人工生殖－試管嬰兒科技之近代發展

CURRENT ASSISTED REPRODUCTIVE TECHNOLOGIES

陳妙汝(Miao-Ju Chen) ； 廖榮華(Jung-Hua Liao)

《秀傳醫學雜誌》 15卷1&2期 (2016/06) Pp. 57-63

https://doi.org/10.3966/156104972016061501007

摘要

體外受精(In Vitro Fertilization; IVF) 即俗稱試管嬰兒，近年在實驗室的各項技術有些新的發展，使懷孕率及活產率明顯提高。卵巢中卵泡庫存量可預測是否容易引卵、是否容易成功懷孕。應用控制低氧環境的三氣體培養箱及胚胎培養液的持續改良，使體外培養至第五天的囊胚形成率高達50-70 %；再者，玻璃化冷凍術(Vitrification)在學者不斷努力己改良後，解凍後的胚胎或卵子存活率已大幅提升。綜此，無論是在取卵週期植入新鮮囊胚，或先行冷凍囊胚，待調整受術妻的內分泌及子宮內膜，到較適合胚胎著床的情況下再行解凍胚胎植入，已使目前試管嬰兒(不分年齡)的懷孕率達30%以上。雷射輔助切片的應用、囊胚培養率的提高、玻璃化冷凍成功率的提升、染色體或基因分析技術的精進、胚胎縮時攝影(Time-lapse) 科技的問世等相輔相成，使得選擇染色體或基因正常的胚胎做植入不再只是理想。

關鍵字

人工生殖 ； 體外受精 ； 胚胎 ； 玻璃化冷凍術 ； 縮時攝影

並列摘要

The pregnancy rate and live birth rate for In Vitro Fertilization (IVF), also known as ＂test-tube babies＂, are currently increasing along with technological advancements. The ovarian reserve plays a crucial role in predicting the response and outcome in couples prior to In Vitro Fertilization. The application of a triple gas incubator to reduce the oxygen concentration and the persistent improvement of culture media have led to a high blastocyst formation rate on Day 5 or 6 (50-70%). Moreover, the improvement of vitrification techniques has increase the post-thaw survival rates of embryos and oocytes. Overall, either transferring fresh blastocysts or freezing embryos in an oocyte retrieval cycle and then transferring the frozen embryos after establishing a more receptive endometrium in another cycle can achieve pregnancy rates over 30%. In sum, the use of laser assisted hatching, the high blastocyst formation rate, the increasing of post-thaw survival rates after vitrification, the improvement of chromosome or genetic diagnosis techniques and the introduction of time-lapse imaging systems for embryo monitoring have made it possible to select euploid or genetic normal embryos for transfer.

並列關鍵字

Assisted Reproduction ； In vitro Fertilization ； Embryo ； Vitrification ； Time-lapse