反复着床失败的原因与对策

Causes and countermeasures of recurrent implantation failure

胚胎着床是一个复杂的过程,包括定位,粘附和侵入。着床的发生与透明带消失、胚泡和子宫内膜同步发育且功能协调关系密切。目前,胚胎着床机制尚无定论,但与之相关因素有:女方宫腔病变(子宫内膜息肉、子宫肌瘤、宫腔粘连、纵膈子宫、子宫内膜炎等)、输卵管积水、子宫内膜异位症,胚胎因素,精子因素,免疫因素和其他(如胚胎移植技术、肥胖、吸烟、甲状腺疾病等),针对病因寻找对策,才能期待更高的着床率和更好的妊娠结局发生。

The implantation of embryo is a complex process including apposition, adhesion and penetration. Successful implantation requires the rupture of zona pellucida, receptive endometrium, anembryo at the blastocyst developmental stage and a synchronized development between endometrium＇and embryonic tissues. The mechanism of recurrent implantation failure （RIF） is not clear. The related causes include uterine cavity lesions such as endometrial polyp, uterine leiomyomata, intrauterine adhesions, the septate uterus, chronic endometritis etc;hydrosalpinx, endometriosis, embryonic factors, sperm factors, immunologic factors and so on. The other causes including teehnique of embryo transfer, obesity, cigarette smoking, thyroid dysfunction, etc are also associated with the failure of implantation. The higher implantation rate and clinical pregnancy rate could be expected after analyzing failure causes and finding countermeasures.