臨床婦人科産科76巻4号

2022年04月発行

増刊号 最新の不妊診療がわかる！―生殖補助医療を中心とした新たな治療体系 第2章　生殖補助医療とその手技 胚培養―着床率の高い受精卵を選別して妊娠率を向上させる

ヒト胚の発生と形態学的胚評価

著者： 大月純子¹

所属機関： ¹岡山大学生殖補助医療技術教育研究センター

ページ範囲：P.58 - P.62

▶卵細胞膜への精子融合地点と第二極体放出地点が近接していると高頻度に雌雄のゲノムを含む1前核（1PN）を形成する．
▶出産に至る胚の雌雄前核形成初期は雄性前核サイズが大きく，雌性前核サイズは徐々に雄性前核サイズに近づき核膜消失直前までに差が縮まる．
▶sERCを呈する卵母細胞は細胞分裂，細胞骨格機構，ミトコンドリア活性などにかかわる遺伝子発現が減少しており，細胞分裂失敗やアクチン分布異常の頻度が高いことが報告されている．

参考文献

1）Otsuki J, et al : A phase of chromosome aggregation during meiosis in human oocytes. Reprod Biomed Online 15 : 191-197, 2007

2）Otsuki J, et al : Noninvasive embryo selection : kinetic analysis of female and male pronuclear development to predict embryo quality and potential to produce live birth. Fertil Steril 112 : 874-881, 2019

3）Wei X, et al : Developmental trajectory of monopronucleated zygotes after in vitro fertilization when they include both male and female genomes. Fertil Steril 117 : 213-220, 2022

4）Miyagi Y, et al : Feasibility of predicting live birth by combining conventional embryo evaluation with artificial intelligence applied to a blastocyst image in patients classified by age. Reprod Med Biol 18 : 344-356, 2019

5）VerMilyea M, et al : Development of an artificial intelligence-based assessment model for prediction of embryo viability using static images captured by optical light microscopy during IVF. Hum Reprod 35 : 770-784, 2020

6）Otsuki J, et al : The relationship between pregnancy outcome and smooth endoplasmic reticulum clusters in MII human oocytes. Hum Reprod 19 : 1591-1597, 2004

7）Saito H, et al : A higher incidence of smooth endoplasmic reticulum clusters with aromatase inhibitors. Reprod Med Biol 18 : 384-389, 2019

8）Massarotti C, et al : Occurrence of smooth endoplasmic reticulum aggregates in metaphase II oocytes : relationship with stimulation protocols and outcome of ICSI and IVF cycles. Hum Reprod 36 : 907-917, 2021

9）Dal Canto M, et al : Dysmorphic patterns are associated with cytoskeletal alterations in human oocytes. Hum Reprod 32 : 750-757, 2017

10）Otsuki J, et al : A higher incidence of cleavage failure in oocytes containing smooth endoplasmic reticulum clusters. J Assist Reprod Genet 35 : 899-905, 2018

11）Stigliani S, et al : Presence of aggregates of smooth endoplasmic reticulum in MII oocytes affects oocyte competence : molecular-based evidence. Mol Hum Reprod 24 : 310-317, 2018