孕酮对子宫内膜、卵细胞及胚胎发育的影响

Influence of Progesterone on Endometrium,Oocyte and Embryo Development

孕酮是一种女性激素,在人类生殖中占有重要地位,可作用于卵巢及子宫,对卵细胞的发育成熟、排卵、胚胎发育、胚胎着床、维持妊娠等具有重要作用。研究认为孕酮分泌不足可能是妊娠早期流产的原因之一。孕酮通过调节子宫内膜的容受性,为胚胎的生长发育提供一个适宜的环境,同时通过调节黄体生成激素(LH)峰及其受体以及对优势卵泡发育的作用来影响卵细胞的成熟及质量。此外胚胎本身的发育也受到孕酮的作用,在体外培养胚胎时添加孕酮能提高囊胚的形成率及植入率。虽然目前对孕酮的药代学及药效学已研究得十分透彻,其人工合成制剂已经投入临床使用,但对其病理生理机制尚存在争议。综述孕酮对子宫内膜、卵细胞及胚胎发育的影响。

Progesterone,as a female hormone,plays a key role in human reproduction. Progesterone participates in regulating the oocyte development and maturation, ovulation,embry development and implantation, and pregnant maintenance. It was found that the inadequate progestei＇one could be one of causes of early abortion. Progesterone regulates the uterine receptivity for implantation and an optimal uterine environment for embryonic development. Progesterone also has positive effects on oocyte maturation and quality by regulating LI-I pulsatility and its receptor, and the development of dominant follicle. In addition,progesterone has a direct effect on the embryo development. In in vitro cultured embryos,progesterone supplementation increased the blastocyst rate and the implantation rate. The pharmacokinetics and pharmacodynamics of progesterone have been well studied, and synthetic progesterone has already been used in clinic. However, there were still much controversy in pathophysiological mechanisms of progesterone. This review summarizes the effects of progesterone on uterine endometrium, oocyte and embryo development.