資料4:家族形成のための生殖医療(石原委員資料)
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1 資料 4 ICMART (Interna.onal Commi3ee Monitoring ART) IFFS (Interna.onal Federa.on of Fer.lity Socie.es) 30/10/18
2 2009Infer.lity (clinical defini.on): a disease of the reproduc.ve system defined by the failure to achieve a clinical pregnancy ager 12 months or more of regular unprotected sexual intercourse Interna,onal Commi3ee for Monitoring Assisted Reproduc,ve Technology (ICMART) and the World Health Organiza,on (WHO) revised glossary of ART terminology, 2009
3 A disease characterized by the failure to establish a clinical pregnancy aler 12 months of regular, unprotected sexual intercourse or due to an impairment of a person s capacity to reproduce either as an individual or with his/her partner. Fer,lity interven,ons may be ini,ated in less than one year based on medical, sexual and reproduc,ve history, age, physical findings and diagnos,c tes,ng. Infer,lity is a disease, which generates disability as an impairment of func,on. 12 / ICMART
4 30 1
5 (IVF: In vitro Fertilization) (ICSI: Intracytoplasmic Sperm Injection) (ART) ART: Assisted Reproductive Technology International IVF Day 40 ARTMAR (WHO) MAR: Medically Assisted Reproduc.on
6 () 500, ,000 FET ICSI IVF 400, , , , , , ,000 50, ,478 42,171 30,287 35,069 24,459 15,887 5,208 8,132 9,95011,65313,034 1,303 1,6822,900 73,927 60,115 95,764 83, , , , , ,335 JSOG
7 JSOG ART 60,000 FET ICSI IVF 50,000 40,000 30,000 20,000 22,465 19,011 16,454 44,678 40,611 36,595 32,148 27,715 10, ,299 4,798 5,5386,5427,930 9,257 12,425 1,5671,812 2,245 2,467
8 Ini,ated cycles 447,790 Transferred cycles 252,835 Pregnancy cycles 75,976 Live Birth cycles 52, , ,835 75,976 52, Female Age JSOG
9 ART(2016) Pregnancy Rate & Live Birth Rate 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Female Age PR/ET PR/ITT LBR/ITT Miscarriage/Pregnancy /ET / / / 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% JSOG Miscarriage Rate
10
11 ART 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 43.4% 42.8% <35 Adopted from JSOG data
12 ART (2012) 100% 80% 60% 40% 20% 0% 23,8 22,6 28,3 23,9 16,7 11,5 13,4 44,7 38,1 34,2 38,3 37,2 34,7 43,2 35,1 35,7 44,9 50,4 52, ,1 36,5 41,4 19,6 Japan Argen,na Brasil Australia USA UK Sweden Finland <35 yr yr 40 yr Zegers- Hochschild, Nygren & Ishihara
13
14 International Committee Monitoring ART
15 2014 1,647,777311, % 9.4% 2013 Freeze all(+53%) International Committee Monitoring ART
16 2014 1, 647,777 1,006,841(+8.6%) 20.2%(+1.0%) 276,317 IVF 663,701 ICSI 456,192(+9.7%) 22.9%(+1.0%) 30,914PGD/PGS(+76%) 28.7%(+8.0%) 108,064(+29.2%) 29.8%(- 2.4%) International Committee Monitoring ART
17 ART 1,647,777 (+9.6%) ,344 (+7.1%) 510, , % (+1.0%), 28.6% (+1.2%) 70.6% ICSI (+1.8%); 27.1% 40(+0.4%) : 1.73 (- 0.08) :, freeze- all, PGT
18 ART(2012) 6,000 5,000 5,179 4,000 3,000 2,732 2,660 2,584 2,562 2,000 1, , Zegers- Hochschild, Nygren & Ishihara
19 Zegers- Hochschild, Nygren & Ishihara
20 ART Maeda E, Ishihara O et al: JOGR 40: , 2014
21 2004ART
22 ART non- donor
23 ART IFFS Surveillance
24 * ** *** * *** ART IFFS Surveillance2013
25 IFFS Surveillance2013 ART
26 DC
27 ART(2010) Zegers- Hochschild, Nygren & Ishihara: The impact of legisla,on and socioeconomic factors In the access to and global prac,ce of ART2018
28 ART2010 Zegers- Hochschild, Nygren & Ishihara: The impact of legisla,on and socioeconomic factors In the access to and global prac,ce of ART2018
29
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