Browsing by Author "Yang, Wen-Jui"

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Embryonic early-cleavage rate is decreased with aging in GnRH agonist but not inantagonist protocols
(2015-05-01)
Yang, Wen-Jui
;
Hwang, Yu-Chyi
;
Lin, Chih-Sheng
;
Hwu, Yuh-Ming
;
Lee, Robert Kuo-kuang
The aim of this study was to evaluate the correlation between embryonic early-cleavage status and the age of patients receiving either a GnRH agonist long protocol or a GnRH antagonist protocol. This retrospective study included 534 patients undergoing a fresh cycle of oocyte retrieval and day-3 embryo transfer. Of the 534 patients treated, 331 received a GnRH agonist long stimulation protocol (GnRH agonist group) for ovarian stimulation and 203 patients received a GnRH antagonist protocol (GnRH antagonist group). By logistic regression analysis, the rate of embryonic early-cleavage was significantly decreased with increasing age of women in the agonist (P < 0.001) but not in antagonist groups (P = 0.61). Based on the results of this study, maternal age is a critical factor for embryonic early-cleavage in agonist protocol but not in antagonist protocol. The results also showed that early-cleavage embryos were of better quality and resulted in a higher pregnancy rate than late-cleavage embryos in the GnRH agonist group. However, embryo quality and pregnancy rate was not significantly different between early and late cleavage embryos in the GnRH antagonist group. We conclude that embryonic early-cleavage status is negatively correlated with aging in women receiving GnRH agonist long down-regulation but not in GnRH antagonist protocols. We also conclude that early cleavage of the zygote is not a reliable predictor for pregnancy potential using the GnRH antagonist protocol.
Is routine single-incision laparoscopic cholecystectomy feasible? A retrospective observational study
(2015-08-01)
Chuang, Shu-Hung
;
Yang, Wen-Jui
;
Chang, Chih-Ming
;
Lin, Chih-Sheng
;
Yeh, Meng-Ching
BACKGROUND: Single-incision laparoscopic cholecystectomy (SILC) has been shown to be safe for uncomplicated gallbladder diseases. Routinely applying SILC is debatable. METHODS: Two hundred SILCs were performed with single-incision multiple-port longitudinal-array and self-camera techniques. RESULTS: Eighty-eight (44%) procedures were scheduled for complicated diseases. The routine group had a higher comorbidity rate, a lower preoperative endoscopic retrograde cholangiopancreatography rate, a higher intraoperative cholangiography rate, a higher proportion of complicated gallbladder diseases, shorter operative time, more intraoperative blood loss, and lower postoperative pethidine dose than the selective group (the first 73 patients). The conversion and complication rates showed no statistical difference. It took fewer cases but longer time to pass the learning phase of SILC for complicated gallbladder diseases. The multivariate analysis showed that male sex and complicated gallbladder diseases were associated with a higher procedure conversion rate, and increased patient age was related to a higher complication rate. CONCLUSIONS: Routine SILC for benign gallbladder diseases is feasible in the experienced phase. Practicing SILC for uncomplicated gallbladder diseases helps to achieve competence in this technique for complicated diseases. (C) 2015 Elsevier Inc. All rights reserved.
Matrix metalloproteinase 2 level in human follicular fluid is a reliable marker of human oocyte maturation in in vitro fertilization and intracytoplasmic sperm injection cycles
(2015-09-04)
Yang, Wen-Jui
;
Liu, Fon-Chang
;
Hsieh, Jih-Sheng
;
Chen, Ching-Hung
;
Hsiao, Shun-Yu
Background: To determine whether matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMP-1 and TIMP-2) in human follicular fluid, have any relationships with oocyte maturation in vivo and subsequent fertilization during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles. Methods: The follicular fluids were obtained from 150 female patients undergoing IVF/ICSI cycles and a total of 1504 oocytes were retrieved for analysis. MMP-2 and MMP-9 activities were measured using zymography assay. TIMP-1 and TIMP-2 concentrations were quantitatively assessed using enzyme-linked immunosorbent assay (ELISA). Results: Human follicular fluid MMP-2 level was significantly associated with the rate of maturity of oocytes (P < 0.001). Furthermore, the MMP-2 was significantly associated with the higher fertilization rate (P < 0.01). There was no significant correlation between follicular MMP-9 and the maturation rate of oocytes. The TIMP-1 and TIMP-2 also showed no correlation with the oocyte maturation rate. Conclusions: The level of gelatinase MMP-2 in human follicular fluid might be a reliable marker of mature oocytes during IVF/ICSI cycles. Furthermore, the MMP-2 expression has a strong association with higher fertilization rate. Further studies are needed to support this theory.