歷史上的今天

• 2016: 一次成功
• 2016: 一次成功
• 2016: 51歲
• 2015: 試管嬰兒成功關鍵在正常染色體胚胎 ccs
• 2015: 彰化基督教醫院基因醫學部和彰化市博元婦產科進行「一條龍試管嬰兒」訂做優生寶寶
• 2015: 胚胎快篩助孕　不孕婦飆淚：我要當媽了
• 2015: 胚胎檢測助孕 彰基幫圓求子夢
• 2015: 一條龍試管嬰兒技術 圓了不孕症求子夢
• 2015: 一條龍試管嬰兒訂做優生寶寶,基因學大躍進
• 2015: 博元婦產科胚胎篩檢 訂做優生寶寶
• 2015: 少了1條染色體 借精求子圓傳宗接代夢(自由時報報導博元婦產科)
• 2015: 博元婦產科​快篩健康胚胎技術 訂做優生寶寶
• 2015: 男子人高胸器傲人　不孕求診竟罹罕見馬賽克鑲嵌症
• 2015: 不孕8年 罕見無精症作祟
• 2015: 少了1條染色體 彰化市博元婦產科 借精求子圓傳宗接代夢
• 2015: 雌雄莫辨？ 男胸器驚人要借精生子
• 2015: 胚胎快篩新技術帶來新型試管嬰兒技術新紀元
• 2015: RMANJ紐澤西團隊的 次世代定序 NGS 研究 nexgen 新鮮胚胎植入的時代已經來臨，冷凍胚胎時代已經過去 RMANJ LAUNCHES NEXGEN CLINICAL TRIAL; NEXT GENERATION SEQUENCING APPROACH TO IN VITRO FERTILIZATION (IVF) 在2014年去年2月10日首先RMANJ他們進行了一個200個人試管嬰兒次世代定序臨床的研究， 這是一個雙盲的研究，實驗組是植入兩個經過次世代定序的胚胎， 而對照組是外觀選擇的胚胎， 次世代無疑它的好處是快速， 最重要的是很便宜， 在之前紐澤西團隊他們是是用qPCR來進行胚胎切片，植入兩個胚胎獲得84.7%的活產率， 他們仍然認為CCS應該可以 更精準或更便宜一些， 所以2014年2月進行了一個次世代定序的臨床研究， 有關RMANJ紐澤西團隊他們在1999年成立至今， 已經誕生3萬個試管寶寶， 在2013年ASRM美國生殖醫學會有發表28篇的學術論文， 他們最為人稱讚的是不斷的開發新的技術， 使用qPCR24染色體選胚胎植入胚胎：快速新鮮胚胎植入， 所以他們最近在美國不孕症與醫學期刊發表一份看法就是， 基於7個理由(見以下參考):CCS新鮮胚胎植入的時代已經來臨，而冷凍胚胎這個時代已經過去， RMANJ試管嬰兒中心更奇怪和有趣的觀察是， 他們直接跳過不使用a-CGH去進行胚胎篩檢， 而從SNP技術跳到qPCR技術再一躍跳到NGS， 而直接跳過a-CGH， 這真的很有趣很值得玩味的一個發現，是不是代表a-CGH： (1)a-CGH在篩檢胚胎太過精準以至於會"誤棄"胚胎。 (2) a-CGH是太繁瑣要冷凍胚胎，使他們讓病人花費冷凍胚胎的費用， a-CGH的晶片費用非常的昂貴，一個胚胎切片在台灣估價要1萬8000元，這對病人來講是很大的負擔， 我們持續觀察美國紐澤西團隊次世代定序這200個研究NGS 統計的的活產率著床率報告， 應該會優於兩個胚胎的qPCR的84.7%的活產率。 參考： REF:: CCS不必冷凍胚胎,如王寶釧苦守寒窰18年等報告！qPCR CCS 新鮮胚胎植入的 "7大" 理由，根據RMANJ紐澤西團隊斯考特Scott的論述，在生育與節育期刊提出 7大鐵證 ，證明進行CCS不用冷凍胚胎，新鮮胚胎植入就大可進行，理由有： (1)因為CCS的正確性和有效性可以大幅提高成功率和胚胎著床率。 (2)提高試管嬰兒成功率是最大的考慮，而胚胎染色體異常比率從25%增加到40歲之後的85%，這使得更需要做CCS。 (3)因為CCS的費用實在是很昂貴，也因此能夠讓病人少錢就是一個patient center care，因此是不是能夠減少病人冷凍胚胎的費用呢？ (4)使用CCS可以減少多胞胎的比率，因為染色體正常就可以進行單一胚胎植入，進行BEST也就是所謂的囊胚期染色體正常單一胚胎植入。根據研究單胞胎和雙胞胎小孩子的體重，單胞胎會比雙胞胎增加650公克。 (5)冷凍胚胎其實是不可以不用的，因為有CCS之後會有單一胞胎植入，單一胚胎植入之後會有冷凍胚胎，這個冷凍胚胎的對象是染色體正常的胚胎。 (6)有一些病人並不能從CCS得到好處，只有部分的病人，比如根據RCT三份的研究發現，如果說打針病人年紀大，取卵數少，AMH低,或者是形成囊胚期胚胎率低，這個做CCS並沒有得到好處。 (7)能夠進行CCS一定要： 1.進行囊胚期胚胎培養、 2.能夠進行胚胎切片、 3.能夠進行快速冷凍的方法。 因此這三大要件都存在的實驗室，才能夠進行CCS新鮮胚胎植入，並不是每一家試管嬰兒中心都有這3個技術這個能力，因此他提出因為有這個7大理由的時機已經成熟， 也因此 進行胚胎全基因放大檢測胚胎的染色體， 進行胚胎的植入"新鮮"胚胎植入，妳不必再冷凍胚胎苦苦等報告了，這一份的學士論文是登在生育與節育期刊2014年9月份。 參考： Comprehensive chromosome screening with synchronous blastocyst transfer: time for a paradigm shift* Recently, the nature of assisted reproductive technology (ART) laboratory investigation has been shifting. Tradition- ally, it has focused on optimizing the culture milieu or assur- ing fertilization; now, a variety of new technologies are available to assess the reproductive potential of individual embryos. Perhaps most prominent has been the resurgence of embryonic aneuploidy screening. The validation of 24-chromosome testing platforms has led to a variety of studies demonstrating higher implantation and delivery rates. These findings are now translating to changes in the para- digm of ART practice. Caution is prudent in times of change, and methodical analyses are needed. Evaluation logically focuses on efficacy in terms of enhanced implantation and delivery rates. Other factors, such as safety, cost, and accessibility also deserve thoughtful consideration. Evaluations of these endpoints should take into account the caliber of the data supporting the ‘‘new paradigm,’’ in parallel with the data supporting the current ‘‘standard of care,’’ and both should be evaluated with the same level of rigor. Several investigators have recently expressed concerns about the implementation of comprehensive chromosomal screening (CCS) in clinical practice. Fortunately, an ever- growing literature is available to provide clinicians and scien- tists with the information they need to evaluate many of the critical issues. Some of the major issues and questions include: 1. Efficacy of 24-chromosome embryonic aneuploidy screening. Multiple studies provide class I data demon- strating higher implantation and delivery rates following 24-chromosome aneuploidy screening. In distinct contrast to fluorescent in-situ hybridization-based preimplantation genetic screening studies in which every randomized controlled trial (RCT) showed either no improvement or active detriment, every RCT involving 24-chromosome screening has demonstrated benefit (1–3). 2. What magnitude of improvement in clinical outcomes is necessary to justify screening? Answering this question inevitably involves a subjective decision that will be made by patients after counseling by the clinicians caring for them. Given that aneuploidy rates vary from 25% in women in their late twenties to 85% for those in their mid-forties, the opportunity for enhancing outcomes will be greatly affected by the age of the female partner and her intrinsic ovarian responsiveness. It is unlikely that im- provements will be made in direct proportion to the aneu- ploidy rate, as many other factors affect delivery rates. Women with high embryonic arrest rates are unlikely to attain the full benefit of screening. Still, the magnitude of the enhanced outcomes seen in the RCTs is substantial. 3. The cost of CCS may be burdensome. Although substantial costs are associated with CCS, even in proportion, they are * This is an open access article under the CC BY-NC-ND license (http:// would appear that this type of screening is appropriate creativecommons.org/licenses/by-nc-nd/3.0/). 660 VOL. 102 NO. 3 / SEPTEMBER 2014 lower than the costs of additional ART cycles. A definitive cost-effectiveness study has not been published to date. Although enhanced delivery rates should translate to fewer treatment cycles, that question must await more detailed analyses before conclusions may be drawn. Additionally, savings attributable to decreased pregnancy losses and the care provided to ongoing aneuploid gestations would need to be considered. Given that, and the impact on transfer or- der discussed below, it is unlikely that cost effectiveness will limit implementation of embryonic aneuploidy screening. 4. Implementation of CCS may actually increase the risk for multiple gestations unless transfer order is reduced. That very fact has already been established in a randomized controlled trial (2). In fact, it is a mathematical certainty. As implantation rates increase, if there is no decrease in transfer order, then multiple gestation rates will inevitably rise. However, it is not reasonable to assume that transfer order would remain the same. For the first time, there are class I data demonstrating eSET after CCS is as effective as double-embryo transfer of unscreened embryos (2). All prior RCTs comparing elective single-embryo transfer (eSET) versus double-embryo transfer found poorer per- transfer outcomes with eSET. If CCS is used, that is no longer true. Equivalent delivery rates are maintained while virtually eliminating the risk of twins. The paradigm using CCS and eSET produced an average gain in birth weight of approximately 650 grams. No other single intervention in obstetrics has produced such a dramatic enhancement in birth weight, which is known to be highly correlated with the health of the child. Of course, the transfer of two screened embryos would further increase pregnancy rates, but at the cost of quite elevated twin rates; thus, it should be discouraged. Armed with these data, utilization of eSET in our program has risen from less than 6% to approximately 60% over a 4-year interval. 5. Embryo cryopreservation is essential to the application of CCS. This is an excellent point, as it is true in many, but not all, programs. Analyses can be completed in as little as 4 hours, and several programs now have testing labora- tories within their facilities. However, that may not be necessary. Data from RCTs demonstrate equivalent deliv- ery rates following the transfer of fresh or vitrified CCS screened blastocysts (2). Furthermore, data now demon- strate meaningfully better obstetrical outcomes in concep- tions following the transfer of cryopreserved embryos. 6. Some subpopulations may not benefit from aneuploidy screening. The studies to date have focused on infertile normal responders. No class I data address the impact of CCS in women who are low responders or have recurrent pregnancy loss. An RCT to determine the impact of CCS in women at risk for low response to gonadotropin stimu- lation has been registered (NCT01977144) and is currently underway. Within the general ART population, individuals who might typically be considered candidates for two- embryo transfer should be offered CCS. Given that the eSET rate was 8.8% in the recently released 2012 Society for Assisted Reproductive Technology (SART) data, it Fertility and Sterility® for very large numbers of patients. Even those patients who desire eSET attain increased delivery rates if the euploid embryos are selected for transfer. Although many of these patients already have excellent delivery rates, it is difficult to imagine a scenario in which the in- creases in implantation rates seen in the RCTs done to date would not be a compelling reason to screen. 7. The need to culture to the blastocyst stage to safely biopsy em
• 2015: 新基因定序NGS 產健康試管嬰
• 2015: 新基因定序NGS 產健康試管嬰篩除壞胚胎費用減半 成功率升為8成
• 2015: 試管嬰兒新世紀：胚胎快篩新鮮植入的時代已經來臨
• 2015: 病人送的「好孕棉」我怎麼好意思送給其他的病人呢
• 2015: 胚胎的染色體異常怎麼那麼多？aCGH
• 2015: 博元婦產科一條龍試管嬰兒訂做優生寶寶 ，己有6對夫 妻懷孕成功
• 2015: 一條龍試管嬰兒訂做一個優生寶寶
• 2015: 史上最棒聖誕禮物　彰化博元婦產科 胚胎快篩助不孕婦成功懷孕
• 2015: 一條龍試管嬰兒 博元婦產科訂做優生寶寶12041423 https://www.youtube.com/watch?v=YSZGcExBGGw
• 2014: 中視新聞報導博元婦產科, 43歲日本媳婦回台求子如願pi
• 2014: [助妳好孕] 求子成功：子宮沾黏息肉 TV109
• 2014: [助妳好孕] 求子成功：輸卵管不通 TV110
• 2014: [助妳好孕] 求子成功：多曩性卵巢TV111
• 2014: [助妳好孕] 求子成功：卵巢功能不佳 TV112
• 2014: [助妳好孕] 求子成功：精蟲抗體 TV113
• 2014: [助妳好孕] 求子成功：寡精症 TV114
• 2014: [助妳好孕] 求子成功：無精症 TV115
• 2014: [助妳好孕] 求子成功：高齡不孕 TV116
• 2014: [助妳好孕] 求子成功：遺傳異常 TV117
• 2014: [助妳好孕] 求子成功：精子银行 TV118
• 2014: [助妳好孕] 求子成功－借卵生子 TV120
• 2014: [助妳好孕] 求子成功-子宮異常 TV121
• 2014: [助妳好孕] 求子成功-快速診斷、快速懷孕 TV122
• 2014: [助妳好孕] 求子成功-習慣性流產 TV123
• 2014: 來自威斯康新州麥迪遜的試管嬰兒病人-台灣博元一次成功就三胞胎
• 2014: 試管嬰兒 驚奇懷孕記!林青容專訪博元婦產科蔡鋒博醫師
• 2014: 第三代基因晶片試管嬰兒 林青蓉專訪博元婦產科蔡鋒博醫師
• 2014: [助妳好孕] 求子成功-雷射胚胎輔助孵化 TV124
• 2014: [助妳好孕] 求子成功-子宮感染 TV125
• 2014: [助妳好孕] 求子成功-高齡不孕 TV126
• 2014: [助妳好孕] 求子成功：人工授精 TV127
• 2014: [助妳好孕] 求子成功：多胞胎減胎 TV129
• 2014: [助妳好孕] 卵巢過度刺激症候群 TV130
• 2014: [助妳好孕] 求子成功：做子宮鏡就懷孕？ TV131
• 2014: [助妳好孕] 求子成功：做腹腔鏡就懷孕？ TV132
• 2014: [助妳好孕] 求子成功趣談-子宮鏡 TV146
• 2014: [助妳好孕] 求子成功趣談-超音波 TV147
• 2014: [助妳好孕] 求子成功趣談-胚胎 TV148
• 2014: [助妳好孕] 求子成功趣談-精蟲危機 TV149
• 2014: [助妳好孕] 試管寶寶故事 TV151
• 2014: [助妳好孕] 求子辛酸故事：心事誰人知？ TV152
• 2014: [助妳好孕] 求子成功故事：迷你試管嬰兒 TV153
• 2014: [助妳好孕] 敗敗敗！多次試管嬰兒－再失敗怎麼辦？ TV154
• 2014: [助妳好孕] 逢年過節，她為何不想回”娘”家？ TV155
• 2014: [助妳好孕] 最想問醫師的10個不孕問題 TV156
• 2014: [助妳好孕] 不孕”新”新聞 TV157
• 2014: [助妳好孕] 搶救精蟲大作戰！ TV158
• 2014: [助妳好孕] 如何行房容易懷孕？ TV159
• 2014: [助妳好孕] 準備什麼試管嬰兒易成功？ TV160
• 2014: [助妳好孕] 試管嬰兒新儀器 TV163
• 2014: [助妳好孕] 從大明星懷孕談高齡不孕 TV164
• 2014: [助妳好孕] 如何增後子宮內膜厚度？ TV165
• 2014: [助妳好孕] 病人故事：男性取精 TV162
• 2014: [助妳好孕]卵子銀行 TV168
• 2014: [助妳好孕]做試管嬰兒前為何吃避孕藥？ TV169
• 2014: [助妳好孕]子宮黃金三條線 TV170
• 2014: [助妳好孕]女人生育的紅、黃、綠燈 TV171
• 2014: [助妳好孕] 試管嬰兒新科技 TV172
• 2014: [助妳好孕] 借精生子成功 TV174
• 2014: [助妳好孕] 精蟲抗體－求子成功 TV175
• 2014: [助妳好孕] 子宮內膜異位症－求子成功 TV176
• 2014: [助妳好孕] 多囊卵巢症候群－求子成功 TV177
• 2014: [助妳好孕] 高泌乳激素，求子成功 TV178
• 2014: [助妳好孕] 人工授精，求子成功 TV179
• 2014: [助妳好孕] 無精症，求子成功 TV180
• 2014: [助妳好孕] 如何植入胚胎，求子成功 TV181
• 2014: [助妳好孕] 冷凍胚胎，求子成功 TV182
• 2014: [助妳好孕] 試管嬰兒為何外孕？ TV183
• 2014: [助妳好孕]不明原因不孕，求子成功 TV184
• 2014: [助妳好孕] 自然試管嬰兒－求子成功　TV186
• 2014: [助妳好孕] 53歲求子成功 TV188
• 2014: [助妳好孕] 搶救子宮 TV202
• 2014: [助妳好孕] 搶救精蟲 TV203
• 2014: [助妳好孕] 子宮鏡，助懷孕！ TV189
• 2014: [助妳好孕]過度刺激，求子成功 TV192
• 2014: [助妳好孕]射精異常，求子成功 TV193
• 2014: [助妳好孕] 人造精子.卵子.子宮.小孩？ TV196
• 2014: 不孕症治療的明日之星：蔡鋒博醫師說明什麼是人造精子.人造卵子.人造子宮.人造小孩？ TV196
• 2014: 九九神功​不是好事，你會不會糖尿病？射精異常，求子成功 TV193
• 2014: 做個試管嬰兒怎麼腹部積水？卵巢​過度刺激，求子成功 TV192
• 2014: 好慘！精子這麼少，太太怎麼受孕​搶救精蟲 TV203
• 2014: 雙角子宮怎麼受孕？墮胎太多次，怎麼受孕？​搶救子宮 TV202