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第 21 回茨城不妊臨床懇話会 2011 年 12 月 18 日 水戸
男女共同参画社会に関する世論調査 世論調査報告書 平成 21 年 10 月調査
男女共同参画社会に関する世論調査
男女共同参画社会に関する世論調査
男女共同参画社会に関する世論調査
男女共同参画社会に関する世論調査
結婚生活年数と妊娠率
まとめ ,[object Object],[object Object],[object Object],[object Object],[object Object]
妊娠成立の五大条件 ,[object Object],[object Object],[object Object],[object Object],[object Object]
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
子宮 腟 卵管 卵巣 女性のからだ
 
 
 
 
 
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
良い卵管 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
良い精子 ,[object Object],[object Object],[object Object],[object Object],[object Object]
患者も医療スタッフも 運動精子=良好精子 と信じてきた
 
 
 
 
 
採卵直後の卵
精子先体-精子の 卵侵入に不可欠
卵への精子進入 雌性、雄性前核
移植胚 8 細胞期胚 胚盤胞期胚
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
 
 
 
 
 
良い子宮 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
着床
よい妊娠を得るためには よい培養環境 ,[object Object],[object Object],[object Object],よい妊娠 受精
 
不妊症とは、 生殖年齢にある男女が妊娠を希望し、 ある一定期間、性生活を行っているにもかかわらず、 妊娠の成立を見ない状態 妊娠を希望し、医学的な治療を必要とする場合         * 一定の期間:           アメリカ生殖医学会・・ 1年           国際産科婦人科連合・・ 2年           日本産科婦人科学会・・ 2年
男女別頻度 男性 女性 女性+男性
 
性交後精子子宮内上昇試験 性交後 18 時間生存運動精子数と妊娠率 運動精子数 妊娠率( % ) 50 50-100 25 25-33 10 12-8 0-5 0-3
[object Object],[object Object],[object Object],[object Object],生殖補助医療  ART
人工授精
I V F ・  E T 採精 採卵 媒精 移植
 
 
 
 

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第21回茨城不妊臨床懇話会資料

Editor's Notes

  1. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  2. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  3. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  4. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  5. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  6. It is evident that the continuous exposure to the hCG-driven LH-activity in MENOPUR results in a different endocrine environment compared with rFSH stimulation The different endocrine profiles between gonadotrophins are associated with a specific endocrine environment for the maturing oocyte that may have a key impact on embryo quality, implantation success (endometrial receptivity), ongoing pregnancy and, ultimately, live birth rates 1 Smitz et al. Hum Reprod 2007; 22 (3): 676–687
  7. 不妊症の定義については標記のようにされている。 アメリカ生殖医学会では「ある一定期間」を 1 年とし、国際産科婦人科連合では 2 年としている。 日本では、 2 年以上経過しても妊娠が成立しない夫婦を、不妊症と診断している。 これらは生殖機能の正常な男女においては、 1 年以内に90%が妊娠するというデータに基づいている。
  8. 体外受精は卵子を体外に取り出し(採卵)、培養液の中で精子に受精させ(媒性)、受精卵(胚)を子宮に戻して着床(移植)、妊娠させることである。手順は以下の通り。 ① 体外受精の 2 ~ 3 時間前に採精。 ② その後精液を洗浄・濃縮し、スイムアップにより運動精子を回収。 ③ 選別した運動精子を培養液で濃度調整し、卵を含む培養液に添加する(媒性)。 ④ 16 ~ 20 時間後に、卵の細胞質内に前核形成が生じているかをみて受精を確認。 ⑤ 72 時間後に、 8 ~ 16 細胞胚の中より割球が均等で細胞質が均一な良質胚を子宮内に移植する。