子宫腺肌病引发不孕的发病机制及治疗进展

Pathogenesis and Treatment Progress of Infertility Caused by Adenomyosis

子宫腺肌病(AM)是一种良性子宫疾病,不仅引起育龄期女性的不孕,还会导致不良的产科并发症,但目前AM引发不孕的具体机制仍不明确,因此需要阐明其复杂的发病机制,以有效治疗AM引发的不孕,提高患者生活质量。目前认为,AM引发的不孕可能是由于子宫肌层结构功能改变、子宫内膜容受性异常及子宫微环境因素而影响排卵、精子动员及胚胎植入所致。目前AM合并不孕的治疗主要是药物治疗,最终需要选择辅助生殖技术,而合理使用药物进行预处理能提高辅助生殖的成功率,而目前介入及手术治疗不作为首选,其应用尚存在争议。因此,寻找合适的针对AM合并不孕的治疗方案对改善患者妊娠结局具有重要意义。

Adenomyosis(AM)is a benign uterine disease that not only causes infertility in women of childbearing age,but also leads to adverse obstetric complications.However,the specific mechanism of infertility caused by AM is still unclear,so it is necessary to elucidate its complex pathogenesis in order to effectively treat infertility caused by AM and improve the quality of life of the patients.Currently,it is believed that infertility caused by AM may be due to changes in the structure and function of the uterine myometrium,abnormal endometrial receptivity,and uterine microenvironment factors that affect ovulation,sperm mobilization,and embryo implantation.At present,the treatment of AM combined with infertility mainly relies on medication,and ultimately,assisted reproductive technology needs to be chosen.Reasonable use of medication for pre-treatment can improve the success rate of assisted reproduction.However,intervention and surgical treatment are not currently the first choices,and their application is still controversial.Therefore,finding suitable treatment plans for AM combined with infertility is of great significance in improving the pregnancy outcomes of the patients.