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辅助生殖技术(assisted reproductive technology,ART)为人类繁衍带来了新的希望和方法。同时,ART的推广也为围产医学带了更多的挑战,如多胎妊娠率高、妊娠合并症发生率高、促排卵药物过度使用等相关问题。改善胚胎着床率和妊娠维持对于提高ART成功率至关重要。ART可能导致子宫内膜容受性受损,而子宫内膜容受性对胎盘滋养细胞的侵袭能力具有重要影响。因此,ART被认为是子痫前期等胎盘源性疾病的潜在风险因素,从而带来了更加复杂的胚胎早期暴露因素,可能对子代发育编程产生不良影响。进一步探明ART对子宫内膜容受性以及滋养细胞生理功能的影响,利用代谢组学等新技术对孕妇的代谢图谱进行分析,开发免疫调节治疗等手段改善胚胎着床,将有希望降低ART导致的不良妊娠结局及子代健康风险。
Assisted reproductive technology (ART) brings new hope and method to human reproduction. At the same time, the promotion of ART has brought more challenges to perinatology, such as the high rate of multiple pregnancy, the high incidence of pregnancy complications and the excessive use of ovulation induction drugs. Improving embryo implantation rate and pregnancy maintenance are critical to increasing ART success. ART may cause impaired endometrial receptivity, whereas endometrial receptivity has a major impact on placental trophoblast invasion. ART is therefore considered as a potential risk factor for placental-derived diseases such as pre-eclampsia, leading to more complex early exposure to embryo that may have an adverse effect on progeny developmental programming. To further explore the impact of ART on endometrial receptivity and trophoblast physiological function, the use of new technologies such as metabolomics analysis of pregnant women metabolic map to develop immunomodulatory treatment and other means to improve embryo implantation, there is hope to reduce ART Lead to adverse pregnancy outcomes and offspring health risks.