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胚胎质量与子宫内膜容受性是决定胚胎能否成功种植的关键。子宫内膜容受性障碍是导致胚胎种植失败的主要原因。近年来,如何改善子宫内膜容受性、提高体外受精-胚胎移植(IVF-ET)技术的胚胎种植率及临床妊娠率已经成为研究的热点。本文通过回顾文献,从增加子宫动脉血流、机械损伤子宫内膜、宫腔灌注某些与子宫内膜容受性相关的细胞因子、药物抑制子宫收缩等方面,对近年来一些研究的进展和新方法的探索进行了阐述。虽然其中的某些治疗方法可以有效提高IVF-ET技术的临床妊娠率,但是仍需高质量的大样本随机双盲对照研究证明其有效性,也亟待制定规范治疗方案及适应证。
Abstract：The embryo quality and endometrial receptivity are key to embryo implantation.Endometrial receptivity disorder is a major cause of unsuccessful embryo implantation.In recent years,how to improve the endometrial receptivity and clinical pregnancy rate of IVF-ET has increasingly drawn attention of researchers.This paper described the advanced progress and therapeutic methods based on different mechanism,such as the increase of uterine artery blood flow,mechanical injury of endometrium,uterine infusion of some cytokines and inhibition of uterine contraction.Although some treatments can effectively improve the clinical pregnancy rate of IVF-ET,it still needs high quality randomly double blind controlled clinical trials to demonstrate their effectiveness.
[1]李华,李蓉,刘洋,等.芬吗通改善反复胚胎移植失败患者子宫内膜血流和提高妊娠率的研究[J].生殖医学杂志,2014,23:37-41.
[2]Dentali F,Ageno W,Rezoagli E,et al.Low-dose aspirin for in vitro fertilization or intracytoplasmic sperm injection:a systematic review and a meta-analysis of the literature[J].J Thromb Haemost,2012,10:2075-2085.
[3]Lodigiani C,Di Micco P,Ferrazzi P,et al.Low-molecularweight heparin in women with repeated implantation failure[J].Womens Health(Lond Engl),2011,7:425-431.
[4]Potdar N,Gelbaya TA,Konje JC,et al.Adjunct lowmolecular-weight heparin to improve live birth rate after recurrent implantation failure:a systematic review and metaanalysis[J].Hum Reprod Update,2013,19:674-684.
[5]Sher G,Fisch JD.Effect of vaginal sildenafil on the outcome of in vitro fertilization(IVF)after multiple IVF failures attributed to poor endometrial development[J].Fertil Steril,2002,78:1073-1076.
[6]Zinger M,Liu JH,Thomas MA.Successful use of vaginal sildenafil citrate in two infertility patients with Asherman’s syndrome[J].J Womens Health(Larchmt),2006,15:442-444.
[7]Takasaki A,Tamura H,Miwa I,et al.Endometrial growth and uterine blood flow:a pilot study for improving endometrial thickness in the patients with a thin endometrium[J].Fertil Steril,2010,93:1851-1858.
[8]Lédée-Bataille N,Olivennes F,Lefaix JL,et al.Combined treatment by pentoxifylline and tocopherol for recipient women with a thin endometrium enrolled in an oocyte donation programme[J].Hum Reprod,2002,17:1249-1253.
[9]Almog B,Shalom-Paz E,Dufort D,et al.Promoting implantation by local injury to the endometrium[J].Fertil Steril,2010,94:2026-2029.
[10]Potdar N,Gelbaya T,Nardo LG.Endometrial injury to overcome recurrent embryo implantation failure:a systematic review and meta-analysis[J/OL].Reprod Biomed Online,2012,25:561-571.
[11]Mansour R,Tawab N,Kamal O,et al.Intrauterine injection of human chorionic gonadotropin before embryo transfer significantly improves the implantation and pregnancy rates in in vitro fertilization/intracytoplasmic sperm injection:aprospective randomized study[J].Fertil Steril,2011,96:1370-1374.
[12]Santibaez A,García J,Pashkova O,et al.Effect of intrauterine injection of human chorionic gonadotropin before embryo transfer on clinical pregnancy rates from in vitro fertilisation cycles:a prospective study[J].Reprod Biol Endocrinol,2014,12:9.
[13]李婷婷,汪翔,岳超敏,等.宫腔内注射人绒毛膜促性腺激素对反复体外受精-胚胎移植失败患者的治疗作用[J].中华临床医生杂志(电子版),2013,7:3862-3865.
[14]Gleicher N,Vidali A,Barad DH.Successful treatment of unresponsive thin endometrium[J].Fertil Steril,2011,95:2123.
[15]Gleicher N,Kim A,Michaeli T,et al.A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies[J].Hum Reprod,2013,28:172-177.
[16]Li Y,Pan P,Chen X,et al.Granulocyte colony-stimulating factor administration for infertile women with thin endometrium in frozen embryo transfer program[J].Reprod Sci,2014,21:381-385.
[17]Yoshioka S,Fujiwara H,Nakayama T,et al.Intrauterine administration of autologous peripheral blood mononuclear cells promotes implantation rates in patients with repeated failure of IVF-embryo transfer[J].Hum Reprod,2006,21:3290-3294.
[18]Okitsu O,Kiyokawa M,Oda T,et al.Intrauterine administration of autologous peripheral blood mononuclear cells increases clinical pregnancy rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure[J].J Reprod Immunol,2011,92:82-87.
[19]陈雷宁,全松,李红,等.单核细胞宫腔灌注联合冻融胚胎移植治疗反复着床失败:附3例报道[J].南方医科大学学报,2011,31:724-726.
[20]Pierzynski P.Oxytocin and vasopressin V(1A)receptors as new therapeutic targets in assisted reproduction[J/OL].Reprod Biomed Online,2011,22:9-16.
[21]Moraloglu O,Tonguc E,Var T,et al.Treatment with oxytocin antagonists before transfer may increase implantation rates after IVF[J/OL].Reprod Biomed Online,2010,21:338-343.
[22]Lan VT,Khang VN Nhu GH,et al.Atosiban improve implantation and pregnancy rates in patients with repeated implantation failure[J/OL].Reprod Biomed Online,2012,25:254-260.
[23]Kalmantis K,Loutradis D,Lymperopoulos E,et al.Three Dimensional Power Doppler evaluation of human endometrium after administration of oxytocine receptor antagonist(OTRa)in an IVF program[J].Arch Gynecol Obstet,2012,285:265-270.
[24]Xu A,Li Y,Zhu L,et al.Inhibition of endometrial fundocervical wave by phloroglucinol and the outcome of in vitro fertilization[J].Reprod Biol,2013,13:88-91.
[25]黄向红,谭小军,贺艳坤,等.生长激素改善冻融胚胎移植周期结局的研究[J].中国实用妇科与产科杂志,2011,27:530-533.
[26]罗国群,邓伟芬,马文敏.生长激素在IVF-ET周期子宫内膜发育不良患者中的应用[J].生殖与避孕,2011,31:769-772.
基本信息:
中图分类号:R714.8
引用信息:
[1]李华,李蓉,王丽娜,等.子宫内膜容受性治疗方法的新进展[J].生殖医学杂志,2015,24(03):240-244.
基金信息:
国家十二五科技支撑计划-子宫内膜损伤机制和治疗方法的研究(2012BA132B05)
2015-03-15
2015-03-15