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?ʤ??٤??᤯?????ƺ????夲?????ȥ??????dz?ǧ?????ȡ???????ˤ??????̤Ǥ?????

???줬?ۻ??????椬???ˤʤä????̤ʤ??ϡ??????????ۤä??Ƥ⼣???ޤ???

?ۻ?????¦?ˤޤ????Τǡ????椬???ˤʤä????̤???????270?????˲????ʤ??ȼ????ޤ?????

ʢ????Ǥ????ȡ??л??ظΤ??ҵܤ??????˽??餫?????????ϼ????䤹???ݥ????ȤǤ???

?Ƥ??ꡢ??????????瘝????ŻҲ?????åȤ??ơ??????ۻ??ο??Ǥ?Ƥ??뤦???ˤ????????ۻ???ư???????????????äƤ??ޤ??ޤ?????

?Ѹ塢???????dz?ǧ???ޤ??????????Ϥ꼣?äƤޤ?????

?????1???ܤμ??????˼??뤵?????????????ͤ??ĤŤ??Ƥ??ޤ????????⥿???ߥ?ȤϤ????ޤ??????¤?????Ǥ???

?ޤ????᤯?ˤϡ??л????줿?İ????֤?????????????Ƥ??줿???????ޤ??????᡹???̿??????ű??˾??餻?Ƥ????????ޤ???

?????????л????????????Ƥ???Ʊ???????⡢????????ǥ???Ť???????´?Ȥ????????ä??????Ǥ????????㤤?ǤΤ??л????????Ǥ?????

???????????????¼??Ǥνв?⥿???ߥ?ʤΤǤ??礦??

?γ????????ԤäƤ??????ǡ??Ĥ??Ƕ??????????4?ͤ??餿??³???ˡ?AMH???ʤ????⤯?ʤäƤ??ޤ??????٤?????????????ޤ?????

1.2ng/ml???餤????3.4?˲???????????3.???5.2g/ml?Ȥ???4?椬8???ˤʤä??Ȥ???AMH??ǯ???ȤȤ????㲼???Ƥ????Ȥ?????????ž?????????????ΤȤ???¿???Ǥ???

?????????????δ????ͤǤ??Τǡ?蝹伣?Ťȥ졼???????ԤäƤ??ޤ???

?????ʺ????ˤ???3?????????餤?ˡ????μ????ˡ???γ????˦?٤Ȥ????????α??ܶ????˴ؤ?????˦???и????Ƥ??ޤ???

??????γ????˦????ʬ?礹???Τ?AMH(Anti-M???llerian Hormone?????ߥ塼?顼?ɥۥ????????ȸƤФ????ۥ??????ǡ????줬?⤤??3?????????????ʺ????ˤ??????Ҥ?ͽ?????ο????狼???ޤ???

ͽ?????Ȥ???ɽ???ϡ??????椫????ȴ???ŤͤƤ????ɤ??????Ĥ?????????뤫????ɽ???Ǥ????γ??????ξ????κ????ϡ??????ľ???μ???????ȴ???Ԥ??ʤ??ǡ??????ޤ?ȯ?餷???????ʤ??٤?¿?????ơ?????뤳?ȤȤʤ??ޤ???

蝹????Ԥ??ȡ???γ????˦???????????????3?????????餤??æ??Ƥ??????ο??????ʤ??ʤ??ΤǤϤʤ????ȹͤ??Ƥ??ޤ???

????????ξ??硢?????Ǥ???????¿???ʤ뤳?Ȥ????ԤǤ??ޤ???

AMH?ϡ??????ˤ??äƤ褯?ʤ??????⤢???Ȥ??????Ȥǡ????Ť??????????Ȥ˷?¬???륯???˥å??⤢???褦?Ǥ????????δ????ͤ????ξ????Ǥϡ??ե??ƥ??ꥣ?ƥ??????˥å??????ͤ????????ä??ȳФ??Ƥޤ???

?ޤ???¬?????ݤ˸���?????ꡢ??????20??30?????٤??????Ǥ????????δ????ͤΤ褦??2?ܤȤ?3?ܤˤʤ뤳?ȤϤʤ??褦?Ǥ???

 

 

蝹??ϡ???????ǥ?Ǥ??פ??????ʤ????̤???????????ޤ???

?????ϡ???????????????ι??蝹??ղ??Υ??⡼?ȹֽ????Ǥ????????륹?饤?ɤǤ?????????

?????Ǻǹ????ˤʤ룴???ФǤ??л????????Ρ??פ????ս鸫?ο??ܤǤ???

??¦???????????Ҳ?????TESE)???Ԥä??γ????????ԤäƤ??????Ǥ???

?Ȥ??���TESE????????¸???Ƥ??????Ҥ?ͻ????ȡ?????????¸Ψ???㤯?ޤ????Ⱝ???????ˡ????????ҤΤʤ??ˤ????????˾??ʤ????Ҥ??ȤäƸ??????????Ƥ??ޤ?????

?????ϱ??ͤ???蝹????ԤäƤ??ơ??Τ??˼??????Ҥμ????????????з??̤??ɤ??ʤ뤳?Ȥ??ͤ??????饤?ɲ??????β??????????ΤȤ?????蝹???Ϥ??ޤ?????

蝹䳫?????ϡ?????????3?ġ?67?????٤????Ҥ???Ⱦǯ??蝹伣?Ť?WHO?????պ????????ˤ鷺?????Ϥ??ʤ?1310???Ĥޤ??????ޤ?????

?????ˤϤӤä??ꤷ?ޤ?????

???礦?ɡ????ε????ǽ??40??????????ǥ??ư????Ʊ???β????٤??Ȼפ??ޤ???

?ޤ????ͤμ??ų??ϸ??ϡ?ǯ??⤯?ʤäƤ??Ƥ????ˤ⤫?????餺????Ψ???⤯?ʤäƤ??ޤ?????

蝹䳫??ľ???κ????Ǥϼ???Ψ??45%?????줬72~60%?ز??????Ƥ??ޤ???

??????蝹??θ??̤ʤΤǤ??礦??

?????Ф??꤬???꺻??????????ǥ?ɤǤ??????????˸?????????????????????¿???Ǥ???

??????????????ǥ?Ȥ????ޤ????????Ҥο??????ʤ???????ǻ?٤??㤤?ˡ???ưΨ???㤤?Ȥ??????ΤǤ???????????ǥ??9???????Ҥ????뵡ǽ?????꤬??????¤????ǽ?㳲?٤Ǥ???

????¿????蝹伣?Ť????̤??????ޤ???

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?????Ǥ????????????Ҥο??????????걿ư???????Ҥξ??֤???ǧ???븲??????ư???ǵ?Ͽ???륷???ƥ??????֤??Ƥ??ޤ???

?˽???????ǥ?ǡ????餫?˸??????ɵ??Ǥ????Τ?ͣ???????????ս鸫?Ǥ???

??ǥ???Ť??ʤ??Ƥ????????????ڤʥ????꡼?˥?ˤʤ??ޤ???

 

 

?????????ȻפäƤ??????蝹??ղ??ͤιֽ????⺣?????Ȥʤ??ޤ?????

???֤??????Х??饤?ɤ??ɤ?ľ????Ƥ??ޤ?????????3???֤Ǵ?λ?Ǥ??뤫????

???Ĥ⥻?ߥʡ????ä??????˶?Ĵ?????Τϡ???ǥ???ŤǤΡ????????Ǥμ??Ť??????ʤ?蝹䱡?μ??Ť??礭?ʰ㤤?Ǥ???

̾???̤ä?ͭ̾?ʥ????˥å??Ǥ⡢???Ԥ??????μ??????Ť??뤳?ȤϤ????ޤ???????Ƥ??ϼ??????Ȥ˴??뤹?뼣?ŤȤʤ??ޤ???

???ո????ˤ????ۥ??????????å???????Ͷȯ?????????Ƥޤ???????äƤ????顢??????롦????뢪?????????뢪?徲????????

?????????Ϥ???ή???ˤʤ??ޤ????????ˤ??????㵡ǽ?????ǤϿ??????ˤ錄?ä?DHEA-S?ʤɤΥ??ץ??????Ȥ??Ȥä??ꤷ?????㵡ǽ?β??????ܻؤ????Ť⤢???ˤϤ????ޤ?????????Ū?ǤϤ????ޤ?????

蝹伣?Ťξ????ϡ?ľ?????????Ƥ뼣?Ť⤢???ޤ???????ä?????ä???36???ָ???????????褦?ʼ??Ť⤢???ޤ?????
?⤷???????餽?줬?Ǥ???ã?ͤ??????Τ??⤷???ޤ????

蝹伣?ŤϿ??????ˤ錄?äƤ??μ??????Ǥ??ꡢ?????ˤ??äƤΥۥ??????Ķ??β??????ҵܡ??????η?ή?β??????ܻؤ??Ƥ????ޤ???

?㤨?С?蝹伣?ŤΤߤ??Ԥä??μ????????ԤäƤ????֤˼???ǥ???Ǥ??ʤ??Ȥ⡢???θ??????????μ??Ť??Ԥ??ȡ??????ޤǥ????ߥå?1??????餿????2???????ͤʤɹԤäƤ??????Ǥ⡢?????ߥå?1???Ǥ褤????ä??ꤹ???褦?ˤʤ??ޤ???

?ޤ??γ????????ԤäƤ??ơ??????Ǥ??????????ʤ??ä??ꥰ?졼?٤??㤤???Ҥˤ????餿?ʤ??ä????Τ????ɤ????졼?ɤ????˰??Ĥ??Ȥ??????ޤ???

?????????μ??????ϡ??¤????ڤʤΤ??Ȼפ??ޤ???

?????ǤϺ????μ??????٤?1????1?????Ԥ??ޤ???

???줬2????1??餤???ȡ????ޤ????????̤??ʤ??褦?Ǥ???

7???????˿??Ťϡ?3????10????31???θ??????ΤߤȤʤ??ޤ???
???????ϽѼԤ?1̾?Τ??ῷ?????б??ϤǤ??ޤ?????

 

???蝹??ղ??Ǥιֱ??Υ??饤?ɤǤ???

?????????ʽ???????ǥ?????ɤΥԥå????å׾㳲???????Ȥ??ƿ??ꤵ???Ƥ??ޤ???

?ԥå????å׾㳲?Ȥϡ?????????????˦?????ɤ?õ?????ơ?????????Ҥ????ɤ???ü?ˤ??????ɺӡʤ??????ˤȸƤФ?????ʬ?ǥ????å????????????˵ۤ?????Ư?????????ޤ???

???ε?ǽ???????????ˡ??????????ҵ??⤫????????ü???ԤäƤ????????Ҥˡ?????????Ҥ??в?ʤ???ǥ???Ǥ??ʤ??ΤǤ???

?ҵ??????ɤ?ʢ?????ˤϡ??ҵ??????ɤΤ????˰ʾ????ȱ֤γ?????????ʢ?夬?????ޤ???

????ʢ?????ˤ??͡??ʥ????ȥ???????????졢?㤨?????ɤΥԥå????åפ??˳??????ꡢ̤???????β???˦(LUF: lutenized unruptured follicle)??????????ꤷ?ޤ???

LUF?ϰ????ΰ?????˦?ΰ??Ĥǡ?¿?????????и????????ΤǤ???

???Ȥ??лҵ??????ɤ??ʹԤ??????Τ˻ҵ?????????ǹ˦?ʤ??????????祳?졼??ǹ˦?ˤȤ??????Τ??????ޤ????????ϻҵ??????ɤ?ʬ???ǤϤ褯?Ȥ?????r-ASRMʬ?ࡧ?ʽ????ƹ???ǥ?ز?ʬ???ˤΣ???4???οʹԤ??????Τˤʤꡢ????????ǥ?θ????ˤʤꤦ???櫓?Ǥ???????????

????ǥ?????͹???????ǥ??Ψ?????˳????????ɤΥԥå????å׾㳲?????????????Τϡ?r-SARMʬ???Ǥ?1??2???ηڤ??´??Τ??Τ?¿???????Ǥ???

?ҵ??????ɤΰ????ι??Ϥʱ??ɾ??֤ǥ????ȥ????????????ޤ????顢???Ȥ??С?蝹??Τ褦?˷????ˤ????????뼣?ŤϤ????????????ȥ?????˽???ξ??֤??????????ΤǤϤʤ????ȹͤ??ޤ???

?????ˤ??????????顢???????֤????????????ä???
?????ǤϤ褯?????äǤ??????????????װ????????Τ??⤷???ޤ?????

 

7??10???????ˤϡ????????????˿??Ť??????ޤ???

???????????ڤ??夲?ơ????夫???ϥ??⡼?????Ťǹ??蝹??ղ??ͤιֽ????ιֻդ?̳???ޤ???

???äȡ??ֵ??˻Ȥ????饤?ɤ??????夲?ޤ?????

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90???ˤʤä??櫓?Ǥ?????

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??????3???֤ιֵ????֤ǡ????饤?ɤǤ??ä??????Τ?2???֡?
?Ĥ?1???֤ϥӥǥ????ꤷ?Ƥ??????ե????????ȤäƤμµ???Ϫ?Ǥ???

?פ??֤??˥??饤?ɤ??????ޤ????????????????Ť??⤿????????ޤ?????

???Ϥ??Ȥ?????????????????ǥ?ˤĤ??ƻפ??Τϡ????٤λҵ??????ɤ??????ˤʤäƤ????ΤǤϤʤ?????

?????פ??ޤ???

???Υ??饤?ɤϹֵ??˻Ȥ????ΤǤ??????ϥ?????С????Ȥ????衼???å????????ز???ESHRE?ˤβ?Ĺ??̳?᤿?ؼԤ????θ????ǡ???????ǥ???Ԥˤ????????λҵ????????���?????٤??????ޤ????Ȥ????ǡ????Ǥ???

 

???Ȼ????±???Ĺ??̳?᤿?????????ػ??ؿͲʸ??????Ρ??鼣?????Υǡ????????????ŤΤ??٤ơ???????P122??

??Ĭ????20ǯ?Ȥ?????30????Ⱦ?Фǡ???ǥ??蝹䱡???ɤ??象????ǯ???Ǥ??????л???????0??????75???᤯???ҵ??????ɤˤʤ????���?Ȥ??????ΤǤ???

???äȤ??ҵ??????ɤδ??Ԥ?????Ĵ?٤??ǡ????ǡ????٤Ƥν??????????ʤ??櫓?ǤϤ????ޤ?????

?ҵ??????ɤ?蝹??Ǻ????Ǥ??????ΤǤϤ????ޤ?????????ˤߤʤɤζ??ˤ??Ф????б?????ǥ???Ť??̤??????Τ??????ޤ???

???ε??????Ťϡ?7??10????????ī8?????????ޤǤȤʤ??ޤ???

˿????????˾?വ???ͤ????Ť??Ƥ??ޤ?????

????2??????줿???ǡ?3???ܤκ????ǤϤ褤???Ӥ??Ф????????Ȥ??????Ȥ?蝹????Ϥ᤿???Ǥ?????

??ʬ?ʲ?????蝹????Ԥ??????????????????Ϥ???FSH???⤯???ä????ꥻ?åȤˡ????μ??????ޤ?FSH???⤤?Ȥ??????Ȥǥꥻ?åȤء?

???δ֤?蝹??ȥ졼???????٤ޤ??Ԥ??????äȺ????????????????ɷ?ˡ?Ǥδ???Ͷȯ???Ԥ?2?ĺ????Ǥ??ơ?2?ĤȤ??褤???졼?ɤ??????Ǥ??ޤ?????

?缣???ˤ????ȡ?????2?ĤΤۤ??ˤ?¿???ξ???˦??ȯ?餷?Ƥ????????ǡ????Ĥδ֤ˤ???Ǥ????ΤˤʤäƤ????褦?Ǥ???

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???ۤɤδ??Ԥ?????Ʊ?????˺????Ǥ??????Ȥ??????ȤϤ????±???5???????Τ???2?????????δ????ͤ??ä??櫓?Ǥ???
?????ʤ??Ȥ⤢?????Ǥ??͡?

???δ????ͤ????㵡ǽ???ɤ??ʤ??ä????Ǥ???????Ĺ???ˤ錄?꿿???ܤ˺????褯?̤??졢2?ĺ????Ǥ???2?ĤȤ??????Ǥ??ޤ??????ޤ???˦??????????10?İʾ???˦?????äƤ????????Ǥ?????
????????2?ĤǤ??Τ?????˦?ޤ????ܤ???3???????????뤷???????Ǥ?????1?Ĥ?Veeck??ʬ????G1???ä??????Ǥ???

????Ū?????㵡ǽ???פ路???ʤ??????ϡ???????1????1??Ǥ?????2???μ??Ť???ų??Ϥ???3???????٤Ͻ???Ū?˹Ԥ????????˽???1???μ??Ťˤ??Ƥ????ޤ???

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???Ťγ??ϻ???????3?????ϡ??ä??Ѳ??˼??Ť??Ԥ??Ȥ??θ??θ??̤??ɤ??褦?Ǥ???