辅助生殖技术中选择性单胚胎移植的研究进展

Research progress of selective single embryo transfer in assisted reproductive technology

辅助生殖技术(assisted reproductive technology, ART)已成为不孕症患者最有效的治疗方法,但多胎妊娠为其最突出的并发症之一。多胎妊娠常引起羊水过多、先兆子痫、低体质量儿、贫血等多项严重的母婴并发症。避免多胎妊娠的方法是单胚胎移植,选择性单胚胎移植已经成为生殖医学未来的发展方向,单胚胎的选择为临床难题。如何保证临床妊娠率又显著降低各类并发症?对于35岁以下的卵巢储备功能正常患者或有优质囊胚的高龄患者,可通过检测其胚胎发育过程中的代谢产物、胚胎持续监测或植入前遗传学诊断,筛选最具发育潜能的胚胎进行移植,改善临床结局。本文通过文献回顾,探讨选择性单胚胎移植的临床应用前景。

Assisted reproductive technology(ART) has become the most effective treatment for infertility patients, but multiple pregnancy is one of the prominent complications. Multiple pregnancies often cause serious maternal and child complications such as polyhydramnios, pre-eclampsia, low birth weight, and anemia. The single embryo transfer is the method to avoid multiple pregnancy, and selective single embryo transfer has become the development direction of reproductive medicine. It ensures the clinical pregnancy rate with reduction of various complications. For patients under 35 years of age with normal ovarian reserve or older patients with high-quality blastocysts, the screening can be performed by detecting metabolites or continuously monitoring embryos or preimplantative genetic diagnosis during embryonic development, so that the potential embryos can be transplanted to improve clinical outcomes. This article reviews the recent progress on the clinical application of selective single embryo in assisted reproduction technology.