辅助生殖技术中预防活性氧对精子的损伤

不育患者精子质量与生殖结局密切相关。活性氧(ROS)在精子获能、精卵融合等众多生理过程中扮演重要角色,但若产生过量或抗氧化能力不足,可在男性生殖系统中引发病理损伤,这些已在男性不育症中得到证实。本文就辅助生殖技术中活性氧的产生、预防问题作一综述。     

辅助生殖技术(ART)助孕获得多胎妊娠行减胎术后妊娠结局观察

目的:探讨辅助生殖技术(ART)获得的多胎妊娠孕早期行经阴道减胎术的有效性和安全性。方法:以经ART助孕获得多胎妊娠行经阴道减胎术的患者123例为减胎组,根据减胎后保留的胎儿数分为双胎组(A组,n=90)和单胎组(B组,n=33)。另以同期经ART助孕获得单胎妊娠(C组,n=36)和双胎妊娠(D组,n=57)的患者为对照组。回顾性分析患者的妊娠结局及妊娠期并发症发生情况。结果:减胎组的减胎成功率为100.0%,妊娠成功率为91.9%。A组胎膜早破发生率、早产发生率、新生儿低出生体质量发生率、新生儿重症监护室(NICU)入住率均高于B组(P<0.05)。结论:多胎妊娠孕早期行经阴道减胎术安全、有效、可行。多胎妊娠实施减胎术中减为单胎更为安全。     

辅助生殖技术相关血栓性疾病的防治

辅助生殖技术(ART)并发血栓性疾病的报道逐年增加,口服避孕药(OCs)、促排卵药物的应用、卵巢过度刺激综合征(OHSS)以及多胎妊娠是血栓性疾病发生的高危因素。在促排卵治疗过程中,应高度警惕高危人群血栓性疾病的发生,早期诊断并积极治疗。血栓性疾病的发生重在预防。对于既往有血栓病史或血栓家族史的高危患者必要时可行相关易栓症的遗传性筛查。     

子宫内膜异位症与辅助生殖技术

子宫内膜异位症(EMs)的发病率逐年增长,是造成不孕的重要原因,但其发病机理以及导致不孕的机制尚不清楚。传统治疗包括药物、手术治疗。随着辅助生殖技术近几年来的发展,对EMs的治疗上升到一个新的高度。本文重点讨论EMs与辅助生殖技术(ART)的关系,为提高临床辅助生殖技术的成功率提供一些新的思路。     

我国人类辅助生殖技术管理问卷调查报告

目的:为修订我国人类辅助生殖技术(ART)管理相关法规和技术指南提供参考。方法:对目前社会和从业人员反映问题较多的卵子捐赠、精子捐赠及管理问题设计问卷调查。结果:共回收142份问卷。调查结果显示85%~95%需要赠卵治疗的妇女没有获得治疗,主要原因是没有捐赠来源。88.7%认为目前有关卵子捐赠的管理条例需要修改。65.6%被调查者反映有医学指征且要求接受"赠精"者,需要等待1年。55.6%被调查者认为有关"赠精"的管理条例需要修改。76.1%的问卷认为我国人类ART应该由一个部门管理,军队医疗机构开展ART的监督管理应纳入全国统一的监管体系。85.9%的问卷认为我国人类ART应该由国家卫生和计划生育委员会统一监督管理。结论:我国人类ART中的卵子捐赠、精子捐赠和监督管理体系等方面的管理规定有待进一步完善。     

辅助生殖技术对子代印记基因影响的研究进展

辅助生殖技术(assisted reproductive technology,ART)是采用医学技术手段使不孕不育夫妇获得妊娠一系列技术的统称,与自然妊娠相比,在体内、体外环境等有所不同,配子及早期胚胎遭受医源性应激,致子代健康风险增加。目前普遍认为ART与配子及早期胚胎印记基因印迹改变相关,进而影响子代出生后远期健康。本文就ART对印记基因的影响进行综述,分别从配子、植入前胚胎、胎盘等方面进行论述,总结了ART与印记基因印迹异常的关系。     

辅助生殖技术妊娠丢失的相关因素分析

辅助生殖技术(ART)后妊娠丢失病因复杂,困扰着大多数不孕患者与临床工作者,明确其相关因素对改善ART妊娠结局至关重要。经过文献综述,夫妻双方年龄、胚胎染色体异常影响ART妊娠结局,而ART方法、多胎妊娠是否影响其妊娠结局,及ART妊娠丢失率是否高于自然妊娠仍需进一步探讨,这为今后的研究提示了相应的研究方向。     

辅助生殖技术前应重视男性不育患者的常规处理

辅助生殖技术(assisted reproductive technique,ART)给男性不育症的治疗和预后带来了巨大改变,但ART前期是否有必要对男性不育开展常规处理存在广泛争议.本文介绍了ART前对男性不育症患者进行常规处理的意义,包括对男性不育常规治疗研究的深化和有助于ART的顺利成功开展.系统介绍了ART前男性不育常规治疗技术,包括药物、手术和实验室技术;常规药物治疗的可能环节与目的,包括确保有足够的精子用于ART,改善ART治疗结局、困难病例及ART失败后的再努力以及对男性不育症中性功能障碍的处理.     

Kisspeptin对女性生殖功能调控机制的研究进展

在女性生殖活动中,kisspeptin参与调控下丘脑-垂体-性腺(HPG)轴的功能,并通过介导雌激素的正负反馈调节促性腺激素释放激素(Gn RH)的分泌,解除促性腺激素抑制激素(Gn IH)对HPG轴的负性调控作用,继而调节促性腺激素(Gn)的分泌及类固醇甾体激素的分泌,并与多种卵巢功能异常疾病的病理过程密切相关。Kisspeptin可调控卵泡发育和排卵发生,并影响子宫内膜容受性的形成。此外,在辅助生殖技术(ART)过程中kisspeptin可代替传统h CG扳机,并降低接受ART治疗的不孕症女性卵巢过度刺激综合征(OHSS)的发生。     

冻融胚胎移植中辅助孵化对妊娠结局及安全性的影响

目的探讨在玻璃化冻融胚胎移植(FET)中,激光辅助孵化(AH)操作后对妊娠结局及母儿安全性的影响。方法回顾性分析2014年1月—2015年10月接受体外受精-胚胎移植(IVF-ET)失败后行FET患者的临床资料,根据患者年龄进行分组后比较AH操作后妊娠结局及母儿并发症的发生情况。结果在正常年龄组(38岁)的患者中,未行AH操作的对照组中胚胎种植率、临床妊娠率、活产率、多胎率均高于AH组,流产率低于AH组,并且差异有统计学意义(P0.05);在高龄(≥38岁)患者中,AH组的胚胎种植率、临床妊娠率较对照组有增高的趋势(P0.05);分娩周期中,AH组与对照组早产率、死胎率、母体并发症、新生儿男女比例、胎龄、出生体质量、新生儿缺陷率等均无统计学差异(P0.05)。结论对于正常年龄患者,卵裂期FET时不建议行AH操作;对于高龄患者,AH操作可提高胚胎种植率及临床妊娠率,但不能明显改善其妊娠结局;AH对母儿安全暂无不良影响。     

辅助生殖技术助孕后的多胎妊娠早孕期减胎91例分析

目的:评价辅助生殖技术(ART)助孕后多胎妊娠早孕期减胎术的安全性及必要性。方法:回顾性分析91例多胎妊娠B超引导下经阴道选择性减胎患者的临床资料,统计其早期流产率、晚期流产率,并将减胎后的患者分为单胎妊娠组及双胎妊娠组,统计各组早产率、早产孕周、早产平均体质量及足月低体质量儿出生率,并与同期施行ART助孕的单胎妊娠及未行减胎的双胎妊娠4 623例进行比较分析。结果:减胎组早期流产率为2.20%,明显优于同期妊娠的早期流产率(10.96%),组间有统计学差异。减胎后的单胎妊娠组早产率、早期流产率及晚期流产率均优于未行减胎的双胎妊娠组。结论:早孕期施行B超引导下经阴道选择性减胎术是安全的,且可有效减少多胎妊娠发生,改善其不良妊娠结局。     

Development of a security system for assisted reproductive technology (ART)

PurposeIn the field of assisted reproductive technology (ART), medical accidents can result in serious legal and social consequences. This study was conducted to develop a security system (called IVF-guardian; IG) that could prevent mismatching or mix-ups in ART.ResultsMany of the label paper samples were toxic to mouse embryo development. We selected a particular label paper (P touch label) that did not affect mouse embryo development. The LED lights were non-toxic to the development of the mouse embryos under any experimental conditions. There were no differences in the clinical pregnancy rates between the IG-applied group and the control group (40/104 = 38.5 % and 30/82 = 36.6 %, respectively).ConclusionsThe application of IG in clinical practice did not affect human embryo development or clinical outcomes. The use of IG reduces the misspelling of patient names. Using IG, there was a disadvantage in that each treatment step became more complicated, but the medical staff improved and became sufficiently confident in ART to offset this disadvantage. Patients who received treatment using the IG system also went through a somewhat tedious process, but there were no complaints. These patients gained further confidence in the practitioners over the course of treatment.     

The wish for a child among individuals who conceive with assisted reproduction technologies

Objective: The objective of the present study was to explore the wish for a child among Greek individuals who had procreated through various assisted reproductive methods. Background: Research has mainly focused on the motives of people to have children, with little attention given to their desire for a child, which has been debated mostly by psychoanalysts, philosophers and anthropologists. Methods: A hermeneutic phenomenology design was used with the large study from which the present data were derived. The sample comprised 19 women who had conceived with assisted reproduction methods, and retrospectively described their overall experience, during an in-depth interview. Results: According to findings, the awareness of the wish to reproduce becomes poignant when women realise that this might not be possible to fulfil. The participants’ motives to reproduce were: (a) appropriate life conditions, and (b) acquisition of social status, whereas their desire to have a child was: (a) to be like the mother of their early years, (b) to become pregnant in order to prove one’s fecundity, and (c) to compensate for guilt over an abortion. Conclusion: Findings suggest that women have both unconscious desires and conscious motives when they embark on the road for parenthood. The identification of both concepts may be of value to researchers, theoreticians, and clinicians who support individuals who wish to become parents.