J Assist Reprod Genet. 2020 May;37(5):1057-1063. doi: 10.1007/s10815-020-01749-y. Epub 2020 Mar 20.
Early pregnancy loss is by far the most frequent outcome of human reproduction. It occurs when despite the timely interaction of gametes and initiation of embryogenesis and implantation of the conceptus, pregnancy continuance fails. From a clinical perspective, early pregnancy loss represents a neglected but relevant issue because of the high incidence, the evolving and yet not fully elucidated mechanism, the possible association with other relevant medical conditions, and the potential psychological sequelae. Our growing understanding of the dialog established between the embryo and the endometrium provides new insights into the etiology of pregnancy loss. Aneuploidies as a cause of early pregnancy loss are known for a long time, but there is now evidence that endometrium is not a passive player. An active selection aimed at impeding implantation of unhealthy embryos actually occurs at the endometrial interface. The concept of selectivity is substituting the one of mere receptivity.
早期妊娠丢失是迄今为止人类生殖最常见的结局。尽管配子及时相互作用，胚胎发生和胚胎着床已经开始，但妊娠仍持续失败。从临床角度来看，早期妊娠丢失是一个被忽视但相关的问题，因为其发生率高，发生机制尚在不断发展但尚未完全阐明，可能与其他相关医疗条件有关，并且可能存在潜在的心理后果。我们对胚胎和子宫内膜之间建立的对话的理解不断加深，为妊娠丢失的病因提供了新的见解。非整倍体作为早期妊娠丢失的一个原因已经存在很长时间，但现在有证据表明，子宫内膜并不是一个被动的参与者。实际上，在子宫内膜界面处存在一种旨在阻止不健康胚胎着床的主动选择。这种选择性的概念取代了单纯的接受性的概念。
