< 輸卵管整形術的效果 >
各位好
我是威廉氏後人 – 李毅評醫師
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這是一位37歲的患者,小飛。
備孕超過5年以上
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37歲的小飛
在五年前備孕一開始接受檢查時
就發現雙側輸卵管阻塞
卵巢功能正常,AMH = 4.8
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除此之外,
先生精子也有活動力不足的問題
總活動力僅15% - 20%左右 (及格標準:>32%)
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五年前
32歲的小飛選擇了某知名醫師接受腹腔鏡輸卵管整形手術
後來手術後過不久
最終,雙側輸卵管仍舊發生阻塞
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三年前,
34歲的小飛
前往台北另一位名醫那接受傳統開腹式輸卵管整形術
這一次手術後
雙側輸卵管在檢查時都有流出顯影劑
後來小飛雖於同年自然懷孕
但發生左側輸卵管外孕
最終將外孕側輸卵管切除
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後來的三年
小飛再也沒懷孕過
雖然再次檢查的輸卵管攝影右側有通
但仍然三年都未能懷孕
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37歲的小飛
最終選擇在我這邊接受第一次試管嬰兒療程
共取卵12顆,有8顆受精
最終得到囊胚5顆,品質中等到中上
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經過一次自然週期解凍植入
就順利懷孕
真是可喜可賀、可喜可賀。
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面對輸卵管因素不孕症
大部分的人都會選擇接受輸卵管手術
然後再嘗試自然懷孕
當然這樣的作法是合情理的
但前提是,
如果同時有其他需要試管嬰兒原因
如高齡、精蟲問題、卵巢早衰等等的情況
選擇接受輸卵管整形術再嘗試自然懷孕往往緩不濟急。
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至於輸卵管手術效果究竟如何呢?
根據過去的研究統計
年輕但雙側輸卵管阻塞的患者
若選擇接受輸卵管整形手術
再自行嘗試一年
最終累積懷孕率共40%
正常懷孕比例33%,子宮外孕7%
但同年齡的試管嬰兒的累積懷孕率是55%
也就是說
如果只有輸卵管這一個問題
精子、年齡、卵巢都沒有問題的情況下
輸卵管整形手術或可一試
但面對同時合併有其他問題的時候
直接選擇做試管嬰兒療程似乎是一個更合理的選擇。
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參考資料:Surgery: Should lysis of adhesions be performed when in-vitro fertilization and embryo transfer are available? Human Reproduction, Volume 9, Issue 12, December 1994, Pages 2339–2341,
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~ 威廉氏後人 – 李毅評醫師 ~
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同時也有2部Youtube影片,追蹤數超過72萬的網紅腦補給,也在其Youtube影片中提到,【蝦皮拍賣】 我現在自己在製作天然寵物肉乾 適合貓狗人吃 ,沒有防腐劑調味料 蝦皮網址: https://shopee.tw/twjerky 訂購LINE: 0900109282 FB/IG: 中崙天然寵物肉乾 【今日內容】 2017年將我們帶入了一個科幻未來 從細胞再生植入器官到使用基因編輯技...
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China Halts Work by Scientist Who Says He Edited Babies’ Genes
中國暫停賀建奎研究基因編輯嬰兒
China said on Thursday that it had suspended the work of a scientist who claims to have created the world’s first genetically edited babies, saying his conduct appeared to be unethical and in violation of Chinese law.
週四,中國表示已暫停一名聲稱創造了世界首例基因編輯嬰兒的科學家的工作,稱其行為不道德,且違反了中國法律。
The scientist, He Jiankui, announced on Monday that he had used the gene-editing technique Crispr to alter embryos, which he implanted in the womb of a woman who gave birth to twin girls this month. At an international conference on Wednesday, he asserted that he was proud of what he had done.
週一,科學家賀建奎宣佈,他利用基因編輯技術Crispr改變胚胎,並將其植入了一名女性的子宮,該名女性在本月生下一對雙胞胎女兒。在週三的一個國際會議上,他堅稱為自己所做的一切感到自豪。
Xu Nanping, China’s vice minister of science and technology, said Dr. He’s work was still being investigated. But based on news reports, he said, Dr. He appeared to have “blatantly violated China’s relevant laws and regulations” and broken “the bottom line of morality and ethics that the academic community adheres to,” the state broadcaster China Central Television reported on Thursday.
中國科技部副部長徐南平表示,對賀建奎工作的調查仍在進行中。根據官方的中央電視臺週四報導,他說,這次媒體報導的基因編輯嬰兒事件「公然違反了我國的相關法規條例」,也突破了「學術界堅守的道德倫理的底線」。
“It is shocking and unacceptable,” Mr. Xu was quoted as saying. “We are resolutely opposed to it.”
這「令人震驚不可接受」,報導引用徐南平的話說,「我們是堅決反對的。」
The suspension follows international condemnation from scientists who maintain that Dr. He’s conduct was unethical. They say there are serious unanswered questions about the safety of embryo editing and a need to make sure that such research is conducted in a transparent, monitored way so the technology is not misused.
在暫停職務之前,國際上的科學家譴責賀建奎的行為不道德。他們表示,胚胎編輯的安全性存在嚴重且尚未解決的問題,需要確保以透明、受監控的方式進行這類研究,以免這項技術遭到濫用。
Mr. Xu had said earlier that Chinese regulations issued in 2003 permitted gene-editing experiments on embryos for research purposes, but only if they remained viable for no more than 14 days.
徐南平早些時候曾表示,中國監管部門在2003年頒佈的法規允許對胚胎進行基因編輯實驗,但前提是這些胚胎的存活時間不超過14天。
On Monday, a group of 122 Chinese scientists issued a statement calling Dr. He’s actions “crazy” and his claims “a huge blow to the global reputation and development of Chinese science.”
週一,122名中國科學家發表連署聲明,稱賀建奎的行為「瘋狂」,他的言論「對於中國科學在全球的聲譽和發展都是重大的打擊」。
At the Second International Summit on Human Genome Editing in Hong Kong on Wednesday, Dr. He acknowledged that he had not made his university in China aware of the research he was doing. He said he had initially paid for the research himself, then later from his university funding.
在週三於香港召開的第二屆人類基因組編輯國際高峰會上,賀建奎承認,他沒有讓他任職的中國大學知道他正在做的這項研究。他表示,最初自己支付了這項研究的費用,後來用的是大學的經費。
Dr. He pushed back against suggestions that he had been secretive about his work, saying that he had presented preliminary aspects of it at conferences and consulted with scientists in the United States and elsewhere. He said he had submitted his research to a scientific journal for review and had not expected to be presenting it at the conference.
賀建奎反駁了有關他對自己的工作守口如瓶的說法,指出他曾在各種會議上展示過初步的研究成果,並諮詢了來自美國和其他地方的科學家。他表示,已經將研究報告提交給了一份科學雜誌進行審議,且原本沒想到會在本次大會上發表。
One of many areas of confusion about Dr. He’s research was the status of a possible pregnancy of a second woman he said he had implanted with an edited embryo. On Wednesday, under questioning from scientists after his talk, Dr. He said there had been a second implantation in an early stage.
關於賀建奎的研究,有許多令人困惑的地方,其中之一是他所說的已經植入了被編輯過的胚胎、可能懷孕的第二名女性的情況。週三,在演講結束後,賀建奎接受了科學家的提問,他表示,第二例植入還處在早期階段。
When asked by Robin Lovell-Badge, a professor of genetics and embryology at the Francis Crick Institute in London, whether by early stage Dr. He meant a “chemical pregnancy” or early miscarriage, Dr. He said “yes.”
當被倫敦Francis Crick Institute的遺傳學和胚胎學教授Robin Lovell-Badge問道,他所說的「早期階段」是指「化學妊娠」(即早期流產)嗎,賀建奎回答,「是的」。
On Thursday, however, Dr. Lovell-Badge told reporters that he could not be sure that Dr. He understood that “chemical pregnancy” referred to a pregnancy that was lost.
然而,Lovell-Badge博士在週四告訴記者,他不能確定賀建奎是否理解「化學妊娠」指的就是流產。
“He doesn’t necessarily know what he’s talking about,” Dr. Lovell-Badge said. “We don’t know. He said he confirmed that essentially they’d done the hormone test for whether or not the woman was pregnant. And the answer is yes. But it’s very early, so it could turn into a chemical pregnancy meaning there was a miscarriage. Many embryos fail to survive.”
「他不一定知道自己在說什麼,」Lovell-Badge博士說,「我們也不知道。他說他可以證實他們已經做了激素檢測,以確定這名女子是否懷孕。答案是肯定的。但現在為時尚早,所以也可能會變成化學妊娠,也就是流產。許多胚胎無法存活。」
Dr. He had been scheduled to speak again at the conference on Thursday, but his talk was canceled.
賀建奎原定於在週四的會議上再次發言,但已被取消。
Dr. Robin Lovell-Badge, who moderated the Wednesday session, said in an email that “it would have been difficult to have sufficient security” for a second talk. He said that Dr. He had decided not to attend after he was told about the security arrangements.
Lovell-Badge博士主持了週三的會議,他在一封電子郵件中說,「很難有足夠的安全措施」保障賀建奎的第二次發言。他表示,賀建奎在得知安保安排後,決定不再參加。
Dr. Lovell-Badge said Thursday that the organizers had felt it was “important to give Dr. He a platform to present what he had done.”
Lovell-Badge博士週四表示,主辦方認為,「給賀建奎一個展示他所做的事情的平臺很重要。」
“We therefore do not regret at all allowing him to present yesterday, but giving him a second opportunity today might also have been viewed as support for him,” he said. “This is another reason the committee did not want him back today.”
「因此,我們一點也不後悔允許他昨天發表演講,但今天給他第二次機會也可能被視為對他的支援,」他說,「這也是委員會不希望他今天再次現身的另一個原因。」
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human embryo 在 多益達人 林立英文 Facebook 的最讚貼文
【時事英文】
Chinese scientists pioneer monkey cloning
中國科學家搶先成功製造出複製猴
Scientists in China have successfully cloned two monkeys, the latest step in the country’s ambition to become a global scientific leader.
中國科學家們成功複製出兩隻猴子,懷著雄心壯志朝成為全球領先科學大國的目標再邁出了最新的一步。
The genetically identical long-tailed macaques born in Shanghai last month, called Zhong Zhong and Hua Hua, are the first primate clones produced through the method that made Dolly the sheep in Scotland in 1996. Their names are a play on the phrase Zhonghua, which means Chinese nation or people.
這兩隻基因相同的長尾獼猴在上個月誕生於上海,取名為中中和華華,它們是自1996年第一隻複製羊「桃莉 (Dolly) 」在蘇格蘭誕生以來,用同樣方法複製出來的首批靈長類動物。牠們名字的寓意為「中華」,即中華民族或中國人民。
Although the cloning method, known as somatic cell nuclear transfer (SCNT), is almost routine in mammals such as sheep, cattle and mice, it has been extremely difficult to replicate in primates. Previous efforts with monkeys often resulted in clones that did not develop properly as embryos or died shortly after birth.
雖然被稱為「體細胞核移植 (SCNT) 」的複製方法用於羊、牛和鼠等哺乳動物已近乎尋常,但在靈長類動物身上極難應用。以前複製猴子的嘗試往往只能得到無法正常發育的胚胎,或者在出生後很快夭折的動物。
Now that SCNT cloning has been achieved with primates, human cloning is possible, said authors of the study, which is published in the journal Cell.
相關研究報告發表於《細胞(Cell)》這本學術期刊上,且其作者們表示,既然靈長類動物已經實現了體細胞核移植複製,人類複製是有可能的。
“The technical barrier is now broken. In principle [this method] can be applied to humans,” said Mu-ming Poo, a co-author, from the Chinese Academy of Sciences Centre for Excellence in Brain Science and Intelligence Technology. But, he added, “we cloned [the macaques] to produce animal models useful for medicine, for human health. There’s no intention for us to apply this method to humans.”
「技術障礙現在被突破了。原則上(這種方法)可以應用於人類,」來自中國科學院腦科學與智慧技術卓越創新中心(CEBSIT)的聯名作者蒲慕明表示。但他補充稱:「我們複製(這些獼猴)以培育用於醫學、服務於人類健康的動物模型。我們並沒有意圖將這種方法應用在人類身上。」
SCNT involves replacing the nucleus of an egg cell with DNA from a differentiated body cell such as skin. This reconstructed egg develops into a clone of the DNA donor.
體細胞核移植涉及用來自分化的體細胞(如皮膚)的DNA取代卵細胞的細胞核。經過重建的卵細胞發育成DNA供體的複製。
In 1999 US researchers at the Oregon National Primate Research Center produced a live cloned rhesus monkey, named Tetra, through embryo splitting — a simpler process that occurs naturally in identical twins but cannot generate more than four clones at a time.
1999年,美國俄勒岡國家靈長類動物研究中心(Oregon National Primate Research Center)的研究人員利用胚胎分裂技術(一種更簡單的過程,在同卵雙胞胎中自然發生,但無法一次產生4個以上的複製體),成功複製出一隻名叫Tetra的恒河猴。
In principle, SCNT can produce a larger number of clones from the same donor, which could help medical research by generating genetically uniform groups of monkeys with specific characteristics.
原則上,體細胞核移植可從相同的供體產生更大數量的複製,有望通過產生具有特定特徵且基因一致的猴群來幫助醫學研究。
The team at the Chinese Academy of Sciences’ Institute of Neuroscience in Shanghai failed in its efforts to produce healthy clones from adult cells but succeeded with fibroblasts — connective tissue cells — from a macaque foetus.
位於上海的中國科學院神經科學研究所的研究小組未能從成體細胞獲得健康的複製體,但用一個獼猴胎兒的成纖維細胞(結締組織細胞)取得了成功。
The researchers not only replace the DNA sequence but also make sure the sequence expression of certain genes and the amount of that expression are co-ordinated so they are in the right place at the right time,” said Gang Fang at New York University Shanghai. “That’s quite difficult.”
「研究人員不僅要替換DNA序列,還要確保某些基因的序列表達以及表達的數量協調一致,使它們在正確的時間到達正確的位置,」上海紐約大學(New York University Shanghai)的方剛表示。「這種操作的難度很大。」
Zhong Zhong, eight weeks, and Hua Hua, six weeks, are apparently developing normally. The Shanghai team expects more macaque clones to be born over the coming months.
8周的中中和6周的華華顯然在正常發育。上海的研究團隊預計未來幾個月會有更多複製獼猴誕生。
The study raises concerns about animal ethics in China, which has less rigid testing regulations than many other countries, though the researchers followed guidelines for animal research set by the US National Institutes of Health. Dr. Poo is encouraging scientists internationally to discuss the issue. “We are very aware that future research using non-human primates anywhere in the world depends on scientists following very strict ethical standards,” he said.
這項研究令人關注中國的動物倫理學,中國的試驗法規沒有其他很多國家那麼嚴格,儘管上海項目的研究人員遵循了美國國立衛生研究院(NIH)制定的動物研究指導方針。蒲慕明鼓勵各國科學家討論這個問題。「我們非常清楚,未來在世界上任何地方利用非人靈長類動物開展研究,都有賴於科學家們遵循非常嚴格的倫理標準,」他表示。
The cloned macaques are examples of the way skyrocketing Chinese state funding of basic research is yielding significant advances in fields ranging from quantum computing to biology.
複製獼猴是又一個例證,說明中國對基礎研究大舉增加相關的資助,這正在從量子計算到生物學等各個領域帶來長遠的進展。
Chinese state-led funding of basic research — science that has no immediate commercial applications — increased to $10 billion in 2015. While that number is about one-quarter of US federal spending on basic research, it represents a vast increase from the $3.9 billion in total state science funding four years earlier, according to China’s National Natural Science Foundation.
在中國,國家主導的基礎研究(沒有直接商業應用的科學研究)經費在2015年增至100億美元。儘管這個數字大約是美國聯邦基礎研究支出的四分之一,但是相比四年前39億美元的國家科研經費總額,算是有著巨大幅度的增加(資料來自中國國家自然科學基金會)。
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【蝦皮拍賣】
我現在自己在製作天然寵物肉乾 適合貓狗人吃 ,沒有防腐劑調味料
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【今日內容】
2017年將我們帶入了一個科幻未來 從細胞再生植入器官到使用基因編輯技術來治療疾病 全球的研究人員和科學家日夜不停的帶給人類這樣的未來 歡迎來到腦補給 今天要來看讓人驚訝的2017年五個科學大發現
5 基改人類胚胎https://futurism.com/a-new-gene-editing-breakthrough-could-forever-change-life-on-earth/
https://www.nature.com/nature/journal/vaop/ncurrent/full/nature23305.html
https://www.technologyreview.com/s/608350/first-human-embryos-edited-in-us/
https://www.digitaltrends.com/cool-tech/human-embryo-crispr-us/
4 人工子宮https://futurism.com/4-artificial-womb-could-revolutionize-treatment-for-premature-children/
https://www.youtube.com/watch?v=dxn6msihFjc
3 外星人的星球https://www.eso.org/public/news/eso1712/
2 生長器官及再生人體組織https://futurism.com/breakthrough-drug-discovery-could-let-scientists-repair-nerve-damage/
https://www.nature.com/ng/journal/vaop/ncurrent/full/ng.3487.html
1 量子計算機將改變世界https://www.youtube.com/watch?v=JhHMJCUmq28
https://kknews.cc/science/npqvkn3.html
【貼心提醒】
訂閱後記得開小鈴鐺才能夠準時接收到新影片哦!
【關於腦補給】
這是一個創新吸收新知識的頻道,在這裡你可以看到世界上新奇的東西、知識。 如果喜歡可以按訂閱,也可以在下面留言你想要知道的主題。
【社交網址】
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Keeping human embryos alive in a dish is getting easier. How are researchers and ethicists responding? ... <看更多>
human embryo 在 Human embryonic development: from peri-implantation to ... 的相關結果
The basic body plan of the mammalian embryo is established through gastrulation, a pivotal early postimplantation event during which the ... ... <看更多>
human embryo 在 Human embryonic development - Wikipedia 的相關結果
Human embryonic development, or human embryogenesis, refers to the development and formation of the human embryo. It is characterised by the processes of ... ... <看更多>