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02 November 2020, Volume 36 Issue 11 Previous Issue    Next Issue

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Immune factors of human endometrium in repeated implantation failure and recurrent spontaneous abortion WANG Xiao-Qiu，LI Da-Jin 2020, 36(11): 1036-1040.  DOI: 10.19538/j.fk2020110102 Abstract ( )   Embryo implantation and development is a complex process of mutual recognition and adaptation between mother and fetus.In this process，trophoblasts express embryonic antigens and secrete cytokines to escape the attack of maternal immune system.The enrichment of characteristic immune cells in decidua forms a unique immune microenvironment at the maternal-fetal interface，which is beneficial to embryo implantation and development.Although the success rate of IVF-ET has been greatly improved in recent years，recurrent implantation failure（RIF）is still a problem that puzzles the development of assisted reproductive technology.That the fetus，as an allograft，is not rejected by the maternal immune system is the key to the establishment and maintenance of pregnancy.Abnormal maternal-fetal immune regulation can cause recurrent spontaneous abortion（RSA），which brings physical and mental and economic burden to the couple.With the development of reproductive immunology，the role of endometrial immune factors in the pathogenesis of RIF and RSA has attracted increasing attention.The immunotherapy also plays an increasingly important role in the treatment of these diseases.This article will expound the molecular mechanisms of endometrial immune factors in RIF and RSA and the current understanding of immunotherapy，in order to provide a reference for future scientific research and clinical treatment.

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Recurrent spontaneous abortion and autoimmune disease WANG Hai-yan 2020, 36(11): 1040-1045.  DOI: 10.19538/j.fk2020110103 Abstract ( )   The autoimmune disease（AID）means that the body produce high titer autobodies and/or lymphocytes which attack the normal cells and tissues，which leads the injury and dysfunction of the organs.AID is the most important cause of pregnancy complications such as recurrent spontaneous abortion（RSA）.The autoimmune diseases  that are more likely to lead to RSA  include systemic lupus erythematosus（SLE），antiphospholipid syndrome（APS），Sjogren's syndrome（SS），rheumatoid arthritis（RA），systemic sclerosis（SSc）and undifferentiated connective tissue disease（UCTD）.The treatment for the RSA resulting  from AID include low dose immunosuppressants and anticoagulation.The treatment outcomes are successful.

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Chromosome abnormality and spontaneous abortion SHAO Yu-han，YAN Jun-hao 2020, 36(11): 1045-1050.  DOI: 10.19538/j.fk2020110104 Abstract ( )   Embryonic chromosomal abnormalities are common reasons of spontaneous abortions，and the main abnormalities of which are aneuploidies.Some embryonic chromosomal abnormalities are due to the fact that one or both of the parents are chromosomal rearrangement carriers，including structural rearrangements such as reciprocal balanced translocations，Robertsonian translocations and inversions，or numerical rearrangements such as Triple X syndrome（47，XXX）and Double Y syndrome（47，XYY）.This article focuses on the research progress in the relationship between chromosomal abnormalities and spontaneous abortion.

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Value the diagnosis and management of cervical incompetence in patients with recurrent spontaneous abortion LI Xue，ZHANG Hong 2020, 36(11): 1050-1054.  DOI: 10.19538/j.fk2020110105 Abstract ( )   Cervical incompetence（CIC） is the main cause of second trimester pregnancy loss.The diagnosis and treatment of CIC should be valued in patients with recurrent spontaneous abortion.The diagnostic criteria and diagnostic methods have developed with the development of clinical practice and experience.Although cervical cerclage is the main treatment method for CIC，there are many controversies about the indications and methods of cerclage.Discussion of the diagnosis and treatment aims at seeking the safest and most effective management for best pregnancy outcome.

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Attention should be paid to the screening and diagnosis of thrombophilia in patients with recurrent spontaneous abortion LI Fan，QIAO Chong 2020, 36(11): 1054-1057.  DOI: 10.19538/j.fk2020110106 Abstract ( )   Recurrent spontaneous abortion refers to three or more times of spontaneous abortion before 28 gestational weeks，and it is a common clinical complication of pregnancy.Its etiology involves many aspects，including genetic，anatomical，immune，endocrine，thrombophilia factors.Thrombophilia refers to the presence of genetic or acquired defects such as anticoagulant protein，coagulation factor，fibrinolytic protein，or the presence of acquired risk factors leading to the tendency of high thromboembolism.Thrombophilia can be divided into two types： inherited thrombophilia and acquired thrombophilia.Current studies have shown that there is a correlation between thrombophilia and recurrent spontaneous abortion.Paying attention to the screening and diagnosis of thromboembolism in patients with recurrent spontaneous abortion，and taking corresponding intervention measures can，to a certain extent，improve the pregnancy success rate of patients.

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Application and monitoring of LMWH in patients with RSA. HU Li-hao，ZHANG Jian-ping 2020, 36(11): 1057-1061.  DOI: 10.19538/j.fk2020110107 Abstract ( )   Patients with recurrent spontaneous abortion should be comprehensively screened for etiologies，and etiological treatment can achieve a good pregnancy outcome.Low molecular weight heparin is mainly used in the prevention and treatment of recurrent spontaneous abortion caused by prethrombotic state，antiphospholipid syndrome and autoimmune diseases.This article reviews the application and monitoring of low molecular weight heparin in patients with recurrent spontaneous abortion.

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Progress in diagnosis and treatment of unexplained recurrent spontaneous abortion BAO Shi-hua 2020, 36(11): 1061-1065.  DOI: 10.19538/j.fk2020110108 Abstract ( )   Recurrent spontaneous abortion is an important reproductive health issue，it is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown in 50% patients，and there are few evidence-based diagnostic and treatment strategies. This review will discuss the progress in the etiology of unexplained recurrent spontaneous abortion，as well as the research in treatments.

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Application of preimplantation genetic testing in recurrent spontaneous abortion LU Yao，SUN Yun 2020, 36(11): 1065-1069.  DOI: 10.19538/j.fk2020110109 Abstract ( )   Recurrent pregnancy loss（RPL）is a common disease which affects many women of reproductive age. Embryonic chromosomal abnormality is one of main causes of RPL. In recent years，with the development of preimplantation genetic testing （PGT），which can be used to avoid miscarriage caused by embryonic aneuploidy，clinical application of PGT has been increasing in patients with RPL.This paper will review the advances of PGT technology during the past 30 years since its invention with regard to testing technique，biopsy technique and its clinical application in RPL.

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Endocrine factors accociated with recurrent spontaneous abortion. WU Sheng-nan，JIN Li-ping 2020, 36(11): 1069-1073.  DOI: 10.19538/j.fk2020110110 Abstract ( )   Recurrent spontaneous abortion（RSA） is a common pregnancy complication with complex and varied etiologies，of which endocrine factors account for 8%～12%.This article mainly reviews endocrine factors such as thyroid dysfunction，hyperprolactinemia，polycystic ovary syndrome and metabolic abnormalities，diabetes and luteal phase deficiency，with the aim of providing new ideas for the prevention and treatment of recurrent spontaneous abortion.

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Diagnosis and treatment of recurrent spontaneous abortion complicated with thyroid disease WEI Xiang-cai，XUAN Jian-yan 2020, 36(11): 1073-1077.  DOI: 10.19538/j.fk2020110111 Abstract ( )   Thyroid dysfunction caused by thyroid disease is one of the common endocrine factors causing recurrent spontaneous abortion（RSA）. In recent years，it has become one of the hot spots in the fields of endocrinology，reproductive medicine and perinatal medicine. Clinically common thyroid diseases mainly include hyperthyroidism，clinical hypothyroidism，subclinical hypothyroidism and autoimmune thyroid diseases.No consensus has been reached on the standardized diagnosis and treatment of RSA patients combined with thyroid disease，so nowadays the phenomenon of inconsistent diagnostic criteria，over-treatment or irregular drug use is common.The purport of this paper is to provide a reference consensus for clinicians in the diagnosis and treatment of RSA patients with thyroid disease.

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Endometriosis，adenomyosis and recurrent spontaneous abortion XU Hong，ZHAO Ai-min 2020, 36(11): 1077-1081.  DOI: 10.19538/j.fk2020110112 Abstract ( )   Endometriosis and adenomyosis are two common gynecological diseases. More and more evidences have shown that these two diseases have important effects on reproduction， being manifestated as infertility and spontaneous abortion clinically， especially abortion in the first trimester. The main causes of spontaneous miscarriage induced by endometriosis are endocrine dysfunction， decreased endometrial receptivity and immune factors. The mechanisms of spontaneous miscarriage caused by adenomyosis are damaged uterine spiral artery remodeling and abnormal structure and function of uterine junction zone. We should pay attention to the screening and diagnosis of endometriosis and adenomyosis in patients with spontaneous abortion， and active treatment is recommended before next pregnancy.