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#c0c0c0;\">\u8003\u5bdf<\/span><\/p>\n<p>\u75c7\u4f8b1\u306f\uff0cHCG\u30ec\u30bb\u30d7\u30bf\u30fc\u304c\u5341\u5206\u6a5f\u80fd\u3057\u3066\u3044\u306a\u3044\u305f\u3081\u5375\u5b50\u304c\u5375\u80de\u58c1\u304b\u3089\u96e2\u308c\u96e3\u304f\uff0c\u63a1\u5375\u6570\u304c\u5c11\u306a\u304f\u306a\u308a\uff0c\u53d7\u7cbe\u306e\u6e96\u5099\u304c\u5341\u5206\u3067\u304d\u3066\u306a\u3044\u305f\u3081\uff0c\u6b63\u5e38\u53d7\u7cbe\u7387\u304c\u4f4e\u304f\uff0c\u80da\u76e4\u80de\u306b\u5230\u9054\u3057\u306a\u304b\u3063\u305f\u3068\u8003\u3048\u3089\u308c\u308b\uff0e\u3055\u3089\u306b\uff0cconventional ICSI\u3067\u306f\u5375\u5b50\u306e\u6d3b\u6027\u5316\u304c\u5341\u5206\u306b\u8a98\u8d77\u3067\u304d\u306a\u304b\u3063\u305f\u305f\u3081\u53d7\u7cbe\u7387\u304c\u4f4e\u304f\uff0c\u53d7\u7cbe\u5f8c\u306e\u767a\u9054\u304c\u9045\u304f\u80da\u76e4\u80de\u306b\u5230\u9054\u3067\u304d\u306a\u304b\u3063\u305f\u3068\u601d\u308f\u308c\u308b\uff0e<\/p>\n<p>\u4ed6\u9662\u306e\u6cbb\u7642\u6b74\u304b\u3089GnRH\u30a2\u30b4\u30cb\u30b9\u30c8\u3067\u30c8\u30ea\u30ac\u30fc\u3092\u884c\u3044IVF \u3067\u53d7\u7cbe\u3055\u305b\u308c\u3070\u80da\u76e4\u80de\u304c\u3067\u304d\u3066\u3044\u308b\u3053\u3068\uff0cconventional ICSI\u5468\u671f\u3067\u79fb\u690d\u3067\u304d\u308b\u80da\u306f\u3067\u304d\u306a\u304b\u3063\u305f\u3053\u3068\u3092\u6df1\u304f\u8003\u3048\u3066\u3044\u308c\u3070\uff0c\u3082\u3046\u5c11\u3057\u65e9\u304f\u598a\u5a20\u3057\u305f\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u6d77\u5916\u306e\u8ad6\u6587\u3067\u306f8\u56de\u76ee\u306e\u63a1\u5375\u3067\u751f\u5150\u3092\u5f97\u3066\u3044\u308b\u3053\u3068\u304b\u3089\u96e3\u3057\u3044\u75c7\u4f8b\u306a\u306e\u3060\u3068\u601d\u3046\u00b9\uff09\uff0eGnRH\u30a2\u30b4\u30cb\u30b9\u30c8\u3092\u30c8\u30ea\u30ac\u30fc\u3068\u3057modified ICSI\u3067\u80da\u76e4\u80de\u304c\u5f97\u3089\u308c\u305f\u3053\u3068\u304b\u3089\uff0c\u5375\u306e\u6d3b\u6027\u5316\u306e\u52b9\u679c\u304c\u3042\u3063\u305f\u3068\u8003\u3048\u308b\uff0e<\/p>\n<p>\u75c7\u4f8b2\u306b\u3064\u3044\u3066\u306f\uff0c7\u500b\u306e\u30ac\u30e9\u30b9\u5316\u80da\u76e4\u80de\u3092\u81ea\u7136\u6392\u5375\u5468\u671f\u3084HRT\u5468\u671f\u306eDay5\u3084Day6\u306b\u79fb\u690d\u3057\u3066\u598a\u5a20\u305b\u305a\uff0cDay7\u306b\u79fb\u690d\u3057\u3066\u598a\u5a20\u51fa\u7523\u3067\u304d\u305f\uff0e\u540c\u69d8\u306b\u884c\u3044\u7d99\u7d9a\u598a\u5a20\u4e2d\u306e\u75c7\u4f8b\u3082\u3042\u308b\u304c\uff0c\u7a00\u306b\u307f\u3089\u308c\u308b\u75c7\u4f8b\u3068\u601d\u308f\u308c\u308b\uff0e\u6d77\u5916\u306e\u8ad6\u6587\u3067\u306f4\u56de\u306eIVF\u30683\u56de\u306e\u5375\u5b50\u63d0\u4f9b\u6cbb\u7642\u306b\u5931\u6557\u3057\u305f\u5f8c\uff0c\u5b50\u5bae\u5185\u819c\u306e\u53d7\u5bb9\u80fd\u3092\u8abf\u3079\u308bendometrial receptivity array test\uff08ERA\uff09\u3092\u7740\u5e8a\u671f\u5185\u819c\u7d44\u7e54\u306b\u8a66\u307f\uff0c\u7740\u5e8a\u671f\u30a6\u30a4\u30f3\u30c9\u30a6\u306b2\u65e5\u306e\u305a\u308c\u3092\u8a8d\u3081\uff0c\u9ec4\u4f53\u30db\u30eb\u30e2\u30f3\u6295\u4e0e\u5f8c7\u65e5\u76ee\u306b\u63d0\u4f9b\u5375\u5b50\u3067\u306e\u80da\u76e4\u80de2\u500b\u3092\u79fb\u690d\u3057\uff0c2\u4eba\u306e\u5065\u5150\u3092\u5f97\u3066\u3044\u308b\uff0e\u53cd\u5fa9\u7740\u5e8a\u4e0d\u6210\u529f\u4f8b\u3067\u306f4\u4eba\u306b1\u4eba\u306f\u7740\u5e8a\u671f\u30a6\u30a4\u30f3\u30c9\u30a6\u306e\u305a\u308c\u304c\u3042\u308b\u3068\u306e\u5831\u544a\u3082\u3042\u308a\uff0c\u5b50\u5bae\u5185\u819c\u306e\u53d7\u5bb9\u80fd\u3092\u500b\u5225\u306b\u78ba\u5b9f\u306b\u8abf\u3079\u308b\u65b9\u6cd5\u306e\u78ba\u7acb\u304c\u671b\u307e\u308c\u308b<sup>4<\/sup><sup>\uff09<\/sup>\uff0e<\/p>\n<p><span style=\"background-color: #c0c0c0;\">\u53c2\u8003\u6587\u732e<\/span><\/p>\n<p>1\uff09 R. Beck-Fruchter, A. Weiss, M. Lavee, et al.: Empty follicle syndrome: successful treatment in a recurrent case and review of the literature. Hum. Reprod., 27: 1357-1367, 2012.<\/p>\n<p>2\uff09 F. Lok, J. Pritchard, H. Lashen.: Successful treatment of empty follicle syndrome by triggering endogenous LH surge using GnRH agonist in an antagonist down-regulated IVF cycle. Hum. Reprod., 18: 2079-2081, 2003.<\/p>\n<p>3\uff09 D. Griffin, R. Feinn, L. Engmann, et al.: Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates. Fertil. Steril., 102: 405-409, 2014.<\/p>\n<p>4\uff09 M. Ruiz-Alonso, N. Galindo, A. Pellicer, et al.: What a difference two days make: \u201cpersonalized\u201d embryo transfer(pET) paradigm: A case report and pilot study. Hum. Reprod., 29: 1244-1247, 2014.<\/p>\n<p>5\uff09 J. Tesarik, L. Rienzi, F. Ubaldi, et al.: Use of a modified intracytoplasmic sperm injection technique to overcome spermborne and oocyte-borne oocyte activation failures. Fertil. Steril.,78:619-624, 2002.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u5f53\u9662\u9662\u9577 \u5ca1\u304c\u30012015\u5e749\u670826\u65e5\uff08\u571f\uff09-27\u65e5\uff08\u65e5\uff09\u306b\u798f\u5ca1\u306b\u3066\u884c\u308f\u308c\u305f\u7b2c18\u56deIVF\u5b66\u4f1a\u306b\u3066\u8b1b\u6f14\u3092\u884c\u3044\u307e\u3057\u305f\u3002 \u8b1b\u6f14\u306e\u5185\u5bb9\u306f\u4e0b\u8a18\u306e\u6284\u9332\u3092\u3054\u89a7\u304f\u3060\u3055\u3044\u3002 \u300e\u30b7\u30f3\u30dd\u30b8\u30a6\u30e0\uff5e ART \u5c02\u9580\u65bd\u8a2d\u3068\u5468\u7523\u671f\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u3000\u751f\u6b96\u533b\u7642\u306e\u73fe\u5834\u304b\u3089\u300f \u8fd1\u5e74\uff0c\u4f53\u5916\u53d7\u7cbe\u306e\u6cbb\u7642\u306e\u9032\u6b69\u306b\u4f34\u3044\u5e83\u304f\u591a\u304f\u306e\u4f53\u5916\u53d7\u7cbe\u5150\u304c\u751f\u307e\u308c\u3066\u304a\u308a\uff0c\u4e0d\u598a\u6cbb\u7642\u306b\u306f\u4e0d\u53ef\u6b20\u306a\u6cbb\u7642\u6cd5\u306b\u306a\u3063\u3066\u3044\u308b\uff0e\u3057\u304b\u3057\uff0c\u753b\u4e00\u7684\u306a\u6cbb\u7642\u3067\u306f\u6210\u529f\u3057\u306a\u3044\u75c7\u4f8b\u3082\u7d4c\u9a13\u3057\uff0c\u52c9\u5f37\u3055\u305b\u3089\u308c\u308b\uff0e\u4eca\u56de\uff0c\u6cbb\u7642\u306b\u82e6\u616e\u3057\u305f\u75c7\u4f8b\u30922\u4f8b\u5831\u544a\u3057\u8003\u5bdf\u3092\u52a0\u3048\u305f\uff0e\u540c\u69d8\u306a\u75c7\u4f8b\u306f\u6d77\u5916\u304b\u3089\u3082\u5831\u544a\u3055\u308c\u3066\u3044\u308b1-4\uff09\uff0e \u75c7\u4f8b1 \u60a3\u8005\uff08M.Y.\uff0938 \u6b73\uff0c2013 \u5e7412 \u67083 \u65e5\u306b\u4eba\u5de5\u6388\u7cbe1 \u56de\uff0c\u4f53\u5916\u53d7\u7cbe1\u56de\uff0cICSI 1\u56de\u5931\u6557\u3057\u6319\u5150\u5e0c\u671b\u306b\u3066\u5f53\u9662\u521d\u8a3a\uff0e\u6708\u7d4c\u306f37 \u301c38\u65e5\u578b\u3067\u3042\u308b\u304c\uff0c\u4e0d\u6574\u3067\u3042\u308b\u3053\u3068\u304c\u591a\u304b\u3063\u305f\uff0e\u7d50\u5a5a\u306f33\u6b73\uff0e\u4e0d\u598a\u6b743\u5e74\uff0e\u598a\u5a20\u6b74\u306f\u306a\u3044\uff0e\u4ed6\u9662\u3067\u306e\u4e0d\u598a\u6cbb\u7642\u6b74\u306f1\u5e74\u9593\u3067\u3042\u308a\uff0c\u4eba\u5de5\u6388\u7cbe1\u56de\uff0c\u4f53\u5916\u53d7\u7cbe\u306f\u30af\u30ed\u30df\u30c3\u30c9\u5468\u671f\u63a1\u5375\u3067\uff0c\u30c8\u30ea\u30ac\u30fc\u306f\u70b9\u9f3b\u85ac\u3092\u4f7f\u7528\u3057\uff0c\u63a1\u53752\u56de\uff08\u63a1\u53751\u56de\u76ee\uff1b\u63a1\u5375\u65709\u500b\uff0c\u5a92\u7cbe\u306b\u3066\u53d7\u7cbe\u3057\uff0c\u80da\u76e4\u80de1\u500b\u51cd\u7d50\uff0e\u878d\u89e3\u80da\u79fb\u690d\u3059\u308b\u3082\u598a\u5a20\u305b\u305a\uff0e\u63a1\u53752\u56de\u76ee\uff1b\u63a1\u5375\u65702 \u500b\uff0cICSI \u3059\u308b\u3082\u79fb\u690d\u306b\u81f3\u3089\u305a\uff09\uff0eAMH27.1 \u301c41.2pmol\/L\uff0c\u7cbe\u6db2\u691c\u67fb\uff1b\u91cf2.5ml\uff0c\u6fc3\u5ea647M\/ml\uff0c\u904b\u52d5\u738760\uff05\uff0c\u4ed6\u533b\u304b\u3089\u7d39\u4ecb\u3055\u308c\u308b\uff0e\u539f\u56e0\u4e0d\u660e\u4e0d\u598a\u75c7\u3068\u8a3a\u65ad\u3057\uff0c\u5f53\u9662\u3067\u306e\u4f53\u5916\u53d7\u7cbe\u3092\u958b\u59cb\u3057\u305f\uff0e \u4f53\u5916\u53d7\u7cbe1\u56de\u76ee\uff1b\u6708\u7d4c\u958b\u59cb3\u65e5\u76ee\u304b\u3089FSH225\u5358\u4f4d\u9023\u65e5\u76ae\u4e0b\u6ce8\uff0c\u5375\u80de\u5f84\u304c1.4cm\u3067\u30a2\u30f3\u30bf\u30b4\u30cb\u30b9\u30c8\u9023\u65e5\u6295\u4e0e\u958b\u59cb\u3057\uff0c\u30c8\u30ea\u30ac\u30fc\u3068\u3057\u3066\u751f\u7406\u958b\u59cb15 \u65e5\u76ee\u306ePM11 \u6642\u306bHCG10,000\u5358\u4f4d\u76ae\u4e0b\u6ce8\u3057\u305f\uff0e\u5375\u80de\u306f\u53f36\u500b\uff0c\u5de64\u500b\u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u306f\u53f31\u500b\uff0c\u5de62\u500b\uff0c2\u500b\u304c\u6210\u719f\u5375\u3067ICSI\u3092\u884c\u3044\uff0c\u6b63\u5e38\u53d7\u7cbe1 \u500b\uff0cDay2 \u30672 \u5206\u5272\uff0cDay5 \u30672 \u5206\u5272\u3068\u767a\u80b2\u505c\u6b62\u3057\u3066\u304a\u308a\u30ad\u30e3\u30f3\u30bb\u30eb\u3068\u306a\u3063\u305f\uff0e \u4f53\u5916\u53d7\u7cbe2\u56de\u76ee\uff1b\u5375\u306e\u8cea\u304c\u60aa\u3044\uff0c\u304b\u3064ICSI\u306b\u3088\u308b\u5375\u5b50\u306e\u6d3b\u6027\u5316\u304c\u4e0d\u5341\u5206\u3068\u8003\u3048\uff0cIVF\u4e88\u5b9a\u3068\u3057\uff0c\u30ed\u30f3\u30b0\u6cd5\u3067FSH225 \u5358\u4f4d\u9023\u65e5\u6295\u4e0e\u3057\u305f\uff0e \u5375\u80de\u306f\u53f36 \u500b\uff0c \u5de68 \u500bHCG5,000 \u6295\u4e0e3 \u65e5\u524d\u306b\u8840\u4e2dE2 \u306f3,725pg\/ml \u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u306f\u53f31\u500b\uff0c\u5de64\u500b\u3067\u3042\u3063\u305f\uff0e\u5a92\u7cbe\u30672PN\u306f1\u500b\u3067\u3042\u308a\uff0cDay5\u306b\u306f\u767a\u80b2\u304c2\u5206\u5272\u3067\u505c\u6b62\u3057\u3066\u3044\u305f\uff0e \u4f53\u5916\u53d7\u7cbe3\u56de\u76ee\uff1b\u5375\u306e\u8cea\u3092\u826f\u304f\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u305f\u30811 \u5468\u671fOCP \u5185\u670d\u3057\uff0c\u30a2\u30f3\u30bf\u30b4\u30cb\u30b9\u30c8\u6cd5\u3068\u3057\uff0c\u8a98\u767a\u306fHMG225IU\u9023\u65e5\u6295\u4e0e\u3067\u884c\u3044\u30c8\u30ea\u30ac\u30fc\u306fHCG10,000IU\u3092\u6295\u4e0e\u3057\u305f\uff0e\u5375\u80de\u306f\u53f36\u500b\uff0c\u5de63\u500b\u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u6570\u306f3\u500b\uff0c\u5a92\u7cbe\u3067\u7cbe\u5b50\u306f\u63a5\u7740\u3057\u3066\u3044\u308b\u304c\uff0c\u6b63\u5e38\u53d7\u7cbe\u306f0\u500b\u3067\u5206\u5272\u3057\u306a\u304b\u3063\u305f\uff0e \u4f53\u5916\u53d7\u7cbe4\u56de\u76ee\uff1b\u3053\u3053\u307e\u3067\u306e\u7d50\u679c\u3067\uff0c\u304a\u305d\u3089\u304f\u6392\u5375\u306e\u5f15\u304d\u91d1\u306e\u52b9\u679c\u304cHCG\u3067\u306f\u4e0d\u5341\u5206\u306a\u3053\u3068\uff0c\u53d7\u7cbe\u306e\u3068\u304d\u5375\u5b50\u306e\u6d3b\u6027\u5316\u304c\u5341\u5206\u306b\u8d77\u3053\u3063\u3066\u3044\u306a\u3044\u53ef\u80fd\u6027\u304c\u3042\u308b\u306e\u3067\u5a92\u7cbe\u3067\u53d7\u7cbe\u3092\u884c\u3046\u3053\u3068\u3092\u60a3\u8005\u306b\u8aac\u660e\u3057\uff0c\u6708\u7d4c\u958b\u59cb\u524d\u306b1\u9031\u9593\u30b8\u30e5\u30ea\u30ca\uff08E2\uff091mg \uff0f\u65e5\u5185\u670d\u3057\uff0c\u30c8\u30ea\u30ac\u30fc\u306f\u70b9\u9f3b\u85ac\u3067\u884c\u3046\u305f\u3081\u306b\u30a2\u30f3\u30bf\u30b4\u30cb\u30b9\u30c8\u6cd5\u3067\u884c\u3044\uff0c\u5375\u5de3\u523a\u6fc0\u306fHMG300\u9023\u65e5\u6295\u4e0e\u3067\u884c\u3063\u305f\uff0e\u5375\u80de\u306f\u53f37\u500b\uff0c\u5de610\u500b\u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u6570\u306f9\u500b\uff0c\u7cbe\u5b50\u306f\u4e0d\u826f\u3067\u3042\u3063\u305f\u305f\u3081ICSI\u3068\u3057\uff0c8\u500b\u6b63\u5e38\u53d7\u7cbe\u3057\uff0cDay3\u30677\u5206\u52721\u500b\u3092\u79fb\u690d\u3057\u305f\uff0e\u305d\u306e\u4ed6\u306fDay3 \u30675 \u5206\u52721 \u500b\uff0c4 \u5206\u52721 \u500b\uff0c2 \u5206\u52724 \u500b\u3067\u3042\u3063\u305f\uff0e\u80da\u76e4\u80de\u306b\u306f\u306a\u3089\u306a\u304b\u3063\u305f\uff0e\u53d7\u7cbe\u65b9\u6cd5\u304cconventional ICSI\u3067\u3042\u3063\u305f\u305f\u3081\u6d3b\u6027\u5316\u304c\u5341\u5206\u8d77\u3053\u3089\u306a\u304b\u3063\u305f\u3068\u8aac\u660e\u3057\uff0c\u7cbe\u5b50\u306e\u72b6\u614b\u304c\u5a92\u7cbe\u3067\u306e\u53d7\u7cbe\u306f\u96e3\u3057\u304f\u306a\u3063\u3066\u3044\u308b\u305f\u3081modified ICSI\uff08M-ICSI\uff095\uff09\u306b\u3059\u308b\u3053\u3068\u3092\u8aac\u660e\u30575\u56de\u76ee\u306e\u6cbb\u7642\u3092\u884c\u3063\u305f\uff0e \u6392\u5375\u8a98\u767a\u306f4\u56de\u76ee\u3068\u540c\u69d8\u306b\u884c\u3063\u305f\uff0e\u5375\u80de\u306f\u53f39\u500b\uff0c\u5de68\u500b\u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u6570\u306f16\u500b\uff0c\u53d7\u7cbe\u306f\u5a92\u7cbe\u306b\u3066\u6b63\u5e38\u53d7\u7cbe\u306f8\u500b\u4e2d6\u500b\uff0cM-ICSI\u306b\u3066\u6b63\u5e38\u53d7\u7cbe\u306f8\u500b\u4e2d8\u500b\u3067\u3042\u3063\u305f\uff0e3\u65e5\u76ee\u306b5 \uff5e 8\u5206\u527213\u500b\uff0cDay5\u306b\u80da\u76e4\u80de1\u500b\uff08\u5a92\u7cbe\uff09\u79fb\u690d\u3057\uff0cDay5 \u306b\u80da\u76e4\u80de5 \u500b\uff08M-ICSI \u306b\u3088\u308b3 \u500b\uff0c\u5a92\u7cbe\u306b\u3088\u308b2\u500b\uff09\u30ac\u30e9\u30b9\u5316\u4fdd\u5b58\u3057\uff0cDay6\u306b2\u500b\uff08\u5a92\u7cbe\u306b\u3088\u308b2\u500b\uff09\u30ac\u30e9\u30b9\u5316\u4fdd\u5b58\u3057\u305f\uff0e\u65b0\u9bae\u80da\u76e4\u80de\u79fb\u690d\u3067\u306f\u598a\u5a20\u305b\u305a\uff0c\u30ac\u30e9\u30b9\u5316\u80da\u76e4\u80de\uff08M-ICSI\u306b\u3088\u308b\uff091\u500b\u878d\u89e3\u79fb\u690d\u3057\u598a\u5a20\u7d99\u7d9a\u4e2d\u3067\u3042\u308b\uff0e \u75c7\u4f8b2 \u60a3\u8005\uff08J.F.\uff0933 \u6b73\uff0c2012 \u5e746 \u670828 \u65e5\u4eba\u5de5\u6388\u7cbe10 \u56de\uff0c\u9855\u5fae\u6388\u7cbe1\u56de\u5931\u6557\u3057\u6319\u5150\u5e0c\u671b\u306b\u3066\u5f53\u9662\u521d\u8a3a\uff0e\u7d50\u5a5a\u306f30\u6b73\uff0c\u4e0d\u598a\u6b743 \u5e74\uff0c \u4ed6\u9662\u3067\u306eAMH11.3ng\/ml\uff0cDay3 \u63a1\u8840\u3067FSH10.4mIU\/ml, LH9.7mIU\/ml\uff0c\u30c6\u30b9\u30c8\u30b9\u30c6\u30ed\u30f367ng\/dl\u3067\u3042\u3063\u305f\uff0e\u598a\u5a20\u6b74\u306f\u306a\u304b\u3063\u305f\uff0e\u521d\u8a3a\u6642\u8a3a\u65ad\u306fPCO\u3068\u7537\u6027\u56e0\u5b50\u3067\u3042\u3063\u305f\uff0e \u5f53\u9662\u3067\u306e\u4f53\u5916\u53d7\u7cbe\u306f\u30a2\u30f3\u30bf\u30b4\u30cb\u30b9\u30c8\u6cd52\u56de\uff0c\u30ed\u30f3\u30b0\u6cd53\u56de\uff0c\u3044\u305a\u308c\u3082\u4f4e\u7528\u91cf\u30d4\u30eb\u30921\u5468\u671f\u5185\u670d\u3057\u524d\u51e6\u7f6e\u3092\u884c\u3044\uff0c\u3059\u3079\u3066ICSI\u3067\u884c\u3063\u305f\uff0e\u65b0\u9bae\u80da\u79fb\u690d\u3092\u4e88\u5b9a\u3057\u305f\u304c\uff0cOHSS\u56de\u907f\u3068\u80da\u306e\u767a\u80b2\u304c\u9045\u3044\u305f\u3081\u884c\u308f\u306a\u304b\u3063\u305f\uff0e5\u56de\u306e\u63a1\u5375\u3067\u8a0811\u500b\u306e\u80da\u76e4\u80de\uff08\u2462\uff5e\u2464\u306e\u6bb5\u968e\u3067Day5\u306bAB\u00d72\uff0cBB\u00d71\uff0cDay6\u306bBB\u00d74\uff0cBC\u00d72\uff0cCB\u00d72\uff09\u304c\u30ac\u30e9\u30b9\u5316\u4fdd\u5b58\u3067\u304d\u305f\uff0e 2013\u5e741\u670816\u65e5\u306b\u30db\u30eb\u30e2\u30f3\u88dc\u5145\uff08HRT\uff09\u5468\u671f\u306eDay5\u306b2\u500b\u878d\u89e3\u79fb\u690d\u3057\u305f\uff0e2013\u5e747\u670827\u65e5\u306bHRT\u5468\u671f\u3067Day5\u306b1\u500b\u878d\u89e3\u79fb\u690d\u3057\u305f\uff0e2013 \u5e7412 \u670814 \u65e5\u306bDay6 \u30672 \u500b\u878d\u89e3\u79fb\u690d\u3057\u305f\uff0e2014\u5e742\u670814\u65e5\u306b\u81ea\u7136\u6392\u5375\u5468\u671f\u3067\u6392\u5375\u5f8c5\u65e5\u76ee\u306b\u878d\u89e3\u79fb\u690d\u3057\u305f\u304c\uff0c\u3044\u305a\u308c\u3082\u8840\u4e2dhCG37mIU\/ml\u307e\u3067\u306e\u5024\u3067\u3042\u3063\u305f\uff0e\u7740\u5e8a\u306b\u554f\u984c\u304c\u3042\u308b\u3068\u8003\u3048\uff0cHRT\u5468\u671f\u306eDay5\u306e\u5b50\u5bae\u5185\u819c\u3092curettage\u3057\u3066\uff0c\u75c5\u7406\u5b66\u7684\u306b\u5b50\u5bae\u5185\u819c\u65e5\u4ed8\u8a3a\u3092\u884c\u3063\u305f\uff0e\u7d50\u679c\u306fPOD3\uff08\u6392\u5375\u5f8c3\u65e5\u76ee\uff09\u3067\u3042\u3063\u305f\uff0eHRT\u5468\u671f\u306eDay7\u306b\u30ac\u30e9\u30b9\u5316\u80da\u76e4\u80de2\u500b\u878d\u89e3\u79fb\u690d\u3057\uff0c\u5065\u5150\u30921\u4eba\u51fa\u7523\u3057\u305f\uff0e \u8003\u5bdf \u75c7\u4f8b1\u306f\uff0cHCG\u30ec\u30bb\u30d7\u30bf\u30fc\u304c\u5341\u5206\u6a5f\u80fd\u3057\u3066\u3044\u306a\u3044\u305f\u3081\u5375\u5b50\u304c\u5375\u80de\u58c1\u304b\u3089\u96e2\u308c\u96e3\u304f\uff0c\u63a1\u5375\u6570\u304c\u5c11\u306a\u304f\u306a\u308a\uff0c\u53d7\u7cbe\u306e\u6e96\u5099\u304c\u5341\u5206\u3067\u304d\u3066\u306a\u3044\u305f\u3081\uff0c\u6b63\u5e38\u53d7\u7cbe\u7387\u304c\u4f4e\u304f\uff0c\u80da\u76e4\u80de\u306b\u5230\u9054\u3057\u306a\u304b\u3063\u305f\u3068\u8003\u3048\u3089\u308c\u308b\uff0e\u3055\u3089\u306b\uff0cconventional ICSI\u3067\u306f\u5375\u5b50\u306e\u6d3b\u6027\u5316\u304c\u5341\u5206\u306b\u8a98\u8d77\u3067\u304d\u306a\u304b\u3063\u305f\u305f\u3081\u53d7\u7cbe\u7387\u304c\u4f4e\u304f\uff0c\u53d7\u7cbe\u5f8c\u306e\u767a\u9054\u304c\u9045\u304f\u80da\u76e4\u80de\u306b\u5230\u9054\u3067\u304d\u306a\u304b\u3063\u305f\u3068\u601d\u308f\u308c\u308b\uff0e \u4ed6\u9662\u306e\u6cbb\u7642\u6b74\u304b\u3089GnRH\u30a2\u30b4\u30cb\u30b9\u30c8\u3067\u30c8\u30ea\u30ac\u30fc\u3092\u884c\u3044IVF \u3067\u53d7\u7cbe\u3055\u305b\u308c\u3070\u80da\u76e4\u80de\u304c\u3067\u304d\u3066\u3044\u308b\u3053\u3068\uff0cconventional ICSI\u5468\u671f\u3067\u79fb\u690d\u3067\u304d\u308b\u80da\u306f\u3067\u304d\u306a\u304b\u3063\u305f\u3053\u3068\u3092\u6df1\u304f\u8003\u3048\u3066\u3044\u308c\u3070\uff0c\u3082\u3046\u5c11\u3057\u65e9\u304f\u598a\u5a20\u3057\u305f\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u6d77\u5916\u306e\u8ad6\u6587\u3067\u306f8\u56de\u76ee\u306e\u63a1\u5375\u3067\u751f\u5150\u3092\u5f97\u3066\u3044\u308b\u3053\u3068\u304b\u3089\u96e3\u3057\u3044\u75c7\u4f8b\u306a\u306e\u3060\u3068\u601d\u3046\u00b9\uff09\uff0eGnRH\u30a2\u30b4\u30cb\u30b9\u30c8\u3092\u30c8\u30ea\u30ac\u30fc\u3068\u3057modified ICSI\u3067\u80da\u76e4\u80de\u304c\u5f97\u3089\u308c\u305f\u3053\u3068\u304b\u3089\uff0c\u5375\u306e\u6d3b\u6027\u5316\u306e\u52b9\u679c\u304c\u3042\u3063\u305f\u3068\u8003\u3048\u308b\uff0e \u75c7\u4f8b2\u306b\u3064\u3044\u3066\u306f\uff0c7\u500b\u306e\u30ac\u30e9\u30b9\u5316\u80da\u76e4\u80de\u3092\u81ea\u7136\u6392\u5375\u5468\u671f\u3084HRT\u5468\u671f\u306eDay5\u3084Day6\u306b\u79fb\u690d\u3057\u3066\u598a\u5a20\u305b\u305a\uff0cDay7\u306b\u79fb\u690d\u3057\u3066\u598a\u5a20\u51fa\u7523\u3067\u304d\u305f\uff0e\u540c\u69d8\u306b\u884c\u3044\u7d99\u7d9a\u598a\u5a20\u4e2d\u306e\u75c7\u4f8b\u3082\u3042\u308b\u304c\uff0c\u7a00\u306b\u307f\u3089\u308c\u308b\u75c7\u4f8b\u3068\u601d\u308f\u308c\u308b\uff0e\u6d77\u5916\u306e\u8ad6\u6587\u3067\u306f4\u56de\u306eIVF\u30683\u56de\u306e\u5375\u5b50\u63d0\u4f9b\u6cbb\u7642\u306b\u5931\u6557\u3057\u305f\u5f8c\uff0c\u5b50\u5bae\u5185\u819c\u306e\u53d7\u5bb9\u80fd\u3092\u8abf\u3079\u308bendometrial receptivity array test\uff08ERA\uff09\u3092\u7740\u5e8a\u671f\u5185\u819c\u7d44\u7e54\u306b\u8a66\u307f\uff0c\u7740\u5e8a\u671f\u30a6\u30a4\u30f3\u30c9\u30a6\u306b2\u65e5\u306e\u305a\u308c\u3092\u8a8d\u3081\uff0c\u9ec4\u4f53\u30db\u30eb\u30e2\u30f3\u6295\u4e0e\u5f8c7\u65e5\u76ee\u306b\u63d0\u4f9b\u5375\u5b50\u3067\u306e\u80da\u76e4\u80de2\u500b\u3092\u79fb\u690d\u3057\uff0c2\u4eba\u306e\u5065\u5150\u3092\u5f97\u3066\u3044\u308b\uff0e\u53cd\u5fa9\u7740\u5e8a\u4e0d\u6210\u529f\u4f8b\u3067\u306f4\u4eba\u306b1\u4eba\u306f\u7740\u5e8a\u671f\u30a6\u30a4\u30f3\u30c9\u30a6\u306e\u305a\u308c\u304c\u3042\u308b\u3068\u306e\u5831\u544a\u3082\u3042\u308a\uff0c\u5b50\u5bae\u5185\u819c\u306e\u53d7\u5bb9\u80fd\u3092\u500b\u5225\u306b\u78ba\u5b9f\u306b\u8abf\u3079\u308b\u65b9\u6cd5\u306e\u78ba\u7acb\u304c\u671b\u307e\u308c\u308b4\uff09\uff0e \u53c2\u8003\u6587\u732e 1\uff09 R. Beck-Fruchter, A. Weiss, M. Lavee, et al.: Empty follicle syndrome: successful treatment in a recurrent case and review of the literature. Hum. Reprod., 27: 1357-1367, 2012. 2\uff09 F. Lok, J. Pritchard, H. Lashen.: Successful treatment of empty follicle syndrome by triggering endogenous LH surge using GnRH agonist in an antagonist down-regulated IVF cycle. Hum. Reprod., 18: 2079-2081, 2003. 3\uff09 D. Griffin, R. Feinn, L. Engmann, et al.: Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates. Fertil. Steril., 102: 405-409, 2014. 4\uff09 M. Ruiz-Alonso, N. Galindo, A. Pellicer, et al.: What a difference two days make: \u201cpersonalized\u201d embryo transfer(pET) paradigm: A case report and pilot study. Hum. Reprod., 29: 1244-1247, 2014. 5\uff09 J. Tesarik, L. Rienzi, F. Ubaldi, et al.: Use of a modified intracytoplasmic sperm injection technique to overcome spermborne and oocyte-borne oocyte activation failures. Fertil. 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ICSI\u3067\u3042\u3063\u305f\u305f\u3081\u6d3b\u6027\u5316\u304c\u5341\u5206\u8d77\u3053\u3089\u306a\u304b\u3063\u305f\u3068\u8aac\u660e\u3057\uff0c\u7cbe\u5b50\u306e\u72b6\u614b\u304c\u5a92\u7cbe\u3067\u306e\u53d7\u7cbe\u306f\u96e3\u3057\u304f\u306a\u3063\u3066\u3044\u308b\u305f\u3081modified ICSI\uff08M-ICSI\uff095\uff09\u306b\u3059\u308b\u3053\u3068\u3092\u8aac\u660e\u30575\u56de\u76ee\u306e\u6cbb\u7642\u3092\u884c\u3063\u305f\uff0e \u6392\u5375\u8a98\u767a\u306f4\u56de\u76ee\u3068\u540c\u69d8\u306b\u884c\u3063\u305f\uff0e\u5375\u80de\u306f\u53f39\u500b\uff0c\u5de68\u500b\u3067\u3042\u3063\u305f\uff0e\u63a1\u5375\u6570\u306f16\u500b\uff0c\u53d7\u7cbe\u306f\u5a92\u7cbe\u306b\u3066\u6b63\u5e38\u53d7\u7cbe\u306f8\u500b\u4e2d6\u500b\uff0cM-ICSI\u306b\u3066\u6b63\u5e38\u53d7\u7cbe\u306f8\u500b\u4e2d8\u500b\u3067\u3042\u3063\u305f\uff0e3\u65e5\u76ee\u306b5 \uff5e 8\u5206\u527213\u500b\uff0cDay5\u306b\u80da\u76e4\u80de1\u500b\uff08\u5a92\u7cbe\uff09\u79fb\u690d\u3057\uff0cDay5 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