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, and Cucurbita 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.

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ObjectiveThe 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.MethodsThis 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 (<10%, 10% to <30%, 30% to <50%, 50% to <70%, 70% to <90%, and 90% to 100%).ResultsRegardless of the ejaculated motile sperm concentration (0.6–280×106/mL motile spermatozoa), the incidence of TFF significantly increased when MSPPI was <10%, and the fertilization rate significantly decreased when MSPPI was <30%. We found that cumulative MSPPI correlated with the cumulative fertilization rate (Spearman correlation, 0.508, p<0.001). Regarding embryo development, we observed no significant differences in the rates of blastocyst development, chemical pregnancy, clinical pregnancy, or live birth among all groups.ConclusionOur findings suggest that MSPPI is a viable indicator for split IVF-ICSI and ICSI. Taken together, by employing the MSPPI test in advance before IVF, ICSI, or split IVF-ICSI cycles, unnecessary split IVF-ICSI and ICSI may be avoided.