国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (5): 397-400.

• 综述 • 上一篇    下一篇

反复种植失败诊断标准的研究进展

刘道英，张建伟   

  1. 250011 济南，山东中医药大学研究生（刘道英）；山东中医药大学附属医院中西医结合生殖与遗传中心（张建伟）
  • 收稿日期:2019-06-19 修回日期:2019-07-08 出版日期:2019-09-15 发布日期:2019-09-11
  • 通讯作者: 张建伟，E-mail：zhangjianwei1970@sina.com E-mail:zhangjianwei1970@sina.com
  • 基金资助:
    山东省重点研发计划项目（2015GSF119028）

Research Progress on Diagnostic Criteria for Recurrent Implantation Failure

LIU Dao-ying, ZHANG Jian-wei   

  1. Shandong University of Traditional Chinese Medicine, Ji′nan 250011, China (LIU Dao-ying); Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji′nan 250011, China (ZHANG Jian-wei)
  • Received:2019-06-19 Revised:2019-07-08 Published:2019-09-15 Online:2019-09-11
  • Contact: ZHANG Jian-wei, E-mａｉｌ： ｚhangjianwei1970@sina.com E-mail:zhangjianwei1970@sina.com

PDF (PC)

9259

摘要： 反复种植失败（recurrent implantation failure，RIF）是限制辅助生殖技术发展的瓶颈。目前RIF的诊断标准仍不统一，本文通过查阅文献，归纳整理出2005年以来RIF的诊断标准共12种，从移植胚胎周期数、移植胚胎数量及质量、移植胚胎期别与周期类型、年龄4方面争议问题进行综述。移植胚胎周期数上有2、3、4、5、6个周期的不同，主要是2个周期和3个周期的争议，并且呈现逐渐减少趋势；移植胚胎数目上有3、4、5、8、10个的不同，亦呈逐渐减少趋势；通过形态学或延时摄影技术挑选优质卵裂期胚胎或囊胚进行移植；移植周期类型包括新鲜胚胎移植和冷冻胚胎移植；年龄通过影响卵巢功能、胚胎质量等方面影响妊娠率、妊娠结局，故应有所限制。目前较为公认的RIF定义为年龄小于40岁，移植3个周期（包括新鲜胚胎移植和冻融胚胎移植），4个及以上优质胚胎，未获得妊娠的不孕女性。诊断标准的不统一阻碍了RIF治疗方式的进步，因此开展高质量的研究，制定并推广规范标准化的RIF诊断标准迫在眉睫。

关键词: 反复种植失败, 胚胎移植, 治疗失败, 诊断标准, 综述

Abstract: Recurrent implantation failure (RIF) is an important influence factor of the development of assisted reproductive technologies (ART). At present, the diagnostic criteria for RIF are still not uniform. Based on the literature review, we summarized 12 diagnostic criteria of RIF that published since 2005 and discussed four controversial issues including the number of embryo transfer cycles, the quantity and quality of transferred embryos, the stage of transferred embryos and type of transfer cycles, and the female age. There were differences in the number of embryo transfer cycles (2, 3, 4, 5 and 6 cycles), mainly in the dispute between 2 and 3 cycles, which showed a decreasing trend. There were differences in the number of transferred embryos (3、4、5、8、10 transferred embryos), which also showed a decreasing trend. High quality embryos or blastocysts were selected for transplantation by the morphology or time-lapse photography. The types of transfer cycles include fresh embryo transfer and frozen embryo transfer. The age should be limited due to its effect on the ovarian function and embryo quality. It is generally recognized that the factors of RIF definition include infertile women aged ＜40 years, 3 or more cycles of transplantation (including fresh embryo transplantation and freeze-thaw embryo transplantation), 4 or more high-quality embryos transferred, and no one pregnancy. The inconsistency of diagnostic criteria hinders the progress of RIF treatment. Therefore, it is urgent to carry out the high-quality research and to formulate a standardized RIF diagnostic criterion.

Key words: Recurrent implantation failure, Embryo transfer, Treatment failure, Diagnostic criteria, Review