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In vitro fertilisation treatment and factors affecting success

机译:体外受精治疗及影响成功的因素

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The efficacy of assisted reproductive technologies has improved significantly over the past decades. The main indications for in vitro fertilisation include tubal obstruction, severe male-factor infertility, severe endometriosis, ovulatory dysfunction, diminished ovarian reserve, and infertility of unexplained cause. In vitro fertilisation has also become an effective treatment option for couples wishing to undergo pre-implantation genetic diagnosis or screening, and for those wishing to cryopreserve their oocytes or embryos for preservation of fertility. The management of women in late reproductive age poses a major challenge; the optimum in vitro fertilisation treatment for poor responders remains elusive. The success of in vitro fertilisation treatment can be optimised by taking an individualised, patient-centered approach to controlled ovarian hyperstimulation. Key components involve selection of an appropriate controlled ovarian protocol, close-cycle monitoring, adjustment of gonadotropin dosage to avoid hyper-response, and individualised timing of human chorionic gonadotropin injection. Future directions of assisted reproductive technologies include development of non-invasive embryo selection methods, use of transcriptomics, proteomics, metabolomics, and time-lapse imaging technologies.
机译:在过去的几十年中,辅助生殖技术的功效已大大提高。体外受精的主要指征包括输卵管阻塞,严重的男性因素不育,严重的子宫内膜异位,排卵功能障碍,卵巢储备减少和原因不明的不育。对于希望进行植入前遗传学诊断或筛查的夫妇,以及希望冷冻卵母细胞或胚胎以保存生育力的夫妇,体外受精也已成为一种有效的治疗选择。育龄妇女的管理面临重大挑战。对于反应较差的人,最佳的体外受精治疗仍然遥遥无期。体外受精治疗的成功可通过采用个性化,以患者为中心的方法来控制卵巢过度刺激来优化。关键组成部分包括选择合适的可控卵巢方案,密切周期监测,调整促性腺激素剂量以避免反应过度以及人绒毛膜促性腺激素注射的个体化时机。辅助生殖技术的未来方向包括开发非侵入性胚胎选择方法,转录组学,蛋白质组学,代谢组学和延时成像技术的使用。

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