Management strategies following implantation failure of euploid embryos.

IF 2.7 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Reproductive Medicine and Biology Pub Date : 2024-04-08 eCollection Date: 2024-01-01 DOI:10.1002/rmb2.12576

Keiji Kuroda

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引用次数: 0

Abstract

Background: Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT-A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence-based testing and treatments for implantation failure after euploid embryo transfer.

Methods: We conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta-analyses.

Results: The recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25-hydroxyvitamin D₃, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low-dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen-thawed single euploid blastocyst transfer using assisted hatching and hyaluronan-enriched transfer medium may support embryo implantation.

Conclusion: To ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence-based tests and treatments should be selected.

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优倍体胚胎植入失败后的管理策略。

背景：胚胎非整倍体植入前基因检测（PGT-A）无法检测到的胚胎因素可能会导致胚泡植入失败；然而，各种非胚胎因素也会对植入造成复杂的干扰。本综述旨在阐明优倍体胚胎移植后植入失败的循证检测和治疗方法：方法：我们对有关优倍体胚胎移植或多胚胎移植周期后植入失败的文献进行了综述，主要包括系统综述和荟萃分析：植入失败的推荐检查包括：（1）宫腔镜检查；（2）子宫内膜CD138免疫组化和细菌培养；（3）血清25-羟维生素D3；（4）血栓性疾病筛查。根据诊断结果，建议采取以下治疗方法：(1) 使用抗生素治疗慢性子宫内膜炎；(2) 补充维生素 D；(3) 改变生活方式；(4) 从着床后开始服用小剂量阿司匹林治疗血栓性疾病。此外，使用辅助孵化和富含透明质酸的移植培养基进行冷冻解冻的单个优倍囊胚移植可支持胚胎着床：结论：为确保后续胚胎移植中的成功妊娠，应选择简单、廉价且以证据为基础的检测和治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive Medicine and Biology Multiple-

CiteScore

5.70

自引率

5.90%

发文量

审稿时长

20 weeks

期刊介绍： Reproductive Medicine and Biology (RMB) is the official English journal of the Japan Society for Reproductive Medicine, the Japan Society of Fertilization and Implantation, the Japan Society of Andrology, and publishes original research articles that report new findings or concepts in all aspects of reproductive phenomena in all kinds of mammals. Papers in any of the following fields will be considered: andrology, endocrinology, oncology, immunology, genetics, function of gonads and genital tracts, erectile dysfunction, gametogenesis, function of accessory sex organs, fertilization, embryogenesis, embryo manipulation, pregnancy, implantation, ontogenesis, infectious disease, contraception, etc.