人工生殖科技之現況及未來

Present Progress and Future of Assisted Reproductive Technologies

人工生殖科技有很大的進步，包括單一精子顯微注射，成功的克服精子數量太少，活動力太差；排卵刺激發展出GnRH 拮抗劑療程及使用GnRH 誘發卵子成熟，加上冷凍胚胎，大大的減少了卵巢過度刺激症；加強體外培養的培養液及環境，可達到囊胚的時期，選擇一個最好的囊胚做植入，可達高著床率及懷孕率，減少多胞胎懷孕早產的危險性；胚胎著床前診斷，檢查出正常的胚胎，再做植入，它可檢查單一基因疾病及染色體異常；卵子冷凍方面，使用玻璃化冷凍或改良式慢速冷凍，對於未婚的婦女及罹患癌症的婦女，提供了保存生育能力的機會；對於已停經的婦女，可用卵子捐贈來達到成功的懷孕，因此人工生殖科技很有效的造福不孕症患者。

Assisted reproductive technologies (ART) have much progress in the treatment of fertility. Intracytoplasmic sperm injection successfully overcomes the problems of severe oligozoospermia and asthenozoospermia. The introduction of the protocol of gonadotropin-releasing hormone (GnRH) antagonist and GnRH agonist trigger in combination of cryopreservation of all embryos eliminate ovarian hyperstimulation syndrome. Improvements of culture medium and culture environment facilitate embryos to develop to the blastocyst stage. Selection of a good blastocyst can attain high implantation and pregnancy rates. The strategy of single embryo transfer can prevent multiple pregnancy and risk of preterm birth. Pre-implantation genetic diagnosis can detect chromosomal and genetic abnormalities that help to select normal embryo for transfer. Cryopreservation of oocytes using refined slowly freezing or vitrification can preserve fertility for female cancer patients. It is also applied to unmarried women for fertility preservation. For the women with premature menopause or decreased oocyte quality, oocyte donation can effectively help them to get pregnancy. Therefore, ART significantly help infertile couples to achieve their dreams.