雌、孕激素剂量与作用时间对子宫内膜的调控

Effect of dose and timing of estrogen and progesterone on endometrium

我们常将生殖过程比作种地,胚胎是种子,子宫内膜是土壤。像等待种子播种的土壤一样,内膜在雌激素的调控下,不断增殖,为胚胎种植做准备,孕激素则使内膜发生分泌改变,开启种植窗,迎接胚胎种植。如果胚胎种植失败,雌、孕激素撤退,内膜则脱落、坏死、再生,进入下一轮的增殖。雌、孕激素比例失调或作用时间异常,会造成功能失调性子宫出血,甚至会导致子宫内膜癌。雌、孕激素的剂型多种多样,且各具特点。雌、孕激素用于准备内膜,将生殖过程的"种子"与"胚胎"割裂开来,使供卵胚胎移植和冷冻胚胎移植成为现实,是辅助生殖领域的一大进步。本文拟就雌、孕激素的剂量与作用时间对子宫内膜的调控这一问题进行综述。

The process of reproduction is often viewed as farming, with the embryo being the seed, and endometrium being the soil. Under the sequential control of estrogen and progestin, endometrium undergoes cycles of proliferation, differentiation, destruction and repair. This ensures that the endometrium is optimally prepared for potential embryo implantation. But in the absence of an embryo, menstruation occurs to allow endometrial regeneration. If there is an imbalance between estrogen and progestin, or an abnormal duration of their action, dysfunctional uterine bleeding occurs. Sometimes it even leads to endometrium carcinoma. Endometrial receptivity can be induced by exogenously administered E2 and P in a variety of regimens, which helps us separate the oocytes from the endometrium, allows us to assess embryo and endometrial growth separately, and promotes the development of donated oocyte implantation and frozen embryo implantation. This paper reviewed the effect of dose and timing of estrogen and progesterone on endometrium.