臨床婦人科産科73巻3号

2019年04月発行

今月の臨床 いまさら聞けない　体外受精法と胚培養の基礎知識 トピックス

良好胚なのになぜ着床しないのか？

著者： 太田志代¹ 中岡義晴¹

所属機関： ¹IVFなんばクリニック

ページ範囲：P.373 - P.380

●着床しない原因の主たるものは胚の染色体異数性であり，女性の加齢とともに発生率は上昇する．

●良好胚を複数回移植しても着床が得られない場合は着床不全を疑い，不育症に準じた精査・治療を行う．

●子宮内フローラやERAなど，着床障害と子宮内環境の関連に関して研究がなされ，臨床でも実用が始まっている．

参考文献

1）日本産科婦人科学会 登録・調査小委員会 : ART登録データブック，2016

2）Harton GL, et al : Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization. FertilSteril 100 : 1695-703, 2013

3）M Noayeri, et al : The effect of preimplantation genetic screening on implantation rate in women over 35 years of age. Cell J 18 : 13-20, 2016

4）Diez-Juan A, et al : Mitochondrial DNA content as a viability score in human euploid embryos : less is better. FertilSteril 104 : 534-541, 2015

5）Inés Barañao R, et al : Interleukin-1 beta levels in human embryo culture supernatants and their predictive value for pregnancy. Early Hum Dev 25 : 71-80, 1997

6）Gott AL, et al : Non-invasive measurement of pyruvate and glucose uptake and lactate production by single human preimplantation embryos. Hum Reprod 5 : 104-108, 1990

7）Empson M, et al : Prevention of recurrent miscarriage for women with antiphospholipid antibody or lupus anticoagulant. Cochrane Database SystRev 2 : CD002859, 2005

8）Sugiura-Ogasawara M, et al : Midline uterine defect size is correlated with miscarriage of euploid embruos in recurrent cases. FertilSteril 93 : 1983-1988, 2010

9）Zeyneloglu HB, et al : Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization and embryo transfer. FertilSteril 70 : 492-499, 1998

10）Moreno I, et al : Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol 215 : 684-703, 2016

11）Kyono K, et al : A pilotstudy and case reports on endometrial microbiota and pregnancy outcome : An analysis using 16S rRNA gene sequencing among IVF patients, and trial therapeutic intervention for dysbiotic endometrium. Reprod Med Biol 18 : 72-82, 2018

12）Ruiz-Alonso M, et al : What a difference two days make : “personalized” embryo transfer（pET） paradigm : a case report and pilotstudy. Hum Reprod 29 : 1244-1247, 2014