p=0.014) when all indicators of ovarian reserve were inserted into a logistic regression model. Conclusion: Lower basal serum AMH level is associated with poor pregnancy outcome for women younger than 35 years old undergoing IVF. The reason is due to less good embryos available for IVF cycle. O17超低卵巢庫存的婦女經試管嬰兒治療的結果 The outcomes of IVF/ICSI in women with extremely poor ovarian reserve周麗玲*1 胡玉銘1,2 林明輝1 林時羽1 李國光1,31 馬偕紀念醫。