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胚胎与母体子宫第一次亲密接触并相互对话,进而建立起直接生理联系的过程被称为胚胎植入。这一过程的正常发生与否决定着胚胎能否继续发育和最终的妊娠结局。正常育龄妇女每个月经周期妊娠成功率只有30%左右,其中近70%的妊娠失败被认为是发生在胚胎植入环节。胚胎植入的成功发生需要具有植入能力的囊胚和处于接受态的子宫之间同步互作并建立起直接的生理联系。在临床的辅助生殖诊疗中,尽管形态正常的胚胎移植到子宫中,妊娠的成功率也只有50%左右,这其中子宫接受态的异常被认为是一个很关键的、急需克服的限制因素。反之,更为可靠的胚胎质量判断标准是辅助生殖治疗研究中的另一个关键问题。针对子宫接受态建立和囊胚激活这两个决定胚胎植入成败的关键事件,阐述了胚胎植入领域近年来的研究进展,介绍了国内科学家在该领域所做的贡献,同时简要探讨了本领域发展面临的问题以及出路,以使读者能明晰胚胎植入这一重要生理过程发生的分子基础以及该领域面临的挑战和未来发展方向。
Embryos and maternal uterus the first intimate contact and dialogue with each other, and then establish a direct physiological relationship between the process is called embryo implantation. The normal occurrence of this process determines whether the embryo can continue to develop and eventually the outcome of pregnancy. Normal women of childbearing age each pregnancy cycle success rate of only about 30%, of which nearly 70% of pregnancy failure is thought to occur in the embryo implantation. The success of embryo implantation requires the ability of implanted blastocysts and the competent uterus to synchronously interact and establish a direct physiological relationship. In clinical assisted reproductive clinics, despite the normal morphology of the embryo transplanted into the uterus, the success rate of pregnancy is only about 50%, of which abnormal uterine acceptance is considered to be a critical and urgent need to overcome the limiting factor. Conversely, a more reliable criterion of embryo quality is another key issue in assisted reproductive therapy research. The key events that determine the success or failure of embryo implantation are the establishment of uterine acceptance and the activation of blastocysts. The progress of embryo implantation in recent years is described, and the contributions made by domestic scientists in this field are introduced. At the same time, The problems facing the development of the field and the way out so that readers can understand the molecular basis of embryo implantation, an important physiological process, the challenges in the field and the future development direction.