国际生殖健康/计划生育

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反复种植失败的免疫因素研究进展及治疗现状

王康霞,蒋欢欢,徐玉萍,曹云霞   

  1. 230032  合肥,安徽医科大学第一附属医院妇产科生殖医学中心,安徽医科大学生殖健康与遗传安徽省重点实验室,安徽省生命资源保存与人工器官工程技术研究中心
  • 出版日期:2018-07-15 发布日期:2018-07-15
  • 通讯作者: 曹云霞,E-mail:caoyunxia6@126.com
  • 基金资助:
    安徽省自然科学基金青年基金(1808085QH273)

Immunological Etiology of Recurrent Implantation Failure

WANG Kang-xia, JIANG Huan-huan, XU Yu-ping, CAO Yun-xia   

  1. Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University,Anhui Province Key Laboratory of Reproductive Health and Genetics, Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei 230032, China
  • Published:2018-07-15 Online:2018-07-15
  • Contact: CAO Yun-xia, E-mail: caoyunxia6@126.com

摘要: 反复种植失败(recurrent implantation failure,RIF)通常是指年龄在40岁以下女性,移植次数≥3次或移植优质胚胎数≥4枚仍未获临床妊娠。胚胎着床是一个母胎相互识别、相互融合的复杂过程。一方面胚胎滋养细胞表达胚胎抗原并分泌细胞因子,以逃避母体免疫系统的攻击;另一方面母体蜕膜特征性的免疫细胞富集,形成母胎界面独特的免疫微环境,有利于胚胎着床。围着床期母胎免疫调节的任一环节失常都可能导致种植失败。目前随着生殖免疫学的发展,免疫因素在建立子宫内膜容受性中的作用日益受到关注,并有使用免疫调节剂改善RIF妊娠结局的报道。本文就RIF免疫因素的研究进展及治疗现状进行阐述。

关键词: 反复种植失败, 胚胎植入, 免疫耐受, 细胞因子类, 治疗

Abstract: The definition of recurrent implantation failure (RIF) usually refers to failure to achieve a clinical pregnancy after going through at least three fresh/frozen cycles or transfer of at least four good-quality embryos in a woman under the age of 40 years. Embryo implantation is a complex process of the recognition and fusion between mater and fetus. On one hand, embryonic trophoblasts can express embryonic antigen and secrete cytokines in order to escape the attack of maternal immune system. On the other hand, the specialized immune cells of maternal decidua are enriched to develop a unique immune microenvironment at maternal-fetal interface. Both of them are beneficial for embryo implantation. Any immunologic disorder of the maternal-fetal interface during implantation may lead to implantation failure. With the development of reproductive immunology, the role of immune factors in the establishment of endometrial receptivity has been paid more and more attention, and the use of immunomodulators to improve the pregnancy outcome of RIF has been reported. In this paper, we described the recent research progress in immunological etiology of RIF and the related therapy.

Key words: Recurrent implantation failure, Embryo implantation, Immune tolerance, Cytokines, Therapy