Coppola F, Tridenti G, Barletta C, Bertoli M, Trentadue R, Barusi L, Ferrari B, Avanzini A M, Salvarani C
Dept. of Obstetric and Gynaecology, University of Parma, Italy.
Acta Biomed Ateneo Parmense. 1992;63(1-2):113-24.
Luteal function, endometrial receptivity, endometrial prolactin and glycoprotein secretions, blastocyst-secreted immunomodulant factors and embryo quality are nowadays considered the main determinants involved in embryo implantation control. The endometrial factors are progesterone-dependent. Out of 128 cycles of ART (AIH-IU, GIFT, IVF-ET), performed in 67 women at the Dept. of Obstetrics and Gynaecology of Parma during the period 1986-1991, 31 conceptions were obtained (pregnancy rate: 24.21%), 7 of which miscarried (abortion rate: 22.58%). According to these data, ART high abortion rate is possibly connected with poor luteo-endometrial function and poor embryo quality. Controlled ovarian hyperstimulation is thought to inhibit embryo implantation after IVF-ET by decreasing endometrial receptivity. Such a situation can be treated either by exogenous progesterone administration or by tubal techniques (GIFT, TET) performed in non-tubal infertility. Both strategies showed to better endometrial receptivity. A delayed intrauterine embryo transfer at blastocyst stage, when cocultures allow to, is supposed to raise the implantation rate in tubal infertility by enhancing embryo selection and endometrial receptivity. This paper also reports preliminarily on the predictive value of beta-HGC and estradiol levels, as well as of endometrial thickness, on early pregnancy outcome.
如今，黄体功能、子宫内膜容受性、子宫内膜催乳素和糖蛋白分泌、囊胚分泌的免疫调节因子以及胚胎质量被认为是参与胚胎着床控制的主要决定因素。子宫内膜因素依赖于孕酮。1986年至1991年期间，在帕尔马妇产科对67名女性进行了128个辅助生殖技术周期（宫内人工授精、配子输卵管内移植、体外受精-胚胎移植），获得了31次妊娠（妊娠率：24.21%），其中7例流产（流产率：22.58%）。根据这些数据，辅助生殖技术的高流产率可能与黄体-子宫内膜功能不良和胚胎质量差有关。控制性卵巢过度刺激被认为会通过降低子宫内膜容受性而抑制体外受精-胚胎移植后的胚胎着床。这种情况可以通过外源性孕酮给药或对非输卵管性不孕患者采用输卵管技术（配子输卵管内移植、输卵管内胚胎移植）来治疗。两种策略都显示能改善子宫内膜容受性。当共培养允许时，在囊胚阶段延迟进行宫内胚胎移植，被认为可以通过增强胚胎选择和子宫内膜容受性来提高输卵管性不孕的着床率。本文还初步报告了β-HCG和雌二醇水平以及子宫内膜厚度对早期妊娠结局的预测价值。
