10-1(조사보고서).PDF

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1 Vol. No. Octob er : 997 Curr ent St atus of A s sisted Repr oductiv e T echnology in K orea,

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4 Fig.. Location of certified ART clinics in Korea,

5 -< > : Table..,., 3.,., 5., 6., 7., 8., 9.,.,.,., 3.,., 5., 6., 7., 8., 9.,.,.,., 3.,., 5., 6., 7., 8., 9., 3., 3., 3., 33., 3., 35., 36., 37., 38., 39.,.,.,., 3.,., 5., 6., 7., 8., ( )., Fax..(p.???? - p.???? ) (, )

6 Name of IVF centre( ) Contact person : ( ) Name Address Tel Fax All data relate to treatment cycles that were started during the calendar year, 997, and to any clinical pregnancies resulting from those treatment cycles. Please complete as many data items as possible (n = number). If data are not available for some items, write NA. Gestational age (duration of pregnancy) should be calculated by adding days ( weeks) to the number of completed weeks between the date of fertilization (conception) and the date of completion of the pregnancy In the following tables :. IVF includes those treatment cycles and pregnancies in which fertilization occurred, or was intended to occur, in the laboratory and fresh embryos were transferred to the uterus or fallopian tubes. This heading excludes : () frozen/thawed embryo transfer cycles ; and () microinsemination techniques.. ICSI includes those treatment cycles and pregnancies that follow transfer of fresh embryos after intracytoplasmic sperm injection. Transfer cycles after both ICSI and embryo freezing are recorded separatedly.. GIFT includes only those cycles and pregnancies in which gametes (oocytes and sperm) were transferred to the fallopian tubes (excluding combined IVF and GIFT in the same cycle, which should be recorded in IVF category).. Any cycles in which frozen/thawed embryos were transferred should be excluded from Tables,, and 3. Pregnancy outcomes after transfer of thawed embryos should be excluded from Tables, 5, 8 and 9.. Oocyte donation cycles and pregnancies should be included in Tables 3,, 5, 8 and 9, and in Table if frozen/thawed embryos were transferred.. Maternal age refers to age at the start of the treatment cycle. If you did not perform IVF practice in 997, check here. Not done If you performed IVF practice in 997, please fill out tables below

7 -< > : Table. Treatment cycles and pregnancies, 997 Treatment cycles/pregnancies* IVF ICSI GIFT n n n Cycles initiated (started) Cycles with attempted oocyte retrieval (aspiration) Cycles with embryo transfer Clinical pregnancies Pregnancies with one or more live births This table excludes cycles in which frozen/thawed embryos were transferred. * The number of cycles started should include both stimulated and natural cycles. Clinical pregnancies include those with clinical signs of pregnancy, sonographic visualization of a gestational sac, or products of conception from curettage. Biochemical pregnancies in which there are only elevated levels of -hcg should not be counted

8 Table. Number of oocyte retrieval cycles and clinical pregnancies by maternal age, cause of infertility, and type of ovulation induction, 997 Characteristics IVF ICSI GIFT Oocyte retrieval Clinical Oocyte retrieval Clinical Oocyte retrieval Clinical cycles attempted Pregnancies cycles attempted pregnancies cycles attempted pregnancies Maternal age at start of treatment. less than 5 years n n n n n n and over Cause(s) of infertility. tubal only. other female only. male factors only. multiple causes. unexplained Ovulation induction. GnRH analogues+other. No GnRH analogues. clomiphene + any other. other drugs. natural cycles This table excludes cycles using frozen/thawed embryos or microinsemination. * The groups in the sections on cause of infertility and ovulation induction are mutually exclusive so each treatment cycle or pregnancy should be included in only one group

9 -< > : Table 3. Embryos or oocytes transferred, 997 Number of embryos/ IVF ICSI GIFT oocytes transferred Transfer Clinical Transfer Clinical Transfer Clinical cycles Pregnancies cycles pregnancies cycles pregnancies. One. Two n n n n n n. Three. Four. Five. Six or more This table excludes cycles in which frozen/thawed embryos were transferred and also those cycles for other types of microinsemination (eg SUZI) Table. Outcome of clinical pregnancies, 997 Outcome of clinical pregnancies* IVF ICSI GIFT Spontaneous abortion (less than completed weeks' gestation) n n n Ectopic pregnancy Induced abortion (less than completed weeks' gestation) Stillbirth : -7 weeks Stillbirth : 8 or more weeks Live birth Total * Include each multiple pregnancy of or more weeks' gestation only once in the table. If both live births and stillbirths occur in the same pregnancy, include it in the figures for live birth. For combined intrauterine and extrauterine pregnancies, count as ectopic pregnancy if intrauterine pregnancy terminates at less than weeks and as stillbirth or live birth if pregnancy is completed at or more weeks. The total number of pregnancies should be the same as in Table. This table excludes pregnancies resulting from transfer of thawed embryos or other microinsemination techniques

10 Table 5. Live births, stillbirths, and early neonatal deaths* by plurality, 997 Plurality/Births IVF ICSIGIFT Singletons live births n n n stillbirths: -7 weeks` gestation stillbirths: 8 weeks` or more early neonatal deaths Twins live births stillbirths: -7 weeks` gestation stillbirths: 8 weeks` or more early neonatal deaths Triplets live births stillbirths: -7 weeks` gestation stillbirths: 8 weeks` or more early neonatal deaths Quadruplets and higher order multiple births live births stillbirths: -7 weeks` gestation stillbirths: 8 weeks` or more early neonatal deaths This table excludes pregnancies resulting from transfer of thawed embryos or from other microinsemination techniques. In this table, n=number of babies, not the number of pregnancies. * Early neonatal deaths are liveborn infants dying in the first 7 days. They should be included in the numbers both of live births and of early neonatal deaths

11 -< > : Table 6. Oocyte retrieval cycles, transfer cycles and pregnancies using special techniques of sperm collection and/or assisted hatching, 997 Selected techniques Oocyte Transfer Clinical Pregnancies retrieval cycles cycles pregnancies with live attempted births. Microepididymal sperm aspiration (MESA). Testicular sperm extraction (TESE). Other and unspecified techniques n n n n. Assisted hatching Table 7. Transfer cycles and pregnancies after oocyte donation, 997 Outcome of clinical pregnancies* IVF ICSI GIFT Oocyte donation: IVF (without embryo freezing) n n n Oocyte donation and frozen/thawed embryos: IVF Oocyte donation: GIFT Donor embryos This table excludes pregnancies resulting from transfer of thawed embryos or other microinsemination techniques

12 Table 8. Gestational age of pregnancies* of or more weeks by plurality, 997 Gestational age Singletons Twins Triplets Quadruplets (Completed weeks) or more IVF : or more Not known Total ICSI : or more Not known Total GIFT : or more Not known Total n n n n This table excludes pregnancies resulting from transfer of thawed embryos or from other microinsemination techniques(eg SUZI). * Count each pregnancy only once for multiple births : include those pregnancies resulting both in live births and stillbirths. If the births in a multiple pregnancy occur in different gestational age groups, include that pregnancy in the shortest gestational age group

13 -< > : Table 9. Birth weight of liveborn and stillborn infants of or more weeks' gestation, 997 Birth weight* Singletons Twins Triplets Quadruplets or more IVF Less than 5g n n n n 5g or more Birth weight not stated Total ICSI Less than 5g 5g or more Birth weight not stated Total GIFT Less than 5g 5g or more Birth weight not stated This table excludes pregnancies resulting from transfer of thawed embryos or from other microinsemination techniques (eg. SUZI). * Include both live births and stillbirths of or more weeks' gestation. In this table, n = number of babies, not the number of pregnancies

14 Table. Pregnancy outcome after transfer of frozen/thawed embryos (including all techniques of oocyte retrieval but excluding ICSI), 997 Cycles and outcome of clinical pregnancies* Number Transfer cycles Clinical pregnancies Spontaneous abortion (less than completed weeks' gestation) Ectopic pregnancy Induced abortion (less than completed weeks' gestation) Pregnancies of weeks Singletons Twins Triplets Quadruplets gestation or more or more Gestational age (pregnancies). - 7 weeks (p) n n n n. 8-3 weeks (p) weeks (p) weeks (p). weeks or more (p). Not known (p) Live births (n) Stillbirth: -7 weeks (n) Stillbirth: 8 or more weeks (n) Early neonatal deaths (n) Birth weight (babies). Less than 5g (n). 5g or more (n). Not known (n) * For live births, stillbirths, early neonatal deaths and birth weight, the numbers of births (n), not pregnancies should be given. For gestational age, the number of pregnancies (p), not births, should be given. For combined intrauterine and extrauterine pregnancies, count as ectopic pregnancy if intrauterine pregnancy terminates at less than weeks and as stillbirth or live birth if pregnancy is completed at or more weeks

15 -< > : Table. Pregnancy outcome after combined ICSI and transfer of frozen/thawed embryos, 997 Cycles and outcome of clinical pregnancies* Number Transfer cycles Clinical pregnancies Spontaneous abortion (less than completed weeks' gestation) Ectopic pregnancy Induced abortion (less than completed weeks' gestation) Pregnancies of weeks Singletons Twins Triplets Quadruplets gestation or more or more Live births n n n n Stillbirth: -7 weeks Stillbirth: 8 or more weeks Early neonatal deaths Gestational age (pregnancies). - 7 weeks. 8-3 weeks weeks weeks. weeks or more. Not known birth weight (babies). Less than 5g. 5g or more. Not known * For live births, stillbirths, early neonatal deaths and birth weight, the numbers of births (n), not pregnancies should be given. For gestational age, the number of pregnancies (p), not births, should be given. For combined intrauterine and extrauterine pregnancies, count as ectopic pregnancy if intrauterine pregnancy terminates at less than weeks and as stillbirth or live birth if pregnancy is completed at or more weeks

16 Table. Embryo freezing, 997 Have you ever performed embryo freezing in 997 Yes No Number of oocyte pick-up(opu) cycles that resulted in embryo freezing in 997 Number of embryos that were frozen in 997 Total number of embryos in frozen storage at 3 December 997 Table 3. Major congenital malformations and chromosomal abnormalities, 997 Technique of Total number of births Number of malformed assisted conception and induced abortions fetuses and infants* IVF: fresh embryos IVF: frozen embryos ICSI: fresh embryos ICSI: frozen embryos Other microinsemination techniques Assisted hatching Oocyte donation * Do not include minor birthmarks of the skin, postural talipes, or clicky hips

17 -< > : (in vitro fertilization and embryo transfer: IVF-ET) (intracytoplasmic sperm injection: ICSI) IVF-ET ICSI. (zygote intrafallopian transfer: ZIFT).,, /, Table. Number of IVF centers according to size (total number of treatment cycles in the year) Number of treatment cycles started in year* Less than , or more Total number of IVF centers Number of IVF centers providing data for this report Number of IVF centers * The total number of treatment cycles is based on all IVF, GIFT, and microinsemination cycles started and those cycles in which there was transfer of frozen/thawed embryos Table. Treatment cycles and pregnancies according to type of ART procedures -hcg. ( ) completed weeks. Microsoft Excel. 3. : ,6 (Table,) , , 6,6 IVF-ET(ICSI ),6 (6.7%), ICSI,58 (5.%) IVF-ET ICSI,57 (87.7%) IVF-ET, (gamete intrafallopian transfer: GIFT) 8 (.%). (cryopreserved embryo transfer: cryopreserved ET),53 (9.%) (Fig. ). (microsurgical epididymasl sperm aspiration: MESA) (testicular sperm extraction: TESE) 9, 7 (assisted hatching),379. (oocyte donation) 336. IVF 7.8%, ICSI 6.8%, GIFT Treatment cycles / pregnancies IVF ICSI GIFT Cycles initiated(started) Cycles with oocyte retrieval Cycles with embryo transfer Clinical pregnancies (CP per transfer, %) Pregnancies with one or more live births (LB per transfer, %) (7.8) 5 (.6) (6.8) 79 (9.) (3.7) 9 (7.) This table excludes cycles in which frozen/thawed embryos were transferred ART : assisted reproductive technology CP : clinical pregnancies LB : live births Fig.. Types of ART procedures

18 % CPR; clinical pregnancy rate ET; embryo transfer LB; live birth Fig. 3. Success rates for different types of ART Table 3. Major congenital malformations and chromosomal abnormalities Technique of assisted conception IVF : fresh embryos IVF : frozen embryos ICSI : fresh embryos ICSI : frozen embryos Other microinsemination techniques Assisted hatching Oocyte donation Total number of births and induced abortions Number of malformed fetuses and infants*(%) 8(.) 3(5.) (.) 3(.3) * Do not include minor birthmarks of the skin, postural talipes, or clicky hips 3.7% IVF.6 %, ICSI 9.%, GIFT 7.% (Table, Fig. 3). ( ) IVF-ET.% (8/37), IVF-ET 5.%(3/58) 3-5%,.%(/96),.3%(3/ 8). (Table 3),... ) Fig.. Percentage of ART users, by ages Fig. 5. Clinical pregnancy rates per oocyte retrieval by age of woman 5.5%, %, 3-3.%, %, 9.5% % (Table, Fig. ) %, %, %, %,.% (Fig. 5). ), (tubal factor only) 36.9%, (other female only) 9.%, (male factors only) 5.%, (multiple causes).%,

19 -< > : Table. Number of oocyte retrieval cycles and clinical pregnancies by maternal age Maternal age at start of treatment Less than 5 years and over IVF ICSI GIFT OR cycles CP OR cycles CP OR cycles CP This table excludes cycles in which frozen/thawed embryos were transferred OR : oocyte retrieval CP : clinical pregnancies Table 5. Number of oocyte retrieval cycles and clinical pregnancies by cause of infertility Cause of infertility IVF ICSI GIFT OR cycles CP OR cycles CP OR cycles CP Tubal only Other female only Male factor only Multiple causes Unexplained This table excludes cycles in which frozen/thawed embryos were transferred OR : oocyte retrieval CP : clinical pregnancies Table 6. Number of oocyte retrieval cycles and clinical pregnancies by type of ovulation induction Ovulation induction IVF ICSI GIFT OR cycles CP OR cycles CP OR cycles CP GnRH analogues + other No GnRH analogues Clomiphene+any other Other drugs Natural cycles This table excludes cycles in which frozen/thawed embryos were transferred OR : oocyte retrieval CP : clinical pregnancies Table 7. Number of transfer cycles and clinical pregnancies by number of embryos/oocyte transferred Number of embryos/oocytes transferred IVF ICSI GIFT transfer cycles CP transfer cycles CP transfer cycles CP One Two Three Four Five Six or more This table excludes cycles in which frozen/thawed embryos were transferred CP : clinical pregnancies

Fig. 6. Primary diagnoses for ART procedures Fig. 8.

Clinical pregnancy rates per oocyte retrieval by cause of infertility (unexplained) 7.

% GnRHa, clomiphene.8%,.% 5.9% (Table 6). GnRHa Fig. 9.

20 Fig. 6. Primary diagnoses for ART procedures Fig. 8. Clinical pregnancy rates per oocyte retrieval by type of ovulation induction Fig. 7. Clinical pregnancy rates per oocyte retrieval by cause of infertility (unexplained) 7.6% (Table 5, Fig. 6). 9.6%, 3.8%, 8.%,.%, 3.3% (Fig. 7).. 3) GnRH agonist(gnrha) ( ) 9.% GnRHa, clomiphene.8%,.% 5.9% (Table 6). GnRHa Fig. 9. Clinical pregnancy rates per transfer by number of embryos/oocytes transferred 9.%,.%, clomiphene 6.%, 6.3% (Fig. 8). ) IVF-ET ICSI 8.8% 3.%, 5 5.7%,.8%, 6.5% (Table 7). 8.% 8.%, 3 35.% 6 36.% (Fig 9)

21 -< > : Table 8. Outcome of clinical pregnancies Outcome of clinical pregnancies IVF ICSI GIFT Spontaneous abortion Ectopic pregnancy Induced abortion Stillbirth:-7wks Stillbirth:8wks or more Live birth This table excludes cycles in which frozen/thawed embryos were transferred Table 9. Live births, stillbirths, and early neonatal deaths* by plurality IVF Live births Stillbirths:-7wks Stillbirths:8wks or more Early neonatal deaths ICSI Live births Stillbirths:-7wks Stillbirths:8wks or more Early neonatal deaths GIFT Live births Stillbirths:-7wks Stillbirths:8wks or more Early neonatal deaths Singletons Twins Triplets Quadruplets or more * Early neonatal deaths are liveborn infants dying in the first 7 days. They should be included in the numbers both of live births and of early neonatal deaths Table. Gestational age of pregnancies of or more weeks by plurality Gestational age (completed weeks) Singletons Twins Triplets Quadruplets or more IVF or more Not known Total 63 9 ICSI or more Not known Total GIFT or more Not known Total

22 % Fig.. Outcomes of clinical pregnancies resulting from ART CPR; clinical pregnancy rate ET; embryo transfer LB; live birth Fig.. Success rates of ART with frozen embryos and fresh embryos.6% 3.7%,,5gm 78.7%, 58.% (Table ).. Fig.. Pluralities among live births 5) 77.5%, 6.%,.9%,.3%,.9% (Table 8, Fig. ). 6) (live birth) 6.3% 3.7%, 3.6%,.3% 38.6%.-5.% (Fig. ).,, 95.6%, 95.%, 95.3 (Table 9) %, 7.5% 7.%. 37.%, 36.8%,.% (Table ).,5gm 7) / (special techniques of sperm collection and/or assisted hatching) (MESA) 9, (TESE) 7 MESA 7.%, TESE 36.6% MESA 7.%, TESE 3.9%., %,.8% (Table ).. (oocyte donation) %, 36.%, 3.%, 3.% (Table 3). 3. (transfer of cryopreserved embryo) 997,6, 997 3,8. 997, ,

23 -< > : Table. Birthweight of liveborn and stillborn infants of or more weeks' gestation Birthweight Singletons Twins Triplets Quadruplets or more IVF Less than 5g 5g or more Birthweight not stated Total ICSI Less than 5g 5g or more Birthweight not stated Total GIFT Less than 5g 5g or more Birthweight not stated Total 7 3 Table. Outcomes of special techniques of sperm collection and assisted hatching MESA TESE Assisted hatching Other and unspecified techniques Cycles with oocyte retrieval Cycles with embryo transfer Clinical pregnancies (CPR per transfer, %) Pregnancies with live births (LB per transfer, %) MESA : microsurgical epididymal sperm aspiration TESE : testicular sperm extraction (7.) 3 (7.) (36.6) 9 (3.9) (6.6) 59 (.8) 3 8 (3.5) 6 (6.7) Table 3. Transfer cycles and pregnancies after oocyte donation OD : IVF without freezing OD : IVF with frozen/thawed embryos OD : GIFT Donor embryos Transfer cycles Clinical pregnancies (CPR per transfer, %) Pregnancies with live births (LB per transfer, %) 9 86 (39.3) 7 (3.) 6 (36.) 36 (3.) (.) (.) OD : oocyte donation Table. Outcomes of transfer of frozen/thawed embryos Transfer cycles Clinical pregnancies (CPR per transfer, %) Outcome of clinical pregnancies Spontaneous abortion Ectopic pregnancy Induced abortion Stillbirth:-7weeks Stillbirth:8 or more weeks Early neonatal deaths Live birth(lb per transfer, %) Combined ICSI (.6) 8(.) All techniques of OR excluding ICSI 3 38 (9.5) (.6)

24 Table 5. Live births, stillbirths, and early neonatal deaths by plurality after transfer of frozen/thawed embryos Singletons Twins Triplets Quadruplets or more Combined ICSI Live births Stillbirths:-7wks Stillbirths:8wks or more Early neonatal deaths All techniques of oocyte retrieval excluding ICSI Live births Stillbirths:-7wks Stillbirths:8wks or more Early neonatal deaths LB : live births Table 6. Gestational age of pregnancies of or more weeks by plurality after transfer of frozen/thawed embryos Gestational age(completed weeks) Singletons Twins Triplets Quadruplets or more Combined ICSI or more Not known 6 3 Total All techniques of oocyte retrieval excluding ICSI or more Not known Total Table 7. Birthweight of liveborn & stillborn infants of or more weeks' gestation after transfer of frozen/thawed embryos Birthweight Singletons Twins Triplets Quadruplets or more Combined ICSI less than 5g 5g or more birthweight not stated 5 total All techniques of oocyte retrieval excluding ICSI less than 5g 5g or more birthweight not stated 6 total ,6 ICSI 97 ICSI,3.6% 9.5%.%.6% (Fig. ). Table, 5, 6,

25 -< > : ,,. ICSI MESA, TESE. /,

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<3033BFF8C0FA2DC3D6BFB5B9CE2E687770> Korean Journal of Obstetrics and Gynecology Vol. 53 No. 12 December 2010 조사보고서한국보조생식술의현황 : 2007년 대한산부인과학회 보조생식술소위원회 Current status of assisted reproductive technology in Korea, 2007 Korean Society of Obstetrics