多囊卵巢综合征患者子宫内膜孕激素抵抗研究进展

Research progress on the mechanism of endometrial progesterone resistance in patients with polycystic ovary syndrome

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是导致育龄期女性不孕的常见内分泌代谢紊乱性疾病。PCOS表现出的内分泌和代谢异常会造成子宫内膜容受性受损,从而导致低胚胎植入率和高流产率。孕激素是调节子宫内膜进入分泌期和良好胚胎容受状态的重要类固醇激素,孕激素效应的减弱会导致子宫功能失衡。PCOS患者已被证实存在子宫内膜孕激素抵抗现象,而孕激素抵抗是导致子宫内膜容受性下降的重要因素之一,可显著增加子宫内膜不典型增生和癌症发生的风险。明确孕激素抵抗在PCOS发生发展中的作用机制,可以有效改善PCOS患者的妊娠结局,同时可以为子宫内膜癌防治提供重要的理论依据。本文对PCOS患者子宫内膜孕激素抵抗效应以及该现象发生发展的相关分子机制进行总结论述,以期为改善PCOS患者子宫内膜容受性提供理论依据。

Polycystic ovary syndrome(PCOS)is a common gynecologic endocrine disease caused infertility of women at the childbearing age.The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrial receptivity,leading to a low rate of implantation and even infertility.Progesterone is an important steroid hormone that regulates the endometrium into the secretory for embryo implantation.Aberrant progesterone signaling can lead to an imbalance in the uterine function.Endometrial progesterone resistance has been confirmed in patients with PCOS,which may be one of the causes of reduced endometrial receptivity.However,the molecular mechanism of progesterone resistance is still unclear.To clarify the mechanism of progesterone resistance can provide an important basis for improving pregnancy outcome and preventing endometrial cancer in PCOS patients.We summarizes the effects of endometrial progesterone resistance in PCOS patients and the related molecular mechanisms of the occurrence and development of progesterone resistance,aiming to provide a theoretical basis for improving the endometrial receptivity of PCOS patients.