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生殖医学中的辅助生殖技术——可能性与局限性

Assisted reproductive technology in reproductive medicine - possibilities and limitations.

作者信息

Szamatowicz Marian

机构信息

Medical Institute PWSIiP in Lomza Department Reproductive Medicine and Gynecological Endocrinology MU in Białystok.

出版信息

Ginekol Pol. 2016;87(12):820-823. doi: 10.5603/GP.2016.0095.

Abstract

Infertility has become an increasingly common health problem and has been estimated to affect approximately 10% of women in the reproductive age. Due to its high prevalence, it has been deemed a social disease by the World Health Organization (WHO). The causes of infertility are numerous and vary from person to person. As for treatment, the three main therapeutic strategies include pharmacological therapy, surgical therapy - mostly endoscopy, and assisted reproductive technology (ART). Recent decades have witnessed great progress in ART, resulting in successful treatment of the previously untreatable cases, particularly in the field of fertility preservation, preimplantation screening for aneuploidy, uterine transplantations and mitochondrial replacement techniques as prevention against a number of severe diseases. Regardless, ART treatment does not guarantee pregnancy and live birth. The success rate is much smaller as compared to the failure rate, it being among its most important limitations. Embryo implantation is an extremely complex process and represents the most critical step of the reproduction process in humans. Attempts to evaluate endometrial receptivity and strategies for its correction have been discussed. The search for new effective predictors of an individual prognosis remains a crucial challenge for the contemporary reproductive medicine.

摘要

不孕症已成为一个日益常见的健康问题,据估计,它影响着约10%的育龄妇女。由于其高发病率,世界卫生组织(WHO)已将其视为一种社会疾病。不孕症的病因众多,因人而异。至于治疗,三种主要的治疗策略包括药物治疗、手术治疗——主要是内窥镜检查,以及辅助生殖技术(ART)。近几十年来,ART取得了巨大进展,成功治疗了以前无法治疗的病例,特别是在生育力保存、非整倍体植入前筛查、子宫移植和线粒体替代技术等领域,以预防多种严重疾病。尽管如此,ART治疗并不能保证怀孕和活产。与失败率相比,成功率要小得多,这是其最重要的局限性之一。胚胎着床是一个极其复杂的过程,也是人类生殖过程中最关键的一步。人们已经讨论了评估子宫内膜容受性的方法及其纠正策略。寻找新的有效个体预后预测指标仍然是当代生殖医学面临的一项关键挑战。

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