臨床婦人科産科76巻11号

2022年11月発行

今月の臨床 生殖医療の安全性―どんなリスクと留意点があるのか？ ART手技の安全性

顕微授精の安全性

著者： 服部裕充¹²³⁴ 田井俊宏¹²³⁴ 京野廣一¹²³⁴

所属機関： ¹京野アートクリニック高輪 ²京野アートクリニック仙台 ³京野アートクリニック盛岡 ⁴Human Ovarian-tissue Preservation Enterprise（HOPE）

ページ範囲：P.1099 - P.1104

●顕微授精周期と出生児数は，世界的に増加を続けている．

●顕微授精が周産期，出生児予後にもたらすリスクについては，一定の見解が得られていないのが現状である．

●顕微授精に付随して精巣精子，人為的卵子活性化が広く行われている．

参考文献

1）Palermo G, et al : Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 340 : 17-18, 1992

2）Devroey P, et al : Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 10 : 1457-1460, 1995

3）Ombelet W, et al : Perinatal outcome of ICSI pregnancies compared with a matched group of natural conception pregnancies in Flanders（Belgium） : a cohort study. Reprod Biomed Online 11 : 244-253, 2005

4）Pinborg A, et al : Infant outcome of 957 singletons born after frozen embryo replacement : the Danish National Cohort Study 1995-2006. Fertil Steril 94 : 1320-1327, 2010

5）Hattori H, et al : Obstetrical and neonatal outcomes of 3,028 singletons born after advanced ART techniques : ejaculated sperm intracytoplasmic sperm injection, artificial oocyte activation, in vitro maturation and testicular sperm extraction. Fertil Reproduction 3 : 25-34, 2021

6）Nagata C, et al : Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies : a nationwide birth cohort study of Japan environment and children's study. BMC Pregnancy Childbirth 19 : 77, 2019

7）Tararbit K, et al : The risk for four specific congenital heart defects associated with assisted reproductive techniques : a population-based evaluation. Hum Reprod 28 : 367-374, 2013

8）Katalinic A, et al : Pregnancy course and outcome after intracytoplasmic sperm injection : a controlled, prospective cohort study. Fertil Steril 81 : 1604-1616, 2004

9）Luke B, et al : The risk of birth defects with conception by ART. Hum Reprod 36 : 116-129, 2021

10）Lie RT, et al : Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods ; a meta-analysis. Int J Epidemiol 34 : 696-701, 2005

11）Wen J, et al : Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection : a meta-analysis. Fertil Steril 97 : 1331-1337, 2012

12）Belva F, et al : Chromosomal abnormalities after ICSI in relation to semen parameters : results in 1114 fetuses and 1391 neonates from a single center. Hum Reprod 35 : 2149-2162, 2020

13）Kissin DM, et al : Association of assisted reproductive technology（ART）treatment and parental infertility diagnosis with autism in ART-conceived children. Hum Reprod 30 : 454-465, 2015

14）Norrman E, et al : School performance in children born after ICSI. Hum Reprod 35 : 340-354, 2020

15）Fedder J, et al : Neonatal outcome and congenital malformations in children born after ICSI with testicular or epididymal sperm : a controlled national cohort study. Hum Reprod 28 : 230-240, 2013

16）Jin L, et al : Neonatal outcome of children born after ICSI with epididymal or testicular sperm : A 10-year study in China. Sci Rep 10 : 5145, 2020

17）Deepti MK, et al : Perinatal outcomes using ejaculate versus surgical sperm retrieval in patients undergoing intracytoplasmic sperm injection for male infertility-a retrospective analysis of 628 cycles. J Hum Reprod Sci 14 : 49-55, 2021

18）佐々木千紗，他 : Y染色体微小欠失の有無がTESEにおける精子回収率とICSI後の成績に与える影響について．日受精着床会誌39 : 67-74, 2022

19）福岡由利子，他 : TESEを施行した1074症例の臨床成績および生児獲得率向上のための検討．日受精着床会誌39 : 75-80, 2022

20）Okuyama N, et al : Long-term clinical outcomes of testicular sperm extraction and intracytoplasmic sperm injection for infertile men. Reprod Med Biol 17 : 82-88, 2018

21）Long R, et al : Risk of birth defects in children conceived by artificial oocyte activation and intracytoplasmic sperm injection : a meta-analysis. Reprod Biol Endocrinol 18 : 123, 2020

22）Kyono K, et al : Birth and follow-up of babies born following ICSI with oocyte activation using strontium chloride or calcium ionophore A23187. J Mamm Ova Res 29 : 35-40, 2012