Uzroci i liječenje ponavljanih implantacijskih neuspjeha

master's thesis

• Title (english): Causes and treatment of recurrent implantation failure
• Author: Lana Dujmović
• Mentor: Dinka Pavičić Baldani (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-09-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Ponavljani implantacijski neuspjeh definira se kao nemogućnost ostvarenja kliničke
trudnoće nakon najmanje tri pokušaja in vitro fertilizacije,pri čemu se u svakom
ciklusu napravi transfer jednog do dvaju visokokvalitetnih embrija u maternicu.
Smatra se da će IVF u 15% slučajeva rezultirati ponavljanim implantacijskim
neuspjehom. Uzrok tomu mogu biti razni očinski i/ili majčinski te embrionalni
čimbenici kao i slabija receptivnost endometrija. Kako bi se saznao točan uzrok koji
je doveo do RIF-a potrebno je napraviti detaljnu dijagnostičku obradu neplodnog
para. Pacijenticama se obavezno radi pregled ultrazvukom te po potrebi pregled
endoskopskim metodama, kako bi se isključila patološka stanja poput endometrioze,
adenomioze, hidrosalpinksa, priraslica, mioma, polipa i prirođenih anomalija
maternice. Potrebno je napraviti i određene laboratorijske pretrage kako bi mogli
isključiti hormonske i metaboličke poremećaje te trombofilije koje bi mogle remetiti
implantaciju embrija. Analiza spermiograma s naglaskom na morfologiju dio je
standardne obrade RIF-a,kao i kariotip oba partnera. Od embrionalnih faktora koji bi
mogli imati negativan utjecaj na implantaciju treba imati na umu upitnu kvalitetu
embrija, ali i mogući problem u transferu embrija u materničnu šupljinu. Liječenje RIFa
se treba bazirati na najrecentnijim znanstvenim istraživanjima te uz sve kirurške i
medikamentozne metode liječenja ne bi trebalo zanemariti ostale, poput psihoterapije
te mijenjanja štetnih navika (pušenje cigareta i učestala konzumacija alkohola).

Abstract (english)

Repeated implantation failure is defined as the inability to achieve a clinical
pregnancy after at least three attempts of in vitro fertilization, whereby in each cycle
one to two high-quality embryos are transferred to the uterus. It is estimated that 15%
of IVF procedures will result in repeated implantation failure. This can be caused by
various paternal and/or maternal and embryonic factors. In order to find out the exact
cause that led to RIF, a detailed diagnostic analysis should be performed.
Patientsmust undergo an utrasonic and endoscopic examination when needed, to
rule out pathological conditions such as endometriosis, adenomyosis, hydrosalpinx,
adhesions, fibroids, polyps and congenital anomalies of the uterus. It is also
necessary to perform certain laboratory tests in order to rule out hormonal and
metabolic disturbances and thrombophilia as well, the conditions that could interfere
with embryo implantation. The sperm analysis with the accent on morfology and
kariotype analysis of both partners should be the part of standard evaluation of RIF.
The embryonic factors that could have a negative impact on implantation includes
quality of the embryo, and the possible problem in the performance of the transfer of
the embryo into the uterine cavity. The treatment of RIF should be based on the
latest scientific research and in addition to all surgical and medicinal methods of
treatment, other treatment methods such as psychotherapy and alteration of
unhealthy habits (smoking cigarettes, frequent alcohol consumption).should be
considered too.

• Keywords: implantacija; neuspjeh; IVF; endometrij; embrij
• Keywords (english): implantation; failure; IVF; endometrium; embryo
• Language: croatian
• URN:NBN: urn:nbn:hr:105:034886
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-09 07:56:06