P4過高易造成懷孕率下降

60000 IVF case顯示
P4過高(>正常質0.8ng/ml)易造成懷孕率下降

P4過高對於冷凍胚胎懷孕率無明顯影響

http://humupd.oxfordjournals.org/content/19/5/433.abstract

COH後,子宮內膜PR 表現上升, ER表現下降

COH後,子宮內膜PR 表現上升, ER表現下降

優質胚胎可能可克服較差(P4上升)之內膜環境

Day 2-3胚胎著床率IR約10-15%

http://humrep.oxfordjournals.org/content/20/6/1541.full

囊胚期胚胎植入可能可降低過早黃體化不良影響

過早黃體化(施打hCG當天hCG>1.5, 機率約18.2%)---可能影響胚胎著床率

延後胚胎植入至囊胚期胚胎植入可能可降低其不良影響

http://www.ncbi.nlm.nih.gov/pubmed/17555751?dopt=Abstract

蜂蜜& Vit E 有助於精蟲生長

動物實驗顯示，蜂蜜& Vit E 有助於精蟲生長

http://www.jhrsonline.org/article.asp?issn=0974-1208;year=2013;volume=6;issue=1;spage=54;epage=58;aulast=Hemadi

Embryo loading方式比較

Embryo loading方式(In Group A, the embryos were drawn directly into the ET catheter from culture microdrop under the oil. In Group B, the embryos were transferred from culture microdrop into G2 medium in center-well dish. )
比較


http://www.jhrsonline.org/article.asp?issn=0974-1208;year=2013;volume=6;issue=1;spage=65;epage=69;aulast=Halvaei

Impact of different embryo loading techniques on pregnancy rates in in vitro fertlizaton/embryo transfer cycles

Background: Embryo transfer (ET) technique is one of the important factors of in vitro fertlization success. Among the different steps in ET technique, less attention has been given to embryo loading (EL). The aim was to compare the impact of two different techniques of EL on pregnancy rate in IVF/ET cycles. Materials and Methods: In this retrospective study, 144 and 170 patients were placed in groups A and B, respectively. In Group A, the embryos were drawn directly into the ET catheter from culture microdrop under the oil. In Group B, the embryos were transferred from culture microdrop into G2 medium in center-well dish. Then, the embryos were drawn into the catheter and finally transferred into the uterus. Both groups were adjusted for other parameters based on the EL technique. The main outcome measure was pregnancy rate. Results: There were insignificant differences for etiology of infertility, source of sperm, type of stimulation protocol, percent of IVF or intracytoplasmic sperm injection type of ET catheter, cycles with good quality embryos and transferred embryos between two groups. The rate of both chemical and clinical pregnancy was higher in Group B compared to A, but the difference was insignificant (P = 0.09 and P = 0.1, respectively). Conclusion: It seems that there is no difference in the outcome by loading the embryo from microdrop or center-well dish.

Table 1: Comparison of different clinical characteristics between groups A (embryo drawn directly from microdrop) and B (embryo drawn from transfer medium)

縮減囊胚腔體積可能可提高冷凍解凍懷孕率

縮減囊胚期胚胎之囊胚腔體積，可能可提高冷凍解凍懷孕率

http://www.rbej.com/content/7/1/99

性生活對於IVF胚胎植入懷孕率並無明顯影響

植入胚胎前後性生活，對於胚胎懷孕率並無明顯影響，甚至可能可提高胚胎著床率

http://humrep.oxfordjournals.org/content/15/12/2653.full

無精症檢查

無精症病患需
測FSH, Testosterone, PRL,
尿液離心精蟲檢查，睪丸切片
PE檢查(靜脈曲張，睪丸萎縮，隱睪，副睪)
染色體分析

Low FSH, low Testosterone---原發性低性腺男性不孕症hypogonadotropic hypogonadism
Normal FSH & Testosterone---可能是阻塞性無精症 ，睪丸先天異常

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093801/?report=reader

培養液長期放置可能對胚胎有不良影響

培養液長期放置於37度C培養箱(overnight)可能對胚胎有不良影響

prolong euilibration of culture medium might be detrimental for embryo.

http://www.ncbi.nlm.nih.gov/pubmed/15705308?dopt=Abstract&holding=f1000,f1000m,isrctn

Reprod Biomed Online. 2005 Jan;10(1):124-9.

胚葉細胞越多對於外界環境之耐受性越高

2-cell比PN時期胚胎更能忍受高溫之培養環境

胚葉細胞越多對於外界環境之耐受性越高
http://www.ncbi.nlm.nih.gov/pubmed/1627931

溫度下降易傷害細胞質內胞器

胚胎細胞核(PN) vs 胚胎細胞質

胚胎細胞質對於溫度(下降)變化之敏感性較細胞核為高

溫度下降容易造成胚胎細胞質內胞器&紡錘體傷害

http://www.ncbi.nlm.nih.gov/pubmed/9211428

低養培養對胚胎是否明顯有益仍充滿爭議

低氧培養(5%O2) vs 大氣培養(19.3%O2)
對胚胎受孕(D0)及早期發育達(D0-3)無明顯差異

對胚胎晚期(D4,5)&著床是否明顯有助益仍充滿爭議

http://www.rbej.com/content/9/1/143