胚盤胞移植（ＢＴ：Blastocyst Transfer)についての私見です。
BTの1つ目の利点は胚の選別にあります。今わが国ではＤ２〜３の卵の評価はVeeck分類が汎用されています。しかしこの分類では正確に良質卵を選別できないとされています。Ｄ２〜３でグレードの良い胚は胚盤胞形成率は高いのですが、Ｄ２〜３でＧ１の胚が胚盤胞にならずＧ３または４が胚盤胞になる逆転現象がたまに起こります。したがって胚の質を正確に見るためにはＢＴが必要となるわけです。従って当クリニックでは無駄な胚移植を防ぐためＤ２〜３で質の悪い胚こそＢＴへもって行きます。あとで解説しますが卵管閉塞でない限り自然周期で1個の胚が得られＤ３でＧ１であればＥＴしても良いでしょう。しかしＧ３以下であれば胚の正常性をみるためにＢＴを選択し胚盤胞に発育しなければＥＴキャンセルし無駄な胚移植を避けられると考えています。（ただし培養技術が進歩したとはいえいまだ未知な部分も多く安易な長期培養は避けたほうが良いかもしれません。）
BTの1つ目の利点は胚の選別にあります。今わが国ではＤ２〜３の卵の評価はVeeck分類が汎用されています。しかしこの分類では正確に良質卵を選別できないとされています。Ｄ２〜３でグレードの良い胚は胚盤胞形成率は高いのですが、Ｄ２〜３でＧ１の胚が胚盤胞にならずＧ３または４が胚盤胞になる逆転現象がたまに起こります。したがって胚の質を正確に見るためにはＢＴが必要となるわけです。従って当クリニックでは無駄な胚移植を防ぐためＤ２〜３で質の悪い胚こそＢＴへもって行きます。あとで解説しますが卵管閉塞でない限り自然周期で1個の胚が得られＤ３でＧ１であればＥＴしても良いでしょう。しかしＧ３以下であれば胚の正常性をみるためにＢＴを選択し胚盤胞に発育しなければＥＴキャンセルし無駄な胚移植を避けられると考えています。（ただし培養技術が進歩したとはいえいまだ未知な部分も多く安易な長期培養は避けたほうが良いかもしれません。）
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D3でグレード３でも、D5で4bb。また、D3で6分割G2でもD5で胚盤胞aaになったこともあります。ワタシの場合は、自分の状態が悪く、オットの状態が良いときでした。
その逆もありました。D3で8分割G1でも胚盤胞まで達しないとか。
今は、D3で状態が良くなくてもあきらめないど！と思っています。あとは着床でがんばるんば、です。
ご参考になれば幸いです
その逆もありました。D3で8分割G1でも胚盤胞まで達しないとか。
今は、D3で状態が良くなくてもあきらめないど！と思っています。あとは着床でがんばるんば、です。
ご参考になれば幸いです
2007/02/10(土) 01:14:03 | URL | しろねこ #OARS9n6I[ 編集]
TESEやICSIでも一回で着床、出産する方が大勢いらっしゃるので、要は着床だっ、と気合を入れなおしている今日このごろです。
2007/02/10(土) 01:35:01 | URL | しろねこ #OARS9n6I[ 編集]
毎日更新を楽しみにしているんですが、なかなか更新されないので残念です。
先生もご多忙かと思いますが、ぜひ更新して下さい。
先生もご多忙かと思いますが、ぜひ更新して下さい。
2007/03/16(金) 00:17:09 | URL | 先生のファン #Yi.ZYDB.[ 編集]
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