控制性超促排卵对子宫内膜的影响

Effects of Controlled Ovarian Hyperstimulation on the Endometrium

控制性超促排卵(controlled ovarian hyperstimulation,COH)是辅助生殖技术的重要组成部分,可显著提高体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的妊娠率。尽管COH在促进卵泡发育和获取卵母细胞数量方面可获得明显的益处,并能够选择高质量的胚胎进行移植,但COH可能涉及种植窗、子宫内膜容受性、孕酮和雌二醇以及子宫收缩功能的改变,影响不孕患者的胚胎种植率和IVF妊娠率。本文就COH后子宫内膜变化的病理生理机制进行综述,以更好地解决不孕症临床治疗的瓶颈问题。

Controlled ovarian hyperstimulation(COH)is an essential part of assisted reproductive technology,which significantly improves the pregnancy rates of in vitro fertilization-embryo transfer(IVF-ET).Despite the clear benefits of COH in promoting follicular development,increasing oocyte count,and enabling the selection of high-quality embryos for transfer,COH may involve changes in the implantation window,endometrial receptivity,progesterone and estradiol levels,as well as uterine contractility,potentially impacting embryo implantation and IVF pregnancy rates in infertile patients.This article reviews the pathophysiological mechanisms of endometrial changes resulting from COH,with the aim of better addressing the bottleneck problems in the clinical treatment of infertility.