Tanaka A, Toeda M, Nagasawa I, Yamamoto T, Nakagata N
Department of Obstetrics and Gynecology, Koshigaya City Hospital, Saitama.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Dec;40(12):1859-66.
We developed a new treatment, Gamete Intrafallopian Transfer with the preincubated oocyte (New GIFT) and applied this method to all kinds of infertility where the patient had at least one tube. We performed 114 New GIFTs and dealt with the factors which influenced the establishment of pregnancy. 1. The pregnancy rate was 37%/cycles (42/114), 42%/patients (42/100) and the abortion rate was 19% (8/42). These results show that the New GIFT was more efficient than the original GIFT. 2. The most important factor for the establishment of pregnancy among the semen parameters was sperm motility, especially at the time of insemination. The pregnancy rate increased as sperm motility became higher. The sperm count did not influence the pregnancy rate significantly except in severe cases of oligozoospermia. 3. The most important factor in oocyte assessment was the number of mature oocytes. The number of oocytes in the pregnant group was much more than that in the nonpregnant group, but the total number of follicles in the pregnant group was found to be from 3 to 7 follicles. No pregnancy occurred when the number of follicles was greater than 11. These results suggested that existence an optimum number of oocytes. Conditions of the corona-cumulus component complex closely related to the establishment of pregnancy. The pregnancy rate was about 60% when more than 2C (-) oocytes (almost all cumulus cells were dispersed) were transferred, but it was only 5% when only C (+) oocytes (hardly any cumulus cells were dispersed) were transferred. 4. The most effective luteal support regimen was the pill. The administration of progesterone induced a high percentage of abortions.
我们研发了一种新的治疗方法，即预孵育卵母细胞的输卵管内配子移植术（新型输卵管内配子移植术），并将该方法应用于至少有一侧输卵管的各类不孕症患者。我们进行了114例新型输卵管内配子移植术，并对影响妊娠建立的因素进行了研究。1. 妊娠率为37%/周期（42/114），42%/患者（42/100），流产率为19%（8/42）。这些结果表明新型输卵管内配子移植术比原始的输卵管内配子移植术更有效。2. 在精液参数中，影响妊娠建立的最重要因素是精子活力，尤其是在授精时。随着精子活力提高，妊娠率增加。除了严重少精子症病例外，精子数量对妊娠率没有显著影响。3. 卵母细胞评估中最重要的因素是成熟卵母细胞的数量。妊娠组的卵母细胞数量远多于未妊娠组，但发现妊娠组的卵泡总数为3至7个卵泡。当卵泡数大于11个时未发生妊娠。这些结果提示存在一个最佳的卵母细胞数量。卵丘 - 卵母细胞复合体的状态与妊娠建立密切相关。当移植超过2C（-）卵母细胞（几乎所有卵丘细胞都已分散）时，妊娠率约为60%，但当仅移植C（+）卵母细胞（几乎没有卵丘细胞分散）时，妊娠率仅为5%。4. 最有效的黄体支持方案是口服避孕药。使用黄体酮会导致较高比例的流产。
