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子宫内膜刺激胚胎移植(SEET):在囊胚移植前将胚胎培养液上清液注入宫腔可提高着床率和妊娠率。

Stimulation of endometrium embryo transfer (SEET): injection of embryo culture supernatant into the uterine cavity before blastocyst transfer can improve implantation and pregnancy rates.

作者信息

Goto Sakae, Kadowaki Takashi, Hashimoto Hiromi, Kokeguchi Shoji, Shiotani Masahide

机构信息

Hanabusa Women's Clinic, Kobe, Japan.

出版信息

Fertil Steril. 2007 Nov;88(5):1339-43. doi: 10.1016/j.fertnstert.2007.01.011. Epub 2007 Jun 7.

Abstract

OBJECTIVE

To evaluate whether stimulation of endometrium embryo transfer (SEET) by injecting embryo culture supernatant (ECS) into the uterus before blastocyst transfer (BT) can improve implantation and pregnancy rates.

DESIGN

Randomized, controlled trial.

SETTING

Private in vitro fertilization clinic.

PATIENT(S): 23 women in the SEET group, and 25 women in the control group.

INTERVENTION(S): Injection of ECS.

MAIN OUTCOME MEASURE(S): Implantation rates, pregnancy rates, and serum beta human chorionic gonadotropin (beta-hCG) levels at 4 weeks and 1 day of gestation.

RESULT(S): Communication between the embryo and the endometrium (cross-talk) plays an important role in implantation. Several embryonic factors that modulate endometrial receptivity have been detected in ECS. In BT, cross-talk is absent until the blastocysts are transferred, so we injected ECS into the uterine cavity before BT to stimulate the endometrium and provide an optimum environment for implantation of forthcoming blastocysts. The implantation rates, pregnancy rates, and beta-hCG levels in the SEET group were statistically significantly higher than those in the BT control group.

CONCLUSION(S): A novel method of embryo transfer based on the concept of embryo-dependent induction of endometrial receptivity, SEET may be an effective option for increasing implantation and pregnancy rates.

摘要

目的

评估在囊胚移植(BT)前向子宫内注射胚胎培养液上清液(ECS)刺激子宫内膜胚胎移植(SEET)是否能提高着床率和妊娠率。

设计

随机对照试验。

地点

私立体外受精诊所。

患者

SEET组23名女性,对照组25名女性。

干预措施

注射ECS。

主要观察指标

妊娠4周零1天时的着床率、妊娠率和血清β-人绒毛膜促性腺激素(β-hCG)水平。

结果

胚胎与子宫内膜之间的交流(相互作用)在着床过程中起重要作用。在ECS中已检测到几种调节子宫内膜容受性的胚胎因子。在BT中,直到囊胚移植时才存在相互作用,因此我们在BT前向子宫腔内注射ECS以刺激子宫内膜,并为即将移植的囊胚着床提供最佳环境。SEET组的着床率、妊娠率和β-hCG水平在统计学上显著高于BT对照组。

结论

基于胚胎依赖诱导子宫内膜容受性概念的一种新型胚胎移植方法,SEET可能是提高着床率和妊娠率的有效选择。

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