Petrogiannis Nikos, Filippa Maria, Chatzovoulou Kalliopi, Petrogiannis Savvas, Filippas Ioannis, Grimbizis Grigoris, Kolibianakis Efstratios, Chatzimeletiou Katerina
ART Unit, Naval Hospital of Athens, 11521 Athens, Greece.
Unit for Human Reproduction, 1st Department of Obstetrics and Gynaecology, Aristotle University Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece.
Medicina (Kaunas). 2025 Feb 20;61(3):367. doi: 10.3390/medicina61030367.
Advancements in assisted reproductive technologies (ARTs) have led to the development of various add-on techniques aimed at improving oocyte quality and enhancing embryo implantation potential. These techniques target critical stages of both oocyte and embryo physiology, including oocyte growth and maturation, fertilization, chromosomal status, and embryo development. Key approaches involve the optimization of in vitro fertilization (IVF) protocols, recruiting capable follicles giving rise to dynamic oocytes to evolve, culture media supplementation, preimplantation genetic testing (PGT), and mitochondrial replacement therapy (MRT), all of which are designed to enhance oocyte competence through its function and metabolism. The use of PGT has been promising in selecting embryos suitable for transfer, thus optimizing implantation success. Emerging technologies, such as platelet-rich plasma treatment (PRP), time-lapse imaging (TLI), and hyaluronan-rich (HA) culture media, claim to improve ovarian rejuvenation and uterine receptivity, embryo selection, as well as embryo implantation potential, respectively. Evidence for certain add-on approaches remains limited, but ongoing research suggests that the use of such treatments may lead to increased clinical pregnancies and live birth rates, especially in poor-prognosis patients. The present review describes the current state of the add-on innovations, their mechanisms of action, as well as their possibilities to increase ART success rates.
辅助生殖技术(ARTs)的进步促使了各种附加技术的发展,这些技术旨在提高卵母细胞质量并增强胚胎着床潜力。这些技术针对卵母细胞和胚胎生理学的关键阶段,包括卵母细胞的生长和成熟、受精、染色体状态以及胚胎发育。关键方法包括优化体外受精(IVF)方案、募集能够产生动态卵母细胞的优质卵泡、培养基补充、植入前基因检测(PGT)以及线粒体替代疗法(MRT),所有这些都是为了通过卵母细胞的功能和代谢来增强其能力。PGT在选择适合移植的胚胎方面很有前景,从而优化着床成功率。新兴技术,如富血小板血浆治疗(PRP)、延时成像(TLI)和富含透明质酸(HA)的培养基,分别声称可以改善卵巢功能、提高子宫容受性、进行胚胎选择以及增强胚胎着床潜力。某些附加方法的证据仍然有限,但正在进行的研究表明,使用这些治疗可能会提高临床妊娠率和活产率,尤其是在预后不良的患者中。本综述描述了附加创新技术的现状、其作用机制以及提高ART成功率的可能性。