反复种植失败的临床处理策略

Clinical Treatment Strategies of Repeated Implantation Failure

辅助生殖技术的迅速发展使众多不孕不育患者通过体外受精-胚胎移植及其衍生技术成功妊娠,然而仍有部分患者存在多次移植优质胚胎后仍未获得临床妊娠的现象,称为反复种植失败(repeated implantation failure,RIF)。RIF是辅助生殖技术中的难题,同时增加了患者的经济负担,加重患者的身心创伤。如何提高胚胎质量、干预母体自身因素(如改善薄型子宫内膜、提高子宫内膜容受性、抑制子宫收缩、改善高凝状态、免疫抑制治疗)以及改变胚胎移植方法等从而改善妊娠结局是目前临床研究的热点。综述不同病因RIF临床处理策略的研究进展,以期为临床工作者提供参考和治疗思路。

The rapid development of assisted reproductive technology has enabled many infertile patients to get successful pregnances through in vitro fertilization and embryo transfer and its derivative technology.However,there are still some patients who have failed to obtain a clinical pregnancy after transferring high-quality embryos for many times.This is called repeated implantation failure(RIF).RIF is a difficult problem in assisted reproductive technology,which increases the economic burden of patients and aggravates their physical and mental trauma.How to improve embryo quality,to intervene maternal factors(such as improving thin endometrium,improving endometrium receptivity,inhibiting uterine contraction,improving hypercoagulability,immunosuppressive therapy)and to change embryo transfer methods so as to improve pregnancy outcomes,are hot spots in clinical research.The research progress of clinical treatment strategies of RIF due to different etiologies was reviewed in order to provide reference and treatment ideas for clinical workers.