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Purpose: Pelvic adhesions inhibit follicular growth and ovum transport, causing female infertility. In this report, we describe successful ovum pick-up (OPU) during adhesiotomy in a woman with severe adhesions that prevented transvaginal OPU. Subsequently, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) were attempted after transport of cumulus-oocyte complexes (COCs). Materials and methods: Clinical examination revealed a chocolate cyst on the patient's left ovary. Her right ovary was adherent to the posterior part of the uterus. COCs were harvested during adhesiotomy and stored at 37°C in a 1.5-ml tube containing Sperm Washing Medium. The tube was transported to our clinic using hot gel bags and a portable infant incubator. Immediately upon arrival, IVF and ICSI were performed. On day 7, two ICSI-derived blastocysts were cryopreserved. Two months later, these blastocysts were transferred to the patient's uterus. Results: The patient conceived, and a normal, healthy boy...

The endometrial condition is a significant factor for successful pregnancy. To regulate endometrial function in fertility treatment, prednisolone (PSL) is administered for suppression of increased natural killer cells and stimulation of endometrium embryo transfer (SEET) to enhance communication between embryo and maternal tissues. We attempted to improve the endometrial condition by PSL administration and SEET during frozen–thawed blastocyst transfer (FBT). Patients took PSL (5 mg) 3 times daily for 3 days after ovulation during the FBT cycle. To analyse effects of PSL combined with SEET, we determined rates of chemical pregnancy, clinical pregnancy, foetal heart movement (FHM) and live birth. Rates of chemical pregnancy, clinical pregnancy and FHM were significantly higher in the PSL(+)/SEET(+) (57.7%, 50.0% and 46.2%, respectively) and PSL(+)/SEET(-) (53.3%, 46.7% and 46.7%, respectively) groups than in the PSL(-)/SEET(+) (30.3%, 18.2% and 18.2%, respectively) and PSL(-)/SEET(-) (22.4%, 22.4% and 18.4%; P = 0.0043, 0.0081 and 0.0055, respectively) groups. The live birth rate was significantly higher in the PSL(+)/SEET(+) group than in the PSL(+)/SEET(-), PSL(-)/SEET(+) and PSL(-)/SEET(-) groups (42.3%, 26.7%, 18.2% and 12.2%, respectively; P = 0.0237). PSL combined with SEET may be a useful adjunct to assisted reproductive technology in women who repeatedly fail to conceive by infertility treatment.

Maternal age is a significant factor in infertility treatment. Ovarian function and oocyte quality decrease with age, whereas the frequency of chromosomal abnormalities increases. In this study, improvement of oocyte quality and ovarian function were attempted using a herbal medicine comprising 7 crude drugs:Angelicae radix,Rehmanniae radix,Plantaginis semen,Lonicerae flos,Carthami flos,Ginseng radix, andCucurbita moschata Duch. Thirty-one women who repeatedly failed to conceive by intracytoplasmic sperm injection took the herbal medicine before breakfast and dinner from the start of menstrual cycle in the ovum pickup cycle. Average patient age was 38.5 ± 0.7 years, and the average ovum pickup frequency on the first dosage day was 7.9 ± 1.5. To analyze the effects of herbal medicine intake, the number of recovered and mature oocytes, their morphology and physical qualities, as well as the rates of fertilization, oocyte development, and pregnancy was compared before and after intake. The recovered and mature oocyte numbers, oocyte morphology and physical qualities, and fertilization rate were not significantly different before and after drug intake. However, the oocyte development rate was significantly higher(58.0%) after herbal medicine intake than before (32.5%; p = 0.0003). Moreover, the successful pregnancy rate was significantly higher after intake than before (6.9% versus 0%; p = 0.0111). Herbal medicine may constitute a useful adjunct to assisted reproductive technology in women.

This case report describes two successful pregnancies after intracytoplasmic sperm injection (ICSI) with testicular spermatozoa that were transported under refrigeration. Two first-time couples consulted our clinic concerned about their primary infertility. No sperm were present in the semen samples from either of the husbands and they were referred to the urology department (UD) of a neighbouring hospital. At the UD, seminiferous tubules were obtained by testicular sperm extraction. The tissue samples were put in a centrifuge tube with phosphate-buffered saline at 6°C and placed with refrigerant in a cushioned styrofoam box that was then transported to our clinic. Immediately upon arrival at our clinic, testicular spermatozoa were extracted. On the same day, ovum pickup was performed and mature oocytes were extracted that were then inseminated by conventional ICSI. Fertilized eggs were cultured for 2 days, and then cleaved embryos were cryopreserved. In one case after 4 months and in the other case after 2 months of cryopreservation, the frozen-thawed embryos were transferred. Both patients became pregnant and normal, healthy babies were born. These results suggest that cases of obstructive azoospermia can be treated with ICSI by refrigerated transport of the seminiferous tubules, in cooperation with a UD, in a small single departmental obstetrics and gynecology clinic.

Objective The decision to use in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or split insemination (IVF-ICSI) in the first cycle is based on the number of motile sperm. Hence, total fertilization failure (TFF) often occurs during IVF cycles, despite normozoospermia. To investigate whether the cumulative motile swim-up spermatozoa percentage at 22 hours post-insemination (MSPPI) is an indicator for ICSI, we analyzed TFF, fertilization, blastocyst development, chemical pregnancy, clinical pregnancy, and live birth rates. Methods This prospective study was performed using data obtained from 260 IVF cycles. At 22 hours after insemination, the remaining swim-up spermatozoa were observed and divided into six groups according to MSPPI (