Celik Onder, Acet Mustafa, Kucuk Tansu, Haberal Esra Tustas, Acet Tuba, Bozkurt Murat, Sahin Levent, Verit Fatma Ferda, Caliskan Eray
1 Private Clinic, Obstetrics and Gynecology, Usak, Turkey.
2 Department of Obstetrics and Gynecology, Medipol University School of Medicine, Istanbul, Turkey.
Reprod Sci. 2017 Feb;24(2):174-192. doi: 10.1177/1933719116654993. Epub 2016 Sep 27.
Regardless of the anatomical locations, some benign gynecological disorders (BGDs) such as peritoneal endometriosis, ovarian endometrioma, adenomyosis, uterine leiomyomas, endometrial polyps, uterine septum, and hydrosalpinges may lead to implantation failure. Despite progress in medical therapies, surgery remains a mainstay of BGDs treatment. Although our knowledge of endometrial receptivity after BGDs surgery is limited, it has allowed for significant improvement in the treatment of female subfertility. Many researchers studied on pregnancy outcome following BGDs surgery, but they did not investigate the possible impact of surgery on endometrial receptivity. They, therefore, concluded that pregnancy rates improved after BGDs surgery based on clinical observations. Many of these clinicians believe that surgical resection of BGDs leads to removal of local mechanical effect over the endometrium. Moreover, they accept that BGDs surgery may inhibit the detrimental signaling and secretion of some molecules from the BGDSs into the endometrium that may lead to favorable effect on the endometrium. However, so far, data from randomized controlled trials or systematic review or meta-analyses to answer the question whether surgical treatment of BGDs can improve endometrial receptivity are lacking. The purpose of this systematic review was to evaluate the results of available publications dealing with the impact of reproductive surgery for BGDs on endometrial receptivity.
无论解剖位置如何，一些良性妇科疾病（BGDs），如腹膜子宫内膜异位症、卵巢子宫内膜异位囊肿、子宫腺肌病、子宫肌瘤、子宫内膜息肉、子宫纵隔和输卵管积水，都可能导致着床失败。尽管医学治疗取得了进展，但手术仍然是BGDs治疗的主要手段。虽然我们对BGDs手术后子宫内膜容受性的了解有限，但它已使女性不孕症的治疗有了显著改善。许多研究人员研究了BGDs手术后的妊娠结局，但他们没有调查手术对子宫内膜容受性可能产生的影响。因此，他们根据临床观察得出结论，BGDs手术后妊娠率有所提高。许多临床医生认为，手术切除BGDs可消除对子宫内膜的局部机械作用。此外，他们认为BGDs手术可能会抑制某些分子从BGDs向子宫内膜的有害信号传导和分泌，这可能对子宫内膜产生有利影响。然而，到目前为止，缺乏来自随机对照试验、系统评价或荟萃分析的数据来回答BGDs的手术治疗是否能改善子宫内膜容受性这一问题。本系统评价的目的是评估现有关于BGDs生殖手术对子宫内膜容受性影响的出版物的结果。
