反复种植失败患者微刺激方案IVF-ET助孕成功一例及文献复习

A successful case report of IVF-ET assisted pregnancy in patient with repeated implantation failure through minimal stimulation protocol and literature review

反复种植失败是体外受精-胚胎移植失败的主要原因之一,尽管其定义及诊疗尚存在争议,但对于反复种植失败的患者应当尽可能找到原因,针对原因进行相应的处理已成为共识。导致反复种植失败的原因可概括为包括卵母细胞质量、精子质量、胚胎遗传物质异常等在内的胚胎质量因素和包括母体解剖结构异常、内膜局部或全身免疫失调、代谢紊乱等在内的母体因素,此外,还存在部分原因不明的反复种植失败,其临床处理办法仍在探索和尝试。本文报道微刺激方案帮助1例2次控制性促排卵IVF、8次移植的反复种植失败患者成功生育的过程,并结合其病史、IVF-ET助孕经过及妊娠结局,对反复种植失败的定义、病因及临床治疗等相关文献进行整理和总结,探讨该患者成功妊娠的可能原因,为反复种植失败患者的诊疗提供新思路。

Repeated implantation failure is one of the main reasons for the failure of assisted reproductive technology.At present,the definition,diagnosis and treatment of repeated implantation failure are still controversial.However,it has become a consensus that it is important to find the cause as much as possible for patients with repeated implantation failure and deal with them accordingly.The causes of repeated implantation failure can be summarized as embryo quality factors including oocyte quality,sperm quality&abnormal embryo genetic material,and maternal factors including maternal anatomical structure abnormality,endometrial local or systemic immune and metabolic disorders,etc.In addition,there are still some unexplained repeated implantation failures.The clinical treatment methods are still being explored and tried.This paper reported on the process of successful childbirth by using a micro-stimulation IVF protocol for a patient with recurrent implantation failure who underwent 2 controlled ovulation induction IVF and 8 transplantations.Based on her medical history,IVF-ET assisted pregnancy process and pregnancy outcomes,the relevant literature on the definition,etiology,and clinical treatment of repeated implantation failure were sorted out and summarized to explore the possible causes of successful pregnancy in the patient,providing new ideas for the diagnosis and treatment of repeated implantation failure patients.