人类辅助生殖技术的研究进展
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摘要
人类辅助生殖技术(ART)包括人工授精(AI)和体外受精-胚胎移植(IVF-ET)及其衍生技术。近年不孕不育患者比例有升高趋势,此外因二胎政策的开放,有生育需求的高龄患者比例有所增加,ART技术现已成为治疗不孕不育患者的重要方式。随着科技的发展,许多衍生技术的应用,包括卵母细胞的体外成熟培养、时差成像系统、精子微量冷冻、代谢组学评估胚胎发育潜能等,弥补了ART技术的不足,使ART技术更完善,更准确地满足患者的需求。但是,新技术的应用仍然存在一些问题,在临床实施过程中,需要不断改进、更新和完善。
Human assisted reproductive technology( ART) includes artificial insemination( AI) and in vitro fertilization and embryo transfer( IVF-ET) and their derivatives. In recent years,the proportion of infertility patients has increased. In addition,with the opening of the second child policy,the proportion of elderly patients with fertility needs has increased. ART technology has become an important way to treat infertility patients. With the development of science and technology,many derivative technologies,including oocyte maturation in vitro,timelaps system,sperm micro-freezing,metabolomics assessment of embryonic development potential,make up for the shortcomings of ART technology,which make ART technology more perfect,and more accurately meet the needs of patients. However,there are still some problems in the application of new technology. In the actual implementation process,the new technology need to constantly improve,update and complete.
Human assisted reproductive technology( ART) includes artificial insemination( AI) and in vitro fertilization and embryo transfer( IVF-ET) and their derivatives. In recent years,the proportion of infertility patients has increased. In addition,with the opening of the second child policy,the proportion of elderly patients with fertility needs has increased. ART technology has become an important way to treat infertility patients. With the development of science and technology,many derivative technologies,including oocyte maturation in vitro,timelaps system,sperm micro-freezing,metabolomics assessment of embryonic development potential,make up for the shortcomings of ART technology,which make ART technology more perfect,and more accurately meet the needs of patients. However,there are still some problems in the application of new technology. In the actual implementation process,the new technology need to constantly improve,update and complete.
引文
[1]乔杰.人类辅助生殖技术新进展[J].中国实用妇科与产科杂志,2008,24(1):33-34.doi:10.3969/j.issn.1005-2216.2008.01.014.
[2]马黔红.辅助生殖技术的新进展[J].中国计划生育和妇产科,2017,9(1):4-7.doi:10.3969/j issn.1674-4020.2017.01.02.
[3]Merviel P,Heraud MH,Grenier N,et al.Predictive factors for pregnancy after intrauterine insemination:an analysis of 1038 cycles and a review of the literature[J].Fertil Steril,2010,93(1):79-88.doi:10.1016/j.fertnstert.2008.09.058.
[4]张玉,甄英贤,李晓茜,等.影响供精人工授精临床妊娠率的多因素分析[J].生殖医学杂志,2018,27(8):765-769.doi:10.3969/j.issn.1004-3845.2018.08.014.
[5]Mehtap P,Gurkan B,Hakan Y.Best protocol for controlled ovarian hyperstimulation in assisted reproductive technologies:fact or opinion?[J].Semin Reprod Med,2014,32(4):262-271.doi:10.1055/s-0034-1375178.
[6]胡琳莉,孙莹璞.辅助生殖临床技术的全面质量管理[J].中国实用妇科与产科杂志,2018,34(6):581-583.doi:10.19538/j.fk2018060102.
[7]廉颖,刘平,乔杰.辅助生殖技术实验室的质量控制体系.中华生殖与避孕杂志,2018,38(8):636-639.doi:10.3760/cma.j.issn.2096-2916.2018.08.007.
[8]Palermo G,Joris H,Devroey P,et al.Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte[J].Lancet,1992,340:17-18.doi.org/10.1016/0140-6736(92)92425-F.
[9]Kirkegaard K,Hindkjaer JJ,Ingerslev HJ.Human embryonic development after blastomere removal:a time-lapse analysis[J].Hum Reprod,2012,27(1):97-105.doi:10.1093/humrep/der382.
[10]Scott RT,Upham KM,Forman EJ,et a1.Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not:a randomized and paired clinical trial[J].Fertil Steril,2013,100(3):624-630.doi:10.1016/j.fertnstert.2013.04.039.
[11]Xu K,Montag M.New perspectives on embryo biopsy:not how,but when and why?[J].Semin Repro Med,2012,30(4):259-266.doi:10.1055/s-0032-1313905.
[12]Huang A,Adusumalli J,Patel S,et al.Prevalence of chromosomal mosaicism in pregnancies from couples with in fertility[J].Fertil Steril,2009,91(6):2355-2360.doi:10.1016/j.fertnstert.2008.03.044.
[13]Dahdouh EM,Balayla J,Audibert F,et al.Technical update:preimplantation genetic diagnosis and screening[J].J Obstet Gynaecol Can,2015,70(9):557-558.PMID:26168107.
[14]Chen CK,Yu HT,Soong YK,et al.New perspectives on preimplantation genetic diagnosis and preimplantation genetic screening[J].Taiwan J Obstet Gynecol,2014,53(2):146-150.doi:10.1016/j.tjog.2014.04.004.
[15]Xu J,Fang R,Chen L,et al.Noninvasive chromosome screening of human embryos by genome sequencing of embryo culture medium for in vitro fertilization[J].Proc Natl Acad Sci USA,2016,113(42):11907-11912.doi:10.1073/pnas.1613294113.
[16]Gómez-Tatay L,Hernández-Andreu JM,Aznar J.Mitochondrial modification techniques and ethical issues[J].J Clin Med,2017,6(3):25-27.doi:10.3390/jcm6030025.
[17]Lane A,Nisker J."Mitochondrial Replacement"technologies and human germline nuclear modification[J].J Obstet Gynaecol Can,2016,38:731-736.doi:10.1016/j.jogc.2016.03.002.
[18]Zhang J,Zhuang GL,Zeng Y,et al.Pregnancy derived from human zygote pronuclear transfer in a patient who had arrested embryos after IVF[J].Reprod Biomed Online,2016,33(4):529-533.doi:10.1016/j.rbmo.2016.07.008.
[19]Eppig JJ,Brien MJ,Wigglesworth K,et al.Effect of in vitro maturation of mouse oocytes on the health and lifespan of adult offspring[J].Human Reproduction,2009,24:922-928.doi:10.1093/humrep/den466.
[20]Kavrut M,Kahrama S.Comparison of two doses of recombinant hcg for oocyte maturation in obese women(BMI>or=30)undergoing assisted reproductive techniques[J].Ginekol Pol,2013,84(7):603-608.
[21]Filali M,Hesters L,Fanchin R,et al.Retrospective comparison of two media for in-vitro maturation of oocytes[J].Reprod Biomed Online,2008,16(2):250-256.
[22]王世凯,薛林涛,何冰,等.胚胎动力学参数与胚胎发育潜能关系的初步研究[J].中国临床新医学,2016,9(9):763-766.doi:10.3969/j.issn.1674-3806.2016.09.01.
[23]刘丽,徐凤琴,王媛媛,等.应用时差成像技术选择优质胚胎移植[J].中国妇幼保健,2016,31(20):4227-4229.doi:10.7620/zgfybj.j.issn.1001-4411.2016.20.47.
[24]马超,胡明广,王赞滔,等.封闭式薄片法对人类微量精子超快速玻璃化冷冻的研究[J].现代妇产科进展,2015,24(10):762-764.doi:10.13283/j.cnki.Xdfckjz.2015.10.011.
[25]Pfeifer S,Fritz M,Mc Clure R,et al.Multiple gestation associated with infertility therapy:an American Society for Reproductive Medicine Practice Committee opinion[J].Fertil Steril,2012,97(4):825-834.doi:10.1016/j.fertnstert.2011.11.048.
[26]宋蕊,王树玉.代谢组学在预测胚胎发育潜能中的研究进展[J].中国优生与遗传杂志,2016,24(10):7-9.doi:10.13404/j.cnki.cjbhh.2016.10.003.
[27]赵庆红,杨著.代谢组学研究及其在胚胎早期发育潜能中的应用[J].生殖医学杂志,2013,22(6):468-472.doi:10.3969/j.issn.1014-3845.2013.06.020.
[28]Yin L,Hang F,Gu LJ,et al.Analysis of birth defects among children3yeaes after conception through assisted reproductive technology in China[J].Birth defects Res ACI in Mol Teratol,2013,97(11):744-749.doi:10.1002/bdra.23116.
[29]Chen Y,Wu L,Zhang W,et al.Delivery modes and pregnancy outcomes of low birth weight infants in China[J].J Perinatol,2016,36(1):41-46.doi:10.1038/jp.2015.137.
[30]李静,毛宝宏,李亚梅,等.辅助生殖技术治疗后单胎出生低体重儿风险性研究[J].中国妇幼保健,2018(2):391-394.doi:10.7620/zgfybj.j.issn.1001-4411.2018.02.51.
[31]Trapphoff T,ElHajj N,Zechner U,et al.DNA integrity,growth pattern,spindle formation,chromosomal constitution and imprinting patterns of mouse oocytes from vitrified preantral follicles[J].Hum Reprod,2010,25:3025-3042.doi:10.1093/humrep/deq278.
[2]马黔红.辅助生殖技术的新进展[J].中国计划生育和妇产科,2017,9(1):4-7.doi:10.3969/j issn.1674-4020.2017.01.02.
[3]Merviel P,Heraud MH,Grenier N,et al.Predictive factors for pregnancy after intrauterine insemination:an analysis of 1038 cycles and a review of the literature[J].Fertil Steril,2010,93(1):79-88.doi:10.1016/j.fertnstert.2008.09.058.
[4]张玉,甄英贤,李晓茜,等.影响供精人工授精临床妊娠率的多因素分析[J].生殖医学杂志,2018,27(8):765-769.doi:10.3969/j.issn.1004-3845.2018.08.014.
[5]Mehtap P,Gurkan B,Hakan Y.Best protocol for controlled ovarian hyperstimulation in assisted reproductive technologies:fact or opinion?[J].Semin Reprod Med,2014,32(4):262-271.doi:10.1055/s-0034-1375178.
[6]胡琳莉,孙莹璞.辅助生殖临床技术的全面质量管理[J].中国实用妇科与产科杂志,2018,34(6):581-583.doi:10.19538/j.fk2018060102.
[7]廉颖,刘平,乔杰.辅助生殖技术实验室的质量控制体系.中华生殖与避孕杂志,2018,38(8):636-639.doi:10.3760/cma.j.issn.2096-2916.2018.08.007.
[8]Palermo G,Joris H,Devroey P,et al.Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte[J].Lancet,1992,340:17-18.doi.org/10.1016/0140-6736(92)92425-F.
[9]Kirkegaard K,Hindkjaer JJ,Ingerslev HJ.Human embryonic development after blastomere removal:a time-lapse analysis[J].Hum Reprod,2012,27(1):97-105.doi:10.1093/humrep/der382.
[10]Scott RT,Upham KM,Forman EJ,et a1.Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not:a randomized and paired clinical trial[J].Fertil Steril,2013,100(3):624-630.doi:10.1016/j.fertnstert.2013.04.039.
[11]Xu K,Montag M.New perspectives on embryo biopsy:not how,but when and why?[J].Semin Repro Med,2012,30(4):259-266.doi:10.1055/s-0032-1313905.
[12]Huang A,Adusumalli J,Patel S,et al.Prevalence of chromosomal mosaicism in pregnancies from couples with in fertility[J].Fertil Steril,2009,91(6):2355-2360.doi:10.1016/j.fertnstert.2008.03.044.
[13]Dahdouh EM,Balayla J,Audibert F,et al.Technical update:preimplantation genetic diagnosis and screening[J].J Obstet Gynaecol Can,2015,70(9):557-558.PMID:26168107.
[14]Chen CK,Yu HT,Soong YK,et al.New perspectives on preimplantation genetic diagnosis and preimplantation genetic screening[J].Taiwan J Obstet Gynecol,2014,53(2):146-150.doi:10.1016/j.tjog.2014.04.004.
[15]Xu J,Fang R,Chen L,et al.Noninvasive chromosome screening of human embryos by genome sequencing of embryo culture medium for in vitro fertilization[J].Proc Natl Acad Sci USA,2016,113(42):11907-11912.doi:10.1073/pnas.1613294113.
[16]Gómez-Tatay L,Hernández-Andreu JM,Aznar J.Mitochondrial modification techniques and ethical issues[J].J Clin Med,2017,6(3):25-27.doi:10.3390/jcm6030025.
[17]Lane A,Nisker J."Mitochondrial Replacement"technologies and human germline nuclear modification[J].J Obstet Gynaecol Can,2016,38:731-736.doi:10.1016/j.jogc.2016.03.002.
[18]Zhang J,Zhuang GL,Zeng Y,et al.Pregnancy derived from human zygote pronuclear transfer in a patient who had arrested embryos after IVF[J].Reprod Biomed Online,2016,33(4):529-533.doi:10.1016/j.rbmo.2016.07.008.
[19]Eppig JJ,Brien MJ,Wigglesworth K,et al.Effect of in vitro maturation of mouse oocytes on the health and lifespan of adult offspring[J].Human Reproduction,2009,24:922-928.doi:10.1093/humrep/den466.
[20]Kavrut M,Kahrama S.Comparison of two doses of recombinant hcg for oocyte maturation in obese women(BMI>or=30)undergoing assisted reproductive techniques[J].Ginekol Pol,2013,84(7):603-608.
[21]Filali M,Hesters L,Fanchin R,et al.Retrospective comparison of two media for in-vitro maturation of oocytes[J].Reprod Biomed Online,2008,16(2):250-256.
[22]王世凯,薛林涛,何冰,等.胚胎动力学参数与胚胎发育潜能关系的初步研究[J].中国临床新医学,2016,9(9):763-766.doi:10.3969/j.issn.1674-3806.2016.09.01.
[23]刘丽,徐凤琴,王媛媛,等.应用时差成像技术选择优质胚胎移植[J].中国妇幼保健,2016,31(20):4227-4229.doi:10.7620/zgfybj.j.issn.1001-4411.2016.20.47.
[24]马超,胡明广,王赞滔,等.封闭式薄片法对人类微量精子超快速玻璃化冷冻的研究[J].现代妇产科进展,2015,24(10):762-764.doi:10.13283/j.cnki.Xdfckjz.2015.10.011.
[25]Pfeifer S,Fritz M,Mc Clure R,et al.Multiple gestation associated with infertility therapy:an American Society for Reproductive Medicine Practice Committee opinion[J].Fertil Steril,2012,97(4):825-834.doi:10.1016/j.fertnstert.2011.11.048.
[26]宋蕊,王树玉.代谢组学在预测胚胎发育潜能中的研究进展[J].中国优生与遗传杂志,2016,24(10):7-9.doi:10.13404/j.cnki.cjbhh.2016.10.003.
[27]赵庆红,杨著.代谢组学研究及其在胚胎早期发育潜能中的应用[J].生殖医学杂志,2013,22(6):468-472.doi:10.3969/j.issn.1014-3845.2013.06.020.
[28]Yin L,Hang F,Gu LJ,et al.Analysis of birth defects among children3yeaes after conception through assisted reproductive technology in China[J].Birth defects Res ACI in Mol Teratol,2013,97(11):744-749.doi:10.1002/bdra.23116.
[29]Chen Y,Wu L,Zhang W,et al.Delivery modes and pregnancy outcomes of low birth weight infants in China[J].J Perinatol,2016,36(1):41-46.doi:10.1038/jp.2015.137.
[30]李静,毛宝宏,李亚梅,等.辅助生殖技术治疗后单胎出生低体重儿风险性研究[J].中国妇幼保健,2018(2):391-394.doi:10.7620/zgfybj.j.issn.1001-4411.2018.02.51.
[31]Trapphoff T,ElHajj N,Zechner U,et al.DNA integrity,growth pattern,spindle formation,chromosomal constitution and imprinting patterns of mouse oocytes from vitrified preantral follicles[J].Hum Reprod,2010,25:3025-3042.doi:10.1093/humrep/deq278.