胞饮突评估子宫内膜容受性的研究进展

Advances in Pinopodes for Endometrial Receptivity Assessment

胚胎植入是一个复杂且受到高度调控的过程,需要囊胚与母体子宫内膜的发育精确同步。胞饮突作为表达于子宫内膜上的一种特殊膜状突起,随月经周期变化表现为不同形态,可分为发育期、成熟期及退化期。目前已有一系列研究证实,胞饮突的数量、覆盖面积及发育阶段等在预测不孕女性种植窗及评估子宫内膜容受性中具有临床价值。胞饮突评分较高、覆盖面积较广且成熟期胞饮突占比较高的女性妊娠结局更佳。其机制可能包括胞饮突通过调节宫腔内容物影响子宫内膜容受性、通过表达植入相关蛋白参与囊胚-子宫内膜相互作用等。然而,对胞饮突精准且客观的评估手段仍待进一步探索,胞饮突评估子宫内膜容受性的精确度也待进一步验证。

Successful embryo implantation is a complex process, which is well regulated by both embryo and endometrium. The precise synchronization between the blastocyst and maternal endometrium is very important.Pinopode, a special cellular process expressed in the endometrium, shows different morphologies with the menstrual cycle, which can be divided into the developing pinopode, the maturated pinopode and the degeneration pinopode. A series of clinical studies have proved that the number, the size of coverage area and the development stage of pinopodes have clinical value in predicting the implantation window and assessing the endometrial receptivity in infertile women. Women with higher pinopode score and wider coverage size of pinopodes, and higher proportion of well developed pinopodes, will have better pregnancy outcomes. The mechanism may include that pinopodes affect the endometrial receptivity by regulating uterine contents, and that pinopodes participate in the blastocyst-endometrial interaction by expressing implant-related proteins. However, the accurate and objective assessment method of pinopode still needs to be explored, while the accuracy of its assessment of endometrial receptivity also needs to be further evaluated.