There is large body of evidence to show that the risk of early pregnancy loss is higher after IVF-ET than after natural conception. Several hypotheses have been proposed to explain this phenomenon. One of the possible etiopathogetic factors is the patient's age which is significantly higher in women undergoing IVF than in the general population of naturally conceiving women. Immunologic factors have also been suggested. It seems that procedures like ICSI do not increase the risk of spontaneous abortion (SAB) after IVF-ET. Moreover, the proportion of products of conception with chromosomal aberration in cases of SAB following ICSI procedure is not elevated. Many authors point to the problem of iatrogenic luteal defect after IVF-ET. The use of luteal support after IVF-ET is widely recommended. Interestingly, firm evidence is lacking regarding the efficacy of progestagen or hCG supplementation on the risk of SAB after IVF-ET. However the issue of the effectiveness of progesterone support in decreasing the risk of SAB after ART procedures is far from being conclusively resolved--it deserves well planned, randomized studied to be performed.

译文

大量证据表明,ivf-et后早期妊娠流产的风险高于自然受孕后。已经提出了几种假设来解释这种现象。可能的病因因素之一是患者的年龄,在接受IVF的妇女中,其年龄明显高于自然受孕妇女的一般人群。还提出了免疫因素。似乎像ICSI这样的程序不会增加ivf-et后自然流产 (SAB) 的风险。此外,在ICSI程序后的SAB病例中,具有染色体畸变的受孕产物的比例并未升高。许多作者指出了ivf-et后医源性黄体缺陷的问题。广泛推荐在ivf-et后使用黄体支持。有趣的是,缺乏关于孕激素或hCG补充对ivf-et后SAB风险的疗效的确凿证据。然而,在ART手术后,孕酮支持在降低SAB风险方面的有效性问题远未得到最终解决-值得进行精心计划的随机研究。

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