子宫内膜微刺激术对胚胎着床的研究进展

Recent study progress on the effect of endometrial local injury on embryo implantation

子宫内膜微刺激术是指通过对子宫内膜的局部机械性轻微损伤,诱导其自身修复、改善子宫内膜容受性,从而提高胚胎着床率的一种方法,主要包括子宫内膜活检及刮匙搔刮。单独宫腔镜检查也可视为子宫内膜轻微刺激的一种方式,其对提高着床率也起到积极作用。对于子宫内膜微刺激术可改善胚胎移植的结局,仍有对此持相反的观点者,在患者选择、手术方式、手术时间等方面仍存在很大争议,且其机制尚不明确。本文主要从子宫内膜微刺激术的概念、机制探讨、临床研究及目前存在的问题四个方面总结其研究进展。

Endometrial local injury, a kind of local minor mechanical injury to endometrium, usually by means of endometrial biopsy or endometrial scraping, is documented to improve embryo implantation and empirically employed in some of reproduction centers. Hysteroscopic examination can also achieve a local minor endometrial injury, which is reported to improve the clinical outcomes of in vitro fertilization and embryo transfer. However, the reported effects of endometrial local injury on embryo implantation and subsequent pregnancy outcomes is controversial, and its mechanism is not yet clear, with controversial opinions on the indication, the operation mode and the timing of this intervention. In this article, the recent progress in this field is reviewed, with focus on the concept, mechanism, clinical application, and some related problems of this intervention.