Vaquero Elena, Lazzarin Natalia, Caserta Donatella, Valensise Herbert, Baldi Marina, Moscarini Massimo, Arduini Domenico
Department of Obstetrics and Gynecology, Ospedale Fatebenefratelli, University of Rome Tor Vergata, Isola Tiberina, 00168 Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 2006 Mar 1;125(1):79-84. doi: 10.1016/j.ejogrb.2005.08.001. Epub 2005 Oct 11.
The aim of the study was to propose a set of tests to clarify the diagnosis of repeated implantation failure in patients undergoing in vitro fertilization (IVF).
Fifty-nine patients with at least two unsuccessful IVF attempts were included in the study. Blood samples were evaluated for the presence of underlying thyroid abnormalities, antiphospholipid antibodies (aPL), increased levels of natural killer cells (NK), inherited thrombophilia and mouse embryo assay factor (MEA-f). The same tests were performed on 20 normal fertile control patients.
Seventy-six percent of IVF patients showed at least one abnormal result. This incidence was higher with respect to that found among control patients (45%). The prevalence of thyroid abnormalities, aPL and increased NK level was higher in IVF patients whereas no differences were observed in terms of prevalence of inherited thrombophilias and MEA-f.
A better understanding of reproductive failure mechanisms should allow an effective diagnostic flow chart and a focused therapeutic option for patients experiencing repeated IVF failure. With this objective in mind, our data provide two important results: thyroid abnormalities, aPL and increased NK levels are more prevalent in women experiencing IVF failure. No evidence was found for an association between inherited thrombophilia and MEA-f and failure to achieve pregnancy after IVF.
本研究的目的是提出一套检测方法，以明确体外受精（IVF）患者反复种植失败的诊断。
本研究纳入了59例至少有两次IVF尝试未成功的患者。对血液样本进行评估，以检测是否存在潜在的甲状腺异常、抗磷脂抗体（aPL）、自然杀伤细胞（NK）水平升高、遗传性血栓形成倾向和小鼠胚胎试验因子（MEA-f）。对20例正常生育的对照患者进行了相同的检测。
76%的IVF患者至少有一项异常结果。这一发生率高于对照患者（45%）。IVF患者中甲状腺异常、aPL和NK水平升高的患病率较高，而在遗传性血栓形成倾向和MEA-f的患病率方面未观察到差异。
更好地了解生殖失败机制应能为经历反复IVF失败的患者提供有效的诊断流程图和有针对性的治疗方案。基于这一目标，我们的数据提供了两个重要结果：甲状腺异常、aPL和NK水平升高在经历IVF失败的女性中更为普遍。未发现遗传性血栓形成倾向和MEA-f与IVF后未怀孕之间存在关联的证据。
