土地与种子

Soil and Seed

胚胎在子宫内膜的种植过程就像种子和土地的关系一样,是相互作用的复杂过程。胚胎("种子")和子宫内膜("土地")的质量是影响种植成功的重要因素。如何选择优质胚胎以提高种植成功率的相关研究很多,但对子宫内膜的评估和如何改善子宫内膜质量的研究相对较少。此篇文章聚焦子宫内膜,涵盖评价子宫内膜的可行方法和如何改善子宫内膜以获得较高种植率的策略。具体而言,是探讨一种新颖的、针对体外受精反复种植失败患者的治疗手段——子宫内膜搔刮术,并推荐几种在各种妇科手术操作过程中保护和避免子宫内膜损伤的方法。

The process of implantation in humans involves a complex interaction between the embryo and the endometrium, very similar to the case of the seed and the soil. Both the quality of the embryo （seed） and the endometrium （soil） are important determinants of successful implantation. There are many studies on how to select good quality embryos to improve implantation rate but relatively few ones on how to assess and improve endometrial quality. This review focuses on the endometrium, including the available methods used to assess the endometrium and strategies to improve the endometrium to achieve a higher implantation rate. Specifically, the role of endometrial scratch, a novel treatment recently introduced to improve the implantation and pregnancy rate in women who previously had recurrent IVF failure will be discussed. Finally, recommendations on how to protect or avoid inadvertent damage to the endometrium during various gynaecology procedures will also be discussed.