Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical pregnancy rate per cycle with embryo transfer. When comparing with international registry data, clinical pregnancy rate per transfer from fresh IVF cycles including ICSI (34.1%,) was comparable to clinical pregnancy rate per transfer in European Society for Human Reproduction and Embryology report was 32.5% though lower than 45.0% for USA data. There was no remarkable difference in status of assisted reproductive technology in Korea between the current report and the data reported in 2008. The age of women trying to get pregnant was reconfirmed to be the most important factor that may have impact on success of ART treatment.
Electronic Mail ; Embryo Transfer ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Korea* ; Live Birth ; Oocyte Donation ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate ; Pregnancy, Twin ; Reproduction ; Reproductive Techniques ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic

Rapid progress has been made in the field of infertility since the first IVF (in vitro fertilization) baby was born in 1978. Controlled ovarian stimulation with FSH is currently the standard procedure for ovarian stimulation before follicular aspiration. Gonadotropin-releasing hormone agonists and antagonists have been used to prevent endogenous LH surge during controlled ovarian hyperstimulation.The goal of controlled ovarian stimulation with gonadotropins is to obtain a large number of mature oocytes and thereby improve the likelihood of obtaining an adequate number of embryos for subsequent transfer. IVF was initially presented as a treatment for tubal factor infertility but was quickly utilized in other areas in the field of infertility, such as male factor infertility and even ovarian failure. ICSI (intracytoplasmic sperm injection) is a more recent approach for male factor treatment, which allows the sperm to be directly injected into the egg using micromanipulation. Preimplantation genetic diagnosis can be performed on embryos prior to the embryo transfer. The complications associated with the IVF program include ovarian hyperstimulation syndrome and multiple pregnancies. The multiple pregnancies are directly related to the practice of transferring multiple embryos at embryo transfer. Each IVF clinic publishes its pregnancy rates. However, comparisons between clinics are difficult because the success rates vary depending on the distribution of underlying causes and age of the patients. The current take-home-baby rate is only 34.7%. In 2005, the Korean government enacted a law to regulate many aspects of IVF practice.
Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Jurisprudence ; Male ; Micromanipulation ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Ovum ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Preimplantation Diagnosis ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic ; Spermatozoa

OBJECTIVE: This study was designed to report the status of assisted reproductive technology (ART) therapy in South Korea between January 1, 2012 and December 31, 2012. METHODS: A localized online survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was first launched and provided to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized as standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI. Thawed embryo transfer (TET) and other related procedures, including surgical sperm retrieval, were surveyed. RESULTS: Data from 33,956 ovum pick-up procedures were provided by 75 clinics in 2012. Of the 33,088 cycles in which ovums were retrieved, a complete transfer was performed in 90.5% (29,932 cycles). In addition, 10,079 FET cycles were confirmed to have resulted in clinical pregnancy, representing a pregnancy rate of 30.5% per ovum pick-up and 33.7% per ET. The most common number of embryos transferred in FET was 2 (41.6%), followed by 3 (34.0%), and non-elective single ETs (10.0%). Of the 10,404 TET cycles in which transfer was completed, 3,760 clinical pregnancies (36.1%) were confirmed by ultrasonography. CONCLUSION: The overall clinical pregnancy rate for FET and TET cycles in 2012 was higher than in 2011 (33.7% vs. 33.2% and 36.1% vs. 31.1%, respectively). The most common number of embryos transferred in FET cycles was 2, unlike in 2011.
Electronic Mail ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Korea* ; Ovum ; Pregnancy ; Pregnancy Rate ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Ultrasonography

One of the most important complications in assisted reproductive technology (ART) is multiple pregnancy, which is associated with an increased risk of maternal and perinatal complications. There have been several attempts to achieve the highest pregnancy rates while minimizing multiple pregnancy rates in in vitro fertilization and embryo transfer (IVF-ET). One approach for this purpose is extended embryo culture and transfer of fewer (one or two) blastocysts. However, there are emerging concerns about the increase of the risk for embryo splitting and subsequent monozygotic multiple pregnancy with this approach. Recently, there have been several reports on the possible increased risk of monozygotic twinning after extended embryo culture and blastocyst transfer. We have experienced a case of two sets of monozygotic twins after intracytoplasmic sperm injection (ICSI) and transfer of two blastocysts. We report the first case of pregnancy of monozygotic twins after blastocysts transfer with a brief review of literature in Korea.
Blastocyst* ; Embryo Transfer* ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Korea ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic* ; Twinning, Monozygotic ; Twins, Monozygotic*

OBJECTIVE: The number of assisted reproductive technology (ART) clinics, ART cycles, clinical pregnancy rate (CPR), and number of newborns conceived using ART have steadily increased in South Korea. This aim of this study was to describe the status of ART in South Korea between January 1 and December 31, 2011. METHODS: A localized online survey was created and sent to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized depending on whether standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI procedures were used. Thawed embryo transfer (TET) and other related procedures were surveyed. RESULTS: Data from 36,990 ART procedures were provided by 74 clinics. Of the 30,410 cycles in which oocytes were retrieved, a complete transfer was performed in 91.0% (n=27,683). In addition, 9,197 cycles were confirmed to be clinical pregnancies in the FET cycles, representing a pregnancy rate of 30.2% per oocyte pick-up and 33.2% per ET. The most common number of embryos transferred in the FET procedures was three (38.1%), followed by two (34.7%) and one (14.3%). Of the 8,826 TET cycles, 3,137 clinical pregnancies (31.1%) were confirmed by ultrasonography. CONCLUSION: While the overall clinical pregnancy rate for the TET cycles performed was lower than the rate reported in 2010 (31.1% vs. 35.4%), the overall CPR for the FET cycles was higher than in 2010 (33.2% in 2011 and 32.9% in 2010). The most common number of embryos transferred in FET cycles was three, as was the case in 2010.
Cardiopulmonary Resuscitation ; Electronic Mail ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Humans ; Infant, Newborn ; Korea* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic ; Ultrasonography

OBJECTIVE: Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea. This study was designed to report on the current status of ART therapy in South Korea between January 1 and December 31 of 2010. METHODS: A revised survey, originally developed by the International Committee Monitoring Assisted Reproductive Technologies, was sent to all available ART centers via email in 2013. Fresh embryo transfer (FET) cases were categorized into standard IVF or intracytoplasmic sperm injections. These cases, the thawing embryo transfer (TET) cases, and other related procedures were surveyed. RESULTS: Data from 30,785 ART procedures were provided by 78 clinics. Of the 28,200 cycles in which oocytes were retrieved, 92.2% of these cycles were completely transferred. In addition, 8,075 cycles were confirmed to be clinical pregnancies in the FET cycles, which represent a pregnancy rate of 28.6% per oocyte pick-up and 31.1% per embryo transfer. The most common number of embryos transferred in the FET was three embryos (37.3%) followed by two embryos (36.3%) and one embryo (14.0%). Of the 6,648 TET cycles transferred, 2,356 clinical pregnancies were confirmed by ultrasonography. The most common number of embryos in the TET group was two embryos (43.4%) followed by three embryos (25.4%) and one embryo (18.9%). CONCLUSION: The clinical pregnancy rate per transfer in the FET cycles was similar in 2009 and 2010. Among the FET cycles where one or two embryos were transferred, the clinical pregnancy rate per transfer slightly increased from 2009 (28.7%) to 2010 (32.9%).
Art Therapy ; Electronic Mail ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Korea ; Oocytes ; Pregnancy ; Pregnancy Rate ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic ; Ultrasonography

We experienced two cases of de novo fetal chromosomal abnormalities after assisted reproductive technology (ART): One case was reciprocal translocation 46,XX,t(6;14)(p21.3;q12) after intracytoplasmic sperm injection and embryo transfer (ICSI-ET) and the other case was 46,X,iso(Xq) after in vitro fertilizaton and embryo transfer (IVF-ET), both were diagnosed prenatally by amniocentesis and postnatally cord blood culture. We report these cases with a brief review of literatures.
Amniocentesis ; Chromosome Aberrations* ; Embryo Transfer ; Fetal Blood ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic

Sperm selection plays an important role in assisted reproductive technology. In recent years, sperm evaluation is not limited to the assessment of sperm motility and morphology, but involves more other sperm characteristics such as sperm ultrastructure, DNA integrity, apoptosis and membrane. Assessment based on these characteristics is becoming the aim of sperm selection. This article gives an overview on several newly developed techniques for sperm selection according to different technical principles, such as electrophoretic separation, zeta potential, HA binding, Annexin V binding, intracytoplasmic morphologically selected sperm injection (IMSI) and microfluidic sperm sorter, which have all been applied to IVF or ICSI with the exception of microfluidic sperm sorter. It also introduces the advantages, disadvantages and application effects of these techniques.
Cell Separation ; Fertilization in Vitro ; methods ; Humans ; Male ; Reproductive Techniques, Assisted ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; methods

For infertility treatment, the selection of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is decided by multiplying indicators (including fallopian tube factors, semen count, and semen motility), except for sperm morphology. In this study, we conducted a retrospective analysis, from implantation to birth, over a period of 5 years. A total of 1873 couples with primary or secondary fallopian tube factors and an increased defective sperm morphology rate (DSMR) were divided into different groups to receive IVF or ICSI cycles. By comparing the outcomes, we found that the F1 group (DSMR <96%, IVF group 1) had higher cleavage rate, biochemical pregnancy rate, clinical pregnancy rate, and live birth rate than the F3 group (DSMR >98%, IVF group 3; P < 0.05). In contrast, there was no significant difference in the ICSI subgroups. Furthermore, a comparison of the outcomes between IVF and ICSI showed that the S3 group (DSMR >98%, ICSI group 3) had higher cleavage rate (P < 0.001), biochemical pregnancy rate (P < 0.05), clinical pregnancy rate (P < 0.05) and live birth rate (P < 0.05) than the F3 group. However, the ICSI subgroup had a lower two pronuclei fertilization rate than the IVF subgroup (P < 0.05). Our data suggest that the sperm morphology should also be considered when selecting IVF or ICSI combined with other semen parameters before the first assisted reproductive technologies (ART) cycle, especially for males with severe sperm defects.
Female ; Fertilization in Vitro ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Reproductive Techniques, Assisted ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Spermatozoa

Infertility affects 10%-15% of couples worldwide. Of all infertility cases, 20%-70% are due to male factors. In the past, men with severe male factor (SMF) were considered sterile. Nevertheless, the development of intracytoplasmic sperm injection (ICSI) drastically modified this scenario. The advances in assisted reproductive technology (ART), specifically regarding surgical sperm retrieval procedures, allowed the efficacious treatment of these conditions. Yet, before undergoing ICSI, male factor infertility requires careful evaluation of clinical and lifestyle behavior together with medical treatment. Epidemiologically speaking, women whose male partner is azoospermic tend to be younger and with a better ovarian reserve. These couples, in fact, are proposed ART earlier in their life, and for this reason, their ovarian response after stimulation is generally good. Furthermore, in younger couples, azoospermia can be partially compensated by the efficient ovarian response, resulting in an acceptable fertility rate following in vitro fertilization (IVF) techniques. Conversely, when azoospermia is associated with a reduced ovarian reserve and/or advanced maternal age, the treatment becomes more challenging, with a consequent reduction in IVF outcomes. Nonetheless, azoospermia seems to impair neither the euploidy rate at the blastocyst stage nor the implantation of euploid blastocysts. Based on the current knowledge, the assessment of male infertility factors should involve: (1) evaluation - to diagnose and quantify seminologic alterations; (2) potentiality - to determine the real possibilities to improve sperm parameters and/or retrieve spermatozoa; (3) time - to consider the available "treatment window", based on maternal age and ovarian reserve. This review represents an update of the definition, prevalence, causes, and treatment of SMF in a modern ART clinic.
Azoospermia ; Female ; Fertilization in Vitro/methods* ; Humans ; Infertility, Male/therapy* ; Male ; Prevalence ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic/methods* ; Spermatozoa