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Korean Journal of Obstetrics & Gynecology 2004;47(11):2167-2172.
Published online November 1, 2004.
Pregnancy Outcomes after Transfer of Frozen-thawed Embryos following ICSI with Ejaculated, Fresh and Frozen-thawed Testicular Sperm.
Soo Kyung Kim, Hye Kyung Byun, Su Jin Choi, Yong Seog Park, Sang Jin Song, Jin Hyun Jun, Mi Kyoung Koong, In Ok Song, Keun Jae Yoo, Kwang Moon Yang, Jin Yeong Kim, Ju Tae Seo, Inn Soo Kang
1Laboratory of Reproductive Biology and Infertility, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Obstetrics and Gynecology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Urology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
OBJECTIVES
This study was performed to evaluate the pregnancy rate following the transfers of frozen- thawed embryos which was derived from intracytoplasmic sperm injection (ICSI) using sperm obtained by ejaculated, testicular sperm extraction (TESE), and frozen-thawed testicular sperm extraction (t-TESE). METHODS: Frozen-thawed embryos were successfully transferred to the patients in 664 cycles among 695 cycles from January 1998 to December 2002, where ICSI was done with various origins of sperm. Subjects were divided into three groups according to the origin of sperm; ejaculated sperm group as a control (n=535), TESE group (n=98) and t-TESE group (n=62). After conventional ICSI, the supernumerary PN stage or developing embryos were cryopreserved by slow freezing protocol with 1, 2-propanediol as cryoprotectant. RESULTS: The survival rate of frozen-thawed embryos was 77.7% (2515/3236) in ejaculated sperm group, 76.6% (441/576) in TESE group and 83.9% (292/348) in frozen-thawed TESE group, respectively. The difference of survival rate of between t-TESE group and other two groups was statistically significant (p<0.01). The good embryo formation rate and positive beta-hCG rate was 46.3% (1164/2515), 28.8% (148/513) in ejaculated sperm group, 49.2% (217/441), 36.6% (34/93) in TESE group and 46.2% (135/292), 34.9% (22/63) in frozen-thawed TESE group, respectively. CONCLUSION: This study demonstrates that comparable pregnancy rate and implantation rate could be achieved after the transfer of frozen-thawed embryos following ICSI using various sources of sperm. As there was no statistically significant difference in pregnacy rate between ICSI with fresh testicular sperm and with frozen-thawed testicular sperm, the sequential cryopreservation of supernumerary testicular sperm and embryos may be a useful method for increasing pregnancy outcome in infertile couples with male factor.
Key Words: Cryopreservation, ICSI, TESE, t-TESE, Frozen-thawed ET
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