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山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (10): 27-32.doi: 10.6040/j.issn.1671-7554.0.2019.760

• • 上一篇    

辅助生殖技术后异位妊娠的防治

黄薇, 朱慧莉   

  1. 四川大学华西第二医院生殖医学科 出生缺陷与相关妇儿疾病教育部重点实验室, 四川 成都610041
  • 发布日期:2022-09-27
  • 通讯作者: 黄薇. E-mail:weihuang64@163.com

Prevention and treatment of ectopic pregnancy after assisted reproductive technology

HUANG Wei, ZHU Huili   

  1. Department of Reproductive Medicine, West China Second University Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan, China
  • Published:2022-09-27

摘要: 辅助生殖技术(ART)已成为导致异位妊娠的主要因素之一,但其确切机制尚不清楚。目前研究认为输卵管因素、超生理的激素环境对子宫内膜容受性的影响、胚胎发育潜能、ART技术操作等可能是ART后异位妊娠的高危因素。从输卵管因素、胚胎因素、辅助生殖技术操作及特殊类型的异位妊娠等方面,讨论ART后异位妊娠的防治。

关键词: 辅助生殖技术, 异位妊娠, 输卵管因素, 胚胎因素

Abstract: Assisted reproductive technology(ART)has become one of the main factors causing ectopic pregnancy(EP), but the exact mechanism remains unclear. Current studies suggest that fallopian tube factors, influence of hyperphysiological hormone environment on endometrial receptivity, embryonic growth potential and ART operations may be 山 东 大 学 学 报 (医 学 版)57卷10期 -黄薇,等.辅助生殖技术后异位妊娠的防治 \=-high risk factors leading to ectopic pregnancy after ART. This article reviewed the prevention and treatment of ectopic pregnancy following ART from the aspects of fallopian factors, embryo factors, ART-related operations, and specific types of EP.

Key words: Assisted reproductive technology, Ectopic pregnancy, Fallopian factor, Embryo factor

中图分类号: 

  • R714.22
[1] Clayton HB, Schieve LA, Peterson HB, et al. Ectopic pregnancy risk with assisted reproductive technology Procedures[J]. Obstet Gynecol, 2006, 107(3): 595-604.
[2] Chang HJ, Suh CS. Ectopic pregnancy after assisted reproductive technology: what are the risk factors?[J]. Curr Opin Obstet Gynecol, 2010, 22(3): 202-207.
[3] Clayto HB, Schieve LA, Peterson HB, et a1. A comparison of heterotopic and intrauterine only pregnancy outcomes after assisted reproductive technologies in the United States from 1999 to 2002[J]. Fertil Steril, 2007, 87(2): 303-309.
[4] Refaat B, Dalton E, Ledge WL. Ectopic pregnancy secondary to in vitro fertilization-embryo implantation: pathogenic mechanisms and management strategies[J]. Reprod Biol Endocrinol, 2015, 13(1): 30. doi: 10.1186/s12958-015-0025-0.
[5] Shaw JL, Dey SK, Critchley HO, et al. Current knowledge of the aetiology of human tubal ectopic pregnant[J]. Hum Reprod Update, 2010, 16(4): 432-444.
[6] 秦力, 王雁玲. 输卵管妊娠着床窗口的分子基础及母胎界面相关分子的表达[J]. 生殖医学杂志, 2003, 12(6): 369-373. QIN Li, WANG Yanling. Expression of the implantation related molecules expressed at implantation window during tubal pregnancy[J]. Journal of Reproductive Medicine, 2003, 12(6): 369-373.
[7] 王丽娜, 乔杰. 辅助生殖技术后的异位妊娠[J]. 实用妇产科杂志, 2009, 25(4): 193-195.
[8] Mitchell C, Prabhu M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment[J]. Infect Dis Clin North Am, 2013, 27(4): 793-809.
[9] Du T, Chen H, Fu R, et al. Comparison of ectopic pregnancy risk among transfers of embryos vitrified on day 3, day 5, and day 6[J]. Fertil Steril, 2017,108(1): 108-116.
[10] Smith LP, Oskowitz SP, Dodge LE, et al. Risk of ectopic pregnancy following 5-day embryo transfer compare with 3-day transfer[J]. Reprod Biomed Online, 2013, 27(4): 407-413.
[11] Muller V. Ectopic pregnancy following in vitro fertilization: meta-analysis and single-center experience during 6 years[J]. Gynecol Endocrinol, 2016, 32(suppl 2): 569-574.
[12] Rosman ER, Keegan DA, Krey L, et al. Ectopic pregnancy rates after in vitro fertilization: a look at the donor egg population[J]. Fertil Steril, 2009, 92(5): 1791-1793.
[13] Zhang B, Cui L, Tang R, et al. Reduced ectopic pregnancy rate on day-5 embryo transfer compared with day-3: a meta-analysis[J]. PLoS One, 2017, 12(1): e0169837.
[14] 李磊, 陈仕萍, 刘寒艳, 等. 辅助生殖技术中影响异位妊娠发生的相关危险因素分析[J]. 实用妇产科杂志, 2018, 4(4): 298-301. LI Lei, CHEN Shiping, LIU Hanyan, et al. Analysis of related risk factors influencing the incidence of ectopic pregnancy in ART(Chin)[J]. Journal of Practical Obstetrics and Gynecology, 2018, 4(4): 298-301.
[15] Li Z, Sullivan EA, Chapman M, et al. Risk of ectopic pregnancy lowest with transfer of single frozen blastocyst[J]. Hum Reprod, 2015, 30(9): 2048-2054.
[16] Polyzos NP, Devroey P. Significantly lower ectopic pregnancy rates after frozen embryo transfer: implications toward segmentation of in vitro fertilization treatment[J]. Fertil Steril, 2012, 98(6): 1419-1420.
[17] Ishihara O, Kuwahara A, Saitoh H. Frozen-thawed blastocyst transfer reduces ectopic pregnancy risk: an analysis of single embryo transfer cycles in Japan[J]. Fertil Steril, 2011, 95(6): 1966-1969.
[18] Bu Z, Xiong Y, Wang K, et al. Risk factors for ectopic pregnancy in assisted reproductive technology: a 6-year,single-center study[J]. Fertil Steril, 2016, 106(1): 90-94.
[19] 王菁, 刘嘉茵, 崔毓桂. 异位妊娠发生机制研究进展及辅助生殖技术相关高危因素分析[J]. 国际生殖健康/计划生育杂志, 2013, 32(3): 203-206. WANG Jing, LIU Jiayin, CUI Yugui. Current knowledge of the aetiology and risk factors of human ectopic pregnancy after assisted reproductive technology(Chin)[J]. Journal of International Reproductive Health/Family Planning, 2013, 32(3): 203-206.
[20] Killick SR. Uhrasound and the receptivity of the endometrium[J]. Reprod Biomed Online,2007, 15(1): 63-67.
[21] Londra L, Moreau C, Strobino D, et al. Ectopic pregnancy after in vitro fertilization: differences between fresh and frozen-thawed cycles[J]. Fertil Steril, 2015, 104(1): 110-118.
[22] Xing W, Ou J, Cai L. Thawed embryo transfer and ectopic pregnancy: a meta-analysis[J]. Arch Gynecol Obstet, 2018, 297(6): 1345-1352.
[23] Jee BC, Suh CS, Kim SH. Ectopic pregnancy rates after frozen versus fresh embryo transfer: a meta-analysis[J]. Gynecol Obstet Invest, 2009, 68(1): 53-57.
[24] Jun SH, Milki AA. Assisted hatching is associated with a higher ectopic pregnancy rate[J]. Fertil Steril, 2004, 81(6): 1701-1703.
[25] Knutzen V,Stratton CJ, Sher G, et a1. Mock embryo transfer in early luteal phase,the cycle before in vitro fertilization and embryo transfer:a descriptive study[J]. Fertil Steril, 1992, 57(1): 156-162.
[26] Lesny P, Killick SR, Robinso J, et a1. Transcervical embryo transfer as a risk for ectopic pregnancy[J]. Fertil Steril, 1999, 72(2): 305-309.
[27] Pope CS, Cook EK, Arny M, et a1. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes[J]. Fertil Steril, 2004, 81(1): 51-58.
[28] Samuel SR, Tournaye H, Polyzos NP. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160000 pregnancies[J]. Hum Reprod, 2016, 31(2): 393-402.
[29] 李旎, 刘风华, 龙晓林, 等. 辅助生殖技术后异位妊娠82例临床分析[J]. 实用妇产科杂志, 2010(5): 386-388. LI Ni, LIU Fenghua, LONG Xiaolin, et al. Analysis of 82 cases of ectopic pregnancy after in vitro fertilization and embryo transfer(Chin)[J]. Journal of Practical Obstetrics and Gynecology, 2010(5): 386-388.
[30] Tohge T, Zhang Y, Peterek S, et al. Ectopic expression of snapdragon Transcription factors facilitate the identification of genes encoding enzymes of anthocyanin decoration in tomato[J]. Plant J, 2015, 83(4): 686-704.
[31] 黄琴, 明蕾, 杨菁,等. 辅助生殖技术后异位妊娠相关因素分析[J]. 生殖医学杂志, 2011, 20(6): 465-469. HUANG Qin, MING Lei, YANG Jing, et al. Analysis of related factors of ectopic pregnancy after assisted reproductive technology[J]. Journal of Reproductive Medicine, 2011, 20(6): 465-469.
[32] 章烨, 谢华芳. 辅助生殖技术后异位妊娠发生的类型及危险因素探讨[J]. 临床和实验医学杂志, 2018(1): 1679-1680. ZHANG Ye, XIE Huafang. An analysis of the type and risk factor of ectopic pregnancy after assisted reproductive technology(Chin)[J]. Journal of Clinical and Experimental Medicine, 2018(1): 1679-1680.
[33] 杨蕴洁, 杨芳, 杨健之, 等. 辅助生殖技术后异位妊娠发生的类型及危险因素探讨[J]. 实用妇产科杂志, 2015(7): 511-515. YANG Yunjie, YANG Fang, YANG Jianzhi, et al. An analysis of the type and risk factor of ectopic pregnancy after assisted reproductive technology(Chin)[J]. Journal of Practical Obstetrics and Gynecology, 2015(7): 511-515.
[34] Rombauts L, McMaster R, Motteram C, et al. Risk of ectopic pregnancy is linked to endometrial thickness in a retrospective cohort study of 8120 assisted reproduction technology cycles[J]. Hum Reprod, 2015, 30(12): 2846-2852.
[35] Kim SW. Correlation between ovarian reserve and incidence of ectopic pregnancy after in vitro fertilization and embryo transfer[J]. Yonsei Med, 2019, 60(3): 285-290.
[36] Lin S, Yang R, Chi H, et al. Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve[J]. Oncotarget, 2017, 8(9): 14570-14575.
[37] Weiss A. Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study[J]. Reprod Biol Endocrinol, 2016, 14(1): 12.
[38] Londra L, Moreau C, Strobino D, et al. Is the type of gonadotropin-releasing hormone suppression protocol for ovarian hyperstimulation associated with ectopic pregnancy in fresh autologous cycles for in vitro fertilization?[J]. Fertil Steril, 2016, 106(3): 666-672.
[39] Clayton HB, Schieve LA, Peterson HB, et al. A comparison of heterotopic and intrauterine-only pregnancy outcomes after assisted reproductive technologies in the United States from 1999 to 2002[J]. Fertil Steril, 2007, 87(2): 303-309.
[40] Xiao S, Mo M, Hu XD, et al. Study on the incidence and influences on heterotopic pregnancy from embryo transfer of fresh cycles and frozen-thawed cycles[J]. J Assist Reprod Genet, 2018, 35(4): 677-681.
[41] Perkins KM, Boulet SL, Kissin DM, et al. Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001-2011[J]. Obstet Gynecol, 2015, 125(1): 70-78.
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