反复种植失败:从病因到治疗的全面总结。
Recurrent implantation failure: A comprehensive summary from etiology to treatment.
机构信息
Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Key Laboratory of Reproductive and Genetic Medicine, China Medical University, National Health Commission, Shenyang, China.
出版信息
Front Endocrinol (Lausanne). 2023 Jan 5;13:1061766. doi: 10.3389/fendo.2022.1061766. eCollection 2022.
Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.
着床是人类生殖的第一步。胚胎和子宫内膜之间的相互作用决定着着床的成功。反复着床失败(RIF)是一种临床现象,其特征是多次胚胎移植后仍未能着床,大约影响 10%正在接受体外受精和胚胎移植的夫妇。尽管关于 RIF 的文献不断增加,但对于 RIF 的诊断和治疗仍没有一个被广泛接受的定义或标准方案。由于缺乏广泛接受的定义,预测和预防 RIF 的进展受到了阻碍。大多数 RIF 夫妇在临床干预后可以怀孕。RIF 夫妇的预后与母体年龄有关。RIF 可由免疫学、易栓症、子宫内膜容受性、微生物组、解剖学异常、男性因素和胚胎非整倍体引起。确定最可能的病因非常重要,针对主要病因的个体化治疗似乎是提高着床率的有效方法。RIF 夫妇需要心理支持和适当的临床干预。需要进一步研究来评估每种治疗方法的诊断方法和有效性,以指导临床治疗。