{"id":17160,"date":"2023-07-25T09:10:55","date_gmt":"2023-07-25T08:10:55","guid":{"rendered":"https:\/\/now-fertility.com\/recomendaciones-de-buenas-practicas-de-eshre-sobre-fallos-recurrentes-de-implantacion-rif\/"},"modified":"2023-07-25T09:10:55","modified_gmt":"2023-07-25T08:10:55","slug":"recomendaciones-de-buenas-practicas-de-eshre-sobre-fallos-recurrentes-de-implantacion-rif","status":"publish","type":"post","link":"https:\/\/now-fertility.com\/es\/recomendaciones-de-buenas-practicas-de-eshre-sobre-fallos-recurrentes-de-implantacion-rif\/","title":{"rendered":"Recomendaciones de buenas pr\u00e1cticas de ESHRE sobre fallos recurrentes de implantaci\u00f3n (RIF)"},"content":{"rendered":"

La Sociedad Europea de Medicina Reproductiva y Embriolog\u00eda (ESHRE) estableci\u00f3 recomendaciones de buenas pr\u00e1cticas que proporcionan una definici\u00f3n de fallo de implantaci\u00f3n recurrente (RIF) junto con recomendaciones sobre c\u00f3mo investigar las causas y c\u00f3mo mejorar las posibilidades de un embarazo.<\/p>\n

Definici\u00f3n de fallo recurrente de implantaci\u00f3n<\/h3>\n

Hay una falta de consistencia en la definici\u00f3n cl\u00ednica de RIF. Los factores clave que deben tenerse en cuenta al establecer la definici\u00f3n de RIF son el n\u00famero de embriones transferidos, si los embriones transferidos se prueban gen\u00e9ticamente y la edad materna. En general, un paciente considerado con RIF y necesita ser investigado incluye:<\/p>\n

    \n
  1. Transferencia de embriones euploides (gen\u00e9ticamente normales):
    \nTransferencia de 2 embriones independientemente de la edad de la mujer.<\/li>\n
  2. Transferencia de embriones de euploid\u00eda desconocida:
    \nTransferencia de 3 embriones en mujeres menores de 35 a\u00f1os.
    \nTransferencia de 4 embriones en mujeres entre 35 a 39 a\u00f1os.
    \nTransferencia de 6 embriones en mujeres mayores de 40 a\u00f1os.<\/li>\n<\/ol>\n

    Investigaciones para RIF<\/h3>\n

    Se han sugerido y estudiado m\u00faltiples factores y causas para el RIF. Sin embargo, no hay pruebas suficientes que permitan utilizar directrices claras para la investigaci\u00f3n y el tratamiento del IRF. Las investigaciones para RIF incluyen la investigaci\u00f3n de factores femeninos y masculinos.<\/p>\n

      \n
    1. Recomendado<\/strong>
      \nun. Revise los factores del estilo de vida (ambos socios).
      \nb. Se recomienda volver a evaluar el grosor endometrial. Se recomienda una revisi\u00f3n del r\u00e9gimen de tratamiento con estradiol si se observa que el endometrio permanece delgado. Se puede considerar la histeroscopia para descartar el s\u00edndrome de Asherman.
      \nc. La evaluaci\u00f3n de APA (s\u00edndrome antifosfol\u00edpido) y SAF se recomienda en mujeres RIF con factores de riesgo adicionales para trombofilia, y se puede considerar en mujeres sin tales factores de riesgo.<\/li>\n
    2. Puede ser considerado<\/strong>
      \nun. Cariotipo (ambos miembros de la pareja) para confirmar la ausencia de una anomal\u00eda cromos\u00f3mica en los padres. Si se detecta una anomal\u00eda cromos\u00f3mica, se recomienda el consejo gen\u00e9tico y, en su caso, las pruebas gen\u00e9ticas preimplantacionales (PGT).
      \nb. Ecograf\u00eda 3D.
      \nc. Histeroscopia cuando hay una sospecha de una anomal\u00eda uterina visualizada en la ecograf\u00eda transvaginal.
      \nd. Pruebas de funci\u00f3n endometrial: Si bien no hay datos suficientes para recomendar el uso rutinario de cualquier prueba de receptividad endometrial disponible comercialmente para diagnosticar la causa de la RIF, se puede considerar la evaluaci\u00f3n de aspectos espec\u00edficos de la funci\u00f3n endometrial mediante pruebas.
      \ne. Se puede considerar la evaluaci\u00f3n de la endometritis cr\u00f3nica (CE). Si se diagnostica CE, se puede considerar el tratamiento con antibi\u00f3ticos.
      \nf. Evaluaci\u00f3n de la funci\u00f3n tiroidea.
      \ng. Evaluaci\u00f3n de los niveles de progesterona folicular tard\u00eda y l\u00fatea media.<\/li>\n
    3. No recomendado<\/strong>
      \nun. No hay datos suficientes para recomendar la medici\u00f3n rutinaria de los niveles de vitamina D o el tratamiento de la deficiencia de vitamina D
      \nb. Perfiles de microbioma uterino y vaginal
      \nc. Prueba de c\u00e9lulas NK perif\u00e9ricas y uterinas
      \nd. Evaluaci\u00f3n de linfocitos T uterinos
      \ne. Evaluaci\u00f3n de los niveles de citoquinas en sangre
      \nf. Compatibilidad HLA-C
      \ng. Fragmentaci\u00f3n del ADN esperm\u00e1tico<\/li>\n<\/ol>\n

      Intervenciones para el RIF<\/h3>\n
        \n
      1. Recomendado<\/strong>
        \nun. Revisar el tratamiento con estradiol si el revestimiento endometrial permanece delgado
        \nb. Se recomienda la atenci\u00f3n y el asesoramiento de los pacientes, ya que se ha informado que las mujeres con RIF tienen niveles significativamente m\u00e1s altos de estr\u00e9s en comparaci\u00f3n con los controles f\u00e9rtiles y saludables y admiten sentimientos de aislamiento social y sensibilidad a los comentarios.
        \nc. Optimizaci\u00f3n de los factores del estilo de vida<\/li>\n
      2. Puede ser considerado<\/strong>
        \nun. Pruebas gen\u00e9ticas preimplantacionales para aneuploid\u00edas (PGT-A)
        \nb. Transferencia embrionaria en estadio de blastocisto
        \nc. Antibi\u00f3ticos si se diagnostica endometritis cr\u00f3nica<\/li>\n
      3. No recomendado<\/strong>
        \nun. Lesi\u00f3n endometrial intencional
        \nb. Inmunomodulaci\u00f3n como la administraci\u00f3n del factor de estimulaci\u00f3n de colonias de granulocitos (G-CSF) (ya sea intrauterino o subcut\u00e1nea), infusi\u00f3n intravenosa de l\u00edpidos, inmunoglobulina intravenosa (IGIV)
        \nc. Infusi\u00f3n intrauterina aut\u00f3loga de c\u00e9lulas mononucleares de sangre perif\u00e9rica (PBMC)
        \nd. Infusi\u00f3n intrauterina de plasma rico en plaquetas (PRP)
        \n<\/span>e. Inyecci\u00f3n intrauterina de hCG
        \nf. Heparina de bajo peso molecular (HBPM)
        \ng. Pretratamiento con agonistas de la GnRH e inhibidores de la aromatasa
        \nh. Eclosi\u00f3n asistida<\/li>\n<\/ol>\n

        Referencia: Human Reproduction Open, 2023, 2023(3), hoad023<\/p>\n","protected":false},"excerpt":{"rendered":"

        La Sociedad Europea de Medicina Reproductiva y Embriolog\u00eda (ESHRE) estableci\u00f3 recomendaciones de buenas pr\u00e1cticas que proporcionan una definici\u00f3n de fallo de implantaci\u00f3n recurrente (RIF) junto con recomendaciones sobre c\u00f3mo investigar las causas y c\u00f3mo mejorar las posibilidades de un embarazo. Definici\u00f3n de fallo recurrente de implantaci\u00f3n Hay una falta de consistencia en la definici\u00f3n cl\u00ednica […]<\/p>\n","protected":false},"author":1,"featured_media":16996,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"2959","stick-header-meta":"enabled","header-above-stick-meta":"on","header-main-stick-meta":"on","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[136],"tags":[],"class_list":["post-17160","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sin-categorizar"],"yoast_head":"\nRecomendaciones de buenas pr\u00e1cticas de ESHRE sobre fallos recurrentes de implantaci\u00f3n (RIF) - NOW-fertility<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/now-fertility.com\/es\/recomendaciones-de-buenas-practicas-de-eshre-sobre-fallos-recurrentes-de-implantacion-rif\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Recomendaciones de buenas pr\u00e1cticas de ESHRE sobre fallos recurrentes de implantaci\u00f3n (RIF) - NOW-fertility\" \/>\n<meta property=\"og:description\" content=\"La Sociedad Europea de Medicina Reproductiva y Embriolog\u00eda (ESHRE) estableci\u00f3 recomendaciones de buenas pr\u00e1cticas que proporcionan una definici\u00f3n de fallo de implantaci\u00f3n recurrente (RIF) junto con recomendaciones sobre c\u00f3mo investigar las causas y c\u00f3mo mejorar las posibilidades de un embarazo. 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