子宫内膜蠕动波与胚胎着床

Endometrial peristalsis wave and embryo im⁃plantation

子宫内膜蠕动波在正常生殖功能调节和胚胎着床中发挥着重要的作用。经阴道超声是目前临床上最常使用、最经济的检测方法。在正常未孕子宫,子宫内膜蠕动波的频率、方向、振幅等在月经周期的不同时期发生变化,与子宫相应的生殖功能一致。促排卵周期子宫内膜蠕动波的变化趋势与自然周期相似,但频率更高。移植前高频蠕动波显著降低体外受精(IVF)临床妊娠机会。添加孕酮、间苯三酚、阿托西班可能通过有效抑制子宫内膜蠕动、促进胚胎着床而改善IVF妊娠结局,特别对于反复着床失败患者,但有待于更多的随机对照研究验证其有效性。子宫内膜蠕动波的机制目前尚不明确,值得进一步研究。

Endometrial peristalsis wave(EPW)plays an important role in the physiological function and the course of embryo implantation.Transvaginal ultrasonography is the most commonly used and economic method to measure EPW.In the normal unpregnant uterus,the frequency,direction and amplitude of EPW display different changs in different phases of menstrual cycle,which is in consistent with reproductive functions of uterus.EPW activity is higher in controlled ovarian hyperstimulation cycle than natural cycle.Hyperperistalsis before embryo transfer significantly decreases the chance of pregnance during in vitro fertilization(IVF).Administration of progesteron,phloroglucinol and atosiban can promote embryo imlantation and improve pregnancy outcomes of IVF by inhibiting EPW,especially in patients with repeated implantation failure.More randomized controlled trials are needed to test the effectiveness.The machenism of EPW is unclear and deserves further studies.