Hum Reprod Open. 2020 Sep 22;2020(3):hoaa040. doi: 10.1093/hropen/hoaa040. eCollection 2020.
Today IVF use is booming all over the world and has even started to play a role in demographic analyses. Prognosis-adjusted estimates suggest that up to two-thirds of couples could achieve a live birth. However, the scenario is less exciting in reality. Discontinuation during the cycles is common, and age and ovarian response continue to be crucial in modulating this rate of success. A growing interest is now given to the risk of abuses and in particular to overtreatment and to prescriptions of useless, if not harmful, expensive additional treatments ('add-ons'). A more rational, evidence-based and wise approach is needed. From a scientific perspective, several obscure aspects remain and warrant future investigations. Of particular interest are the neglected role of sperm selection, the potential adult implications of early embryo life and the issue of sustainability.
如今，体外受精（IVF）在全球的应用正蓬勃发展，甚至已开始在人口分析中发挥作用。经预后调整的估计表明，多达三分之二的夫妇能够实现活产。然而，现实情况却没那么乐观。周期中断的情况很常见，年龄和卵巢反应仍是调节成功率的关键因素。人们现在越来越关注滥用风险，尤其是过度治疗以及开具无用甚至有害的昂贵额外治疗（“附加治疗”）的处方。需要一种更合理、基于证据且明智的方法。从科学角度来看，仍存在几个模糊的方面，值得未来进行研究。特别值得关注的是精子选择被忽视的作用、早期胚胎生命对成人的潜在影响以及可持续性问题。
