张晓芸,曾湘晖

随着全球不孕症发病率上升，辅助生殖技术（ART）的应用日益广泛，但术后妊娠丢失率居高不下仍是临床面临的重要挑战。本综述系统梳理了ART术后妊娠丢失的影响因素，包括胚胎因素（染色体非整倍体、发育潜能与质量评估）、母体因素（子宫解剖异常、内分泌代谢紊乱、免疫异常、血栓前状态、感染及其他环境与基础因素）、男方因素（精子DNA碎片率、染色体异常、表观遗传学异常）以及治疗相关因素（控制性卵巢刺激方案、胚胎实验室操作）。通过整合现有研究证据，本文总结了各因素的作用机制及临床意义，并提出分层分步的临床管理思路，同时展望了未来通过新技术（如胚胎评估技术革新）和大样本研究优化ART治疗策略的方向，旨在为降低妊娠丢失率、提高活产率提供循证依据。

辅助生殖技术；妊娠丢失；胚胎因素；母体因素；男方因素；治疗相关因素；染色体非整倍体；精子DNA碎片率

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