PDF(Pubmed)
Abstract：
Successful implantation of embryos depends on the synchronous cross-talks between the endometrial wall and the competent blastocyst within the window of implantation (WOI). Hence, the WOI has a major significance in assisted reproductive technology (ART). However, in some cases, women do not have fixed WOI in ART cycles in order to enhance the rate of successful clinical pregnancy. However, there have been stances where women do not have a fixed WOI, and it shifts in subsequent menstrual periods. This contributes to the chances of recurrent implantation failure (RIF). Another factor that contributes to RIF is erratic endometrial receptivity, which hinders the chances of successful implantation of the conceptus in the endometrium. This case series consists of four case studies where the patients were believed to be suffering from RIF due to variable WOI or erratic endometrial receptivity and the routine protocol followed nowadays failed to make them conceive. In order to resolve the condition, we proposed a novel strategy in an attempt to improve pregnancy rates in these cases. An innovative method of embryo transfer known as mixed double-embryo transfer (MDET), which involved the transfer of one day 3 embryo and one day 5 blastocyst on day 6 of progesterone, led to possible pregnancy outcomes. A viable pregnancy was validated based on the human chorionic gonadotropin (β-hCG) test report, and two of the cases delivered healthy babies. Thus, this case series provides a unique approach to addressing the issues of RIF. However, larger studies are required to validate the possible use of this technique.
摘要：
胚胎的成功植入取决于子宫内膜壁与植入窗口（WOI）内的感受态胚泡之间的同步交叉对话。因此，WOI在辅助生殖技术(ART)中具有重要意义。然而,在某些情况下,女性在ART周期中没有固定的WOI，以提高临床妊娠成功率。然而,有些立场是女性没有固定的女性，它在随后的月经期发生变化。这有助于复发性植入失败(RIF)的机会。导致RIF的另一个因素是子宫内膜容受性不稳定，这阻碍了子宫内膜成功植入概念的机会。该病例系列包括四个病例研究，其中患者被认为由于可变的WOI或不稳定的子宫内膜容受性而患有RIF，而如今遵循的常规方案未能使他们受孕。为了解决这个问题，我们提出了一种新的策略，试图提高这些病例的妊娠率。一种称为混合双胚胎移植（MDET）的创新胚胎移植方法，其中涉及孕酮第6天的第3天胚胎和第5天胚泡的移植，导致可能的妊娠结局。根据人绒毛膜促性腺激素（β-hCG）测试报告验证了可行的妊娠，其中两个病例分娩了健康的婴儿。因此，本案例系列提供了解决RIF问题的独特方法。然而,需要更大的研究来验证这种技术的可能使用。
