支原体感染与辅助生殖技术失败的研究进展

支原体在女性生殖道中具有较高的感染率,绝大多数女性感染后无明显症状或仅表现为轻微临床症状,易被患者忽视。支原体可通过介导免疫炎症反应,引起输卵管和子宫内膜形态和功能发生改变,从而导致不孕。对于辅助生殖技术(ART)失败的女性,应考虑支原体引起内膜容受性改变造成胚胎植入失败的可能。因此,再次行胚胎植入前,可建议进行宫腔镜检查、内膜活检、宫颈分泌物涂片检测以判断是否存在支原体感染引起的慢性子宫内膜炎。若存在支原体感染,应采用抗生素等多种手段进行干预,再行经阴道超声多普勒(TVS)检测内膜厚度、血流及蠕动波来评估疗效,从而避免辅助生殖的再次失败。此外,支原体感染对辅助生殖失败的影响可能存在个体差异。

Mycoplasma Infection and Assisted Reproductive Technology Failure

The infection rate of mycoplasma is high in the female reproductive tract.The clinical symptoms of mycoplasma infection could be inapparent,or mild in those infected women.Mycoplasma can cause the morphological and functional changes in fallopian tube and endometrium by immune inflammation,which could lead to infertility.In those women with assisted reproductive technology (ART) failure,the change of endometrial receptivity induced by mycoplasma infection should be considered as a potential cause of the embryo implantation failure.The hysteroscopy,endometrial biopsy and cervical secretions smear to detect the chronic endometritis caused by mycoplasma infection can be suggested before the next embryo implantation.If the detection shows the positive mycoplasma infection,antibiotics and others should be used.To evaluate the efficacy of treatment,transvaginal ultrasonography is used to detect the thickness,blood flow and peristaltic wave of endometrium,so as to avoid the failure of assisted reproduction.In addition,the effect of mycoplasma infection on reproductive failure may have individual difference.