辅助生殖技术治疗对妊娠结局及女性远期健康影响的研究进展

Research progress on assisted reproductive technology effects on pregnancy outcomes and women's long-term health

辅助生殖技术(assisted reproductive technology,ART)为不孕症女性提供了生育的机会,但是治疗过程中涉及的非生理性干预可能会通过影响妊娠大环境增加母体严重不良妊娠结局的发生风险。另外,促排卵药物的使用,如枸橼酸氯米芬(克罗米芬)、促性腺激素等会使机体性激素水平升高,反复周期性使用促排卵药物是否增加女性远期罹患乳腺癌、子宫内膜癌和卵巢癌等妇科肿瘤的风险,以及内分泌代谢系统和心血管系统的远期并发症等风险是否增加,目前也尚无定论。由于ART治疗患者的年龄、体质量指数、基础慢性疾病和不孕原因等都可能是混杂因素,需要进一步随访并利用大数据,逐渐明确ART对女性妊娠结局及远期健康的影响,为临床医生制定临床决策和个体化的治疗方案提供重要参考依据。

Assisted reproductive technology(ART)offers infertile women the chance to have children,but the unphysiological interventions involved in the treatment may increase the risk of a serious adverse pregnancy outcome by affecting the pregnancy environment.In addition,the use of ovulation drugs,such as clomiphene citrate,gonadotrophin,make the body sex hormone levels rise.Whether periodic use of stimulating ovulation drugs repeatedly increases the risk of breast cancer and gynecological tumors,such as endometrial cancer and ovarian cancer,as well as endocrine metabolism system disorders and cardiovascular system diseases has not been determined.Furthermore,the patient's age,body mass index,underlying chronic disease and infertility factors are all likely to be confounding factors.It needs more further follow-up cohort study and uses big data to clarify ART influence on female pregnancy outcomes and the long-term health gradually.It will provide important reference data for reproductive doctors to make reasonable treatment plan according to the specific condition of patients with the purpose of protecting women's long-term health.