Koot Y E M, Teklenburg G, Salker M S, Brosens J J, Macklon N S
Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Biochim Biophys Acta. 2012 Dec;1822(12):1943-50. doi: 10.1016/j.bbadis.2012.05.017. Epub 2012 Jun 7.
Despite expanding global experience with advanced reproductive technologies, the majority of IVF attempts do not result in a successful pregnancy, foremost as a result of implantation failure. The process of embryo implantation, a remarkably dynamic and precisely controlled molecular and cellular event, appears inefficient in humans and is poorly understood. However, insights gained from clinical implantation failure, early pregnancy loss, and emerging techologies that enable molecular interrogation of endometrial-embryo interactions are unravelling this major limiting step in human reproduction. We review current molecular concepts thought to underlie implantation failure, consider the contribution of embryonic and endometrial factors, and discuss the clinical value of putative markers of impaired endometrial receptivity. Finally we highlight the nature of the dialogue between the maternal endometrium and the implanting embryo and discuss the concept of natural embryo selection. This article is part of a Special Issue entitled: Molecular Genetics of Human Reproductive Failure.
尽管全球在先进生殖技术方面的经验不断增加，但大多数体外受精尝试并未成功妊娠，首要原因是着床失败。胚胎着床过程是一个极其动态且精确控制的分子和细胞事件，在人类中似乎效率低下且了解甚少。然而，从临床着床失败、早期妊娠丢失以及能够对子宫内膜 - 胚胎相互作用进行分子研究的新兴技术中获得的见解，正在揭示人类生殖这一主要限制步骤。我们回顾了当前被认为是着床失败基础的分子概念，考虑了胚胎和子宫内膜因素的作用，并讨论了子宫内膜容受性受损的假定标志物的临床价值。最后，我们强调了母体子宫内膜与着床胚胎之间对话的本质，并讨论了自然胚胎选择的概念。本文是名为《人类生殖失败的分子遗传学》特刊的一部分。
