由子宫内膜受体导向的胚胎移植:对证据的系统审查和元分析
Demian Glujovsky1,2, Karinna Lattes3, Mariana Miguens4
1Center for Studies in Genetics and Reproduction (CEGYR - Eugin group), Buenos Aires, Argentina. demian.glujovsky@gmail.com.
Journal of assisted reproduction and genetics
|January 30, 2026
概括
以子宫内膜受容性分析 (TERT) 为指导的个性化胚胎移植 (pET) 显示,在转移未经测试的胚胎的女性中,复发性植入失败 (RIF) 的活产率 (LBR) 可能增加. 在非RIF患者中,不支持常规TERT的使用.
科学领域:
- 生殖医学 生殖医学
- 遗传学和基因组学 在
- 临床试验 临床试验
背景情况:
- 辅助生殖技术 (ART) 旨在优化怀孕结果.
- 正在探索个性化胚胎移植 (pET) 策略,以提高成功率.
- 子宫内膜受体分析 (TERT) 是用于指导pET的工具.
研究的目的:
- 评估 TERT 指导的 pET 的有效性和安全性,与 ART 中的标准胚胎移植 (sET) 相比.
- 综合来自随机对照试验 (RCT) 和队列研究 (CS) 的证据.
主要方法:
- 系统性审查和RCT和CS的元分析.
- 搜索了多个数据库,直到2025年11月.
- 使用随机效应模型和合成赔率比率 (ORs) 收集数据.
- 小组分析包括以前的破产和euploid转移.
主要成果:
- 包括44项研究 (4项RCT,40项CS).
- 在非RIF女性中,pET与ERA在LBR与sET (中度确定性) 中差异很小.
- 在转移未经检测的胚胎的RIF女性中,TERT引导的pET可能增加了LBR (OR 1.58;中等确定性).
- 在RIF女性患有euploid转移的益处的证据非常不确定 (确定性非常低).
结论:
- 目前的证据不支持在非RIF患者中常规使用TERT.
- 在未经测试的胚胎的RIF患者中,TERT引导的pET可能会增加LBR,但在euploid胚胎中,益处是不确定的.
- 需要进一步进行高质量的RCT,特别是对于接受euploid移植的RIF患者,并比较TERT平台.
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