von Wolff Michael, Germeyer Ariane, Strowitzki Thomas
Abteilung für gynakologische Endokrinologie und Fertilitätsstörungen, Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland.
Gynakol Geburtshilfliche Rundsch. 2009;49(2):69-79. doi: 10.1159/000197905. Epub 2009 Mar 25.
So far, implantation is a poorly understood process, which involves several paradoxical cell-biological mechanisms. First, 50% of the embryo is paternal and immunologically foreign material, and second, both the endometrium and embryo are covered by epithelial tissue to prevent cellular fusion. The adhesion and invasion of the blastocyst require an accurate coordination of embryonic and endometrial physiology and the modulation of maternal immune tolerance. Endometrial function plays an important role in assisted reproduction. Pathologies such as fibroids, hydrosalpinges, endometriosis and the polycystic ovary syndrome have a significant negative impact on implantation but can be treated in most cases. Therapeutic strategies to improve endometrial and embryonic function in recurrent implantation disorders are however still controversially discussed.
到目前为止，着床是一个尚未被充分理解的过程，它涉及多种矛盾的细胞生物学机制。首先，胚胎的50%是父系的且是免疫外来物质，其次，子宫内膜和胚胎都被上皮组织覆盖以防止细胞融合。囊胚的黏附和侵入需要胚胎与子宫内膜生理的精确协调以及母体免疫耐受的调节。子宫内膜功能在辅助生殖中起着重要作用。诸如子宫肌瘤、输卵管积水、子宫内膜异位症和多囊卵巢综合征等病症对着床有显著负面影响，但在大多数情况下可以得到治疗。然而，针对反复着床失败改善子宫内膜和胚胎功能的治疗策略仍存在争议。
