Makrigiannakis Antonis, Makrygiannakis Fanourios, Vrekoussis Thomas
Department of Obstetrics and Gynecology, Medical School, University of Crete, Heraklion, Greece.
Front Cell Dev Biol. 2021 Mar 16;9:613277. doi: 10.3389/fcell.2021.613277. eCollection 2021.
Repeated implantation failures are a constant challenge in reproductive medicine with a significant impact both on health providers and on infertile couples. Several approaches have been proposed so far as effective; however, accumulative data have clarified that most of the treatment options do not have the evidence base for a generalized application to be suggested by the relevant societies. Implantation failures are attributed to either poor quality embryos or to defected endometrial receptivity. The current review aims to summarize in a systematic way all the new trends in managing RIF via interference with endometrial receptivity. The authors focus mainly, but not exclusively, on endometrial injury prior to embryo transfer and endometrial priming with autologous cells or biological agents. To this direction, a systematic search of the Pubmed database has been conducted taking into account the emerged evidence of the last two decades. All the suggested interventions are herein presented and analyzed in terms of reproductive outcomes. It is evident that properly powered and designed randomized trials are needed to support a new standard approach in RIF treatment that will safely be incorporated in national and international guidelines.
反复种植失败是生殖医学中持续存在的挑战，对医疗服务提供者和不孕夫妇都有重大影响。到目前为止，已经提出了几种有效的方法；然而，累积数据表明，大多数治疗选择缺乏相关学会建议广泛应用的证据基础。种植失败归因于胚胎质量差或子宫内膜容受性缺陷。本综述旨在系统总结通过干扰子宫内膜容受性来管理反复种植失败的所有新趋势。作者主要但不限于关注胚胎移植前的子宫内膜损伤以及用自体细胞或生物制剂进行子宫内膜预处理。为此，考虑到过去二十年出现的证据，对PubMed数据库进行了系统检索。本文根据生殖结局对所有建议的干预措施进行了介绍和分析。显然，需要有足够样本量和精心设计的随机试验来支持反复种植失败治疗的新标准方法，并将其安全纳入国家和国际指南。
