医学英语

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Evidence-based investigation and of recurrent pregnancy loss

There is no doubt that the introduction of series of new assisted reproduction technologies (ART) has recently greatly improved treatment options available for infertile couples. Most of these couples will now be offered treatments that are general accepted and of evidence-based. Unfortunately, the situation much less clear regarding couples with recurrent pregnancy loss (RPL), who are often treated as second-class infertility patients in the health care system. Accurate prevalence figures are not available, but it has been estimated that 2%--5% of women have RPL, definite as two or more consecutive losses of intrauterine pregnancies before the 28th gestational week.
Although the array of diagnostic tests and possible therapeutic interventions in the management of RPL have grown significantly, in 1992 U.S. study showed that the total live birth rate had not increase in a cohort of RPL patients from 1987 to 1991 as compared with a similar group from 1968 to1977.
The motivation of ours was the fact that many of large number of diagnostic tests that have become available for the investigation of the patients with RPL are probably of doubtful value and need proper evaluation and standardization. Furthermore, many treatments also need proper evaluation concerning their therapeutic value and possible risks.
One reason for the slow progress of RPL research might be related to the fact that RPL is a complex area in which information from many disciplines, such as gynecology, genetics, epidemiology, occupational medicine, immunology, hematology, and endocrinology, are to be integrated to ensure that the research is valid. The collaboration of many disciplines unfortunately has been estimated infrequently, with the result that most investigation in this area have been narrowly focused, lacking an integrate approach to the subject.
A key element in our workshop was to let experts from the different disciplines present their specific views on the causes and treatments of RPL.
Gynecologists, obstetricians, and fertility specialists from our university participated in the 2-day workshop held in Urumchi in 2005.  The following view summarizes the conclusions from the discussions undertaken between the participants during the workshop.  
  

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