Kuijsters Nienke Petronella Maria, Methorst Willem Gerardus, Kortenhorst Madeleine Susanne Quirine, Rabotti Chiara, Mischi Massimo, Schoot Benedictus Christiaan
Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands; Department of Electrical Engineering (Signal Processing Systems), Eindhoven Technical University, Eindhoven, The Netherlands.
Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands.
Reprod Biomed Online. 2017 Jul;35(1):50-71. doi: 10.1016/j.rbmo.2017.03.019. Epub 2017 Apr 12.
Although uterine contractions in the non-pregnant uterus have been studied extensively, the knowledge gained has not been used in general fertility treatment work-up. In this review paper, we provide an overview of the current knowledge on uterine peristalsis (UP), based on the available literature. This literature shows that UP influences pregnancy chances in both natural and artificial cycles. Although the physiological background of these contractions is not completely clear, we know that several factors can be of influence, like uterine pathologies and hormones. Several options to alter pregnancy outcome by interfering with uterine contractions have been studied. Our meta-analysis on therapeutic options shows positive results of progesterone at time of embryo transfer in IVF cycles or prostaglandins at time of intrauterine insemination, although the quality of evidence is low. These therapies are probably most beneficial in selected groups of patients with abnormal contraction patterns. The introduction of an objective and user-friendly UP measuring tool suitable for use in daily practice would make it possible to identify and monitor these patients. We suggest that future research should focus on the physiology of initiation of UP and on the development of an effective standard measuring tool.
尽管对非妊娠子宫的收缩进行了广泛研究，但所获知识尚未应用于一般的生育治疗检查中。在这篇综述文章中，我们根据现有文献对子宫蠕动（UP）的当前知识进行了概述。这些文献表明，UP在自然周期和人工周期中都会影响受孕几率。尽管这些收缩的生理背景尚不完全清楚，但我们知道有几个因素可能会产生影响，比如子宫病变和激素。已经研究了几种通过干扰子宫收缩来改变妊娠结局的方法。我们对治疗方案的荟萃分析表明，在体外受精（IVF）周期胚胎移植时使用孕酮或在宫内授精时使用前列腺素会有积极效果，尽管证据质量较低。这些疗法可能对选定的子宫收缩模式异常的患者群体最为有益。引入一种客观且用户友好的、适用于日常实践的UP测量工具将能够识别和监测这些患者。我们建议未来的研究应聚焦于UP起始的生理学以及开发一种有效的标准测量工具。
