Though the previous studies (Ⅰ, Ⅱ), it was observed that human follicular fluid (HFF) was more effective than human fetal cord serum (HFCS) on promoting meiotic resumption of oocytes and improving embryonic development of mouse in vitro. On the
basis
of these results, we have gradually exchanged HFCS with HFF as protein supplement in human ART. This study was performed to investigate the efficiency of HFF on improving the pregnancy rate in ART. Oocytes were retrieved transvaginally from
patients
treated with pituitary suppression with GnRH-agonist and ovarian stimulation with human menopausal gonadotro-pin IHMG) and pure follicle stimulating hormone (FSH). Aspirated oocytes were rinsed and cultured in TCM-199 containing HFF, and the
concentrations of HFF were adjusted to 10, 20, and 30% according to the use for insemination, embryo growth and embryo transfer, respectively. As possible as, we tried to do embryo transfer into fallopian tube to mimic the coincidence of the cell
stage
with the place of sojourn in vivo, so we performed various ART programs (IVF & ET; in vitro fertilization, ZIFT; zygote intra fallopian-tube transfer, ZIFT & ET) according to the tubal conditions of patients. On the while, intra cytoplasmic sperm
injection (ICSI) was used to assist IVF of the patients who had known poor standard IVF results by immunological or severe male factor. Of the 255 cycles of ART programs using HFF as protein supplement, 118 cycles turn out to the succeeded in
pregnancy
(46.2%, per cycle, p<0.05), while 21 pregnancies were achieved in the 69 cycles using HFCS (30.4%). The 255 cycles using HFF were subdivided into cycles with the type of ART programs, and each pregnancy rate of the ART programs were 44.7% (IVF &
ET,
76/170 cycles), 53.4% (ZIFT, 31/58 cycles) and 40.7% (ZIFT & ET, 11/27 cycles), respectively. In the 61 ICSI cycles using HFF, 28 cycles succeed in pregnancy (45.9%), while 7 pregnancies were obtained in the 17 ICSI cycles using HFCS. Also the
ongoing
pregnancy rate in the group using HFF (78.8%, 93/118 cycles) was higher than that in the group using HFCS (61.9%). Therefore, we found that the use of HFF as protein supplement was more suitable and effective than the use of HFCS to improve the
pregnancy rate in ART.
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