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绝经过渡期间的子宫内膜发育:与卵泡动力学的初步关联。

Endometrial development during the transition to menopause: preliminary associations with follicular dynamics.

作者信息

Baerwald A, Vanden Brink H, Lee C, Hunter C, Turner K, Chizen D

机构信息

Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

Department of Obstetrics, Gynecology and Reproductive Sciences, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

Climacteric. 2020 Jun;23(3):288-297. doi: 10.1080/13697137.2020.1721455. Epub 2020 Feb 20.

Abstract

This study aimed to test the hypothesis that the development of functional luteal phase dominant follicles (LPDFs) is associated with increased endometrial growth as women transition to menopause. Endometrial thickness (ET), follicle development, and hormone production were characterized in ovulatory women of mid-reproductive age (MRA; 18-35 years,  = 10) and advanced reproductive age (ARA; 45-55 years,  = 16). Transvaginal ultrasonography was conducted every 1-3 days during one interovulatory interval to quantify ET and the diameters of follicles ≥2 mm. Blood was drawn at each visit to measure progesterone, estradiol, inhibin A, follicle stimulating hormone, and luteinizing hormone. In the MRA group, ET was lower (8.87 vs. 10.1 mm) in women with typical versus no LPDFs, in association with greater luteal phase estradiol (91.1 vs. 48.8 ng/l). In the ARA group, luteal phase endometrial growth was greater (12.0 vs. 10.4 mm) in women with typical versus no LPDFs, in association with lower progesterone (10.7 vs. 13.8 μg/l; LPDF effect  < 0.1) and inhibin A (35.6 vs. 51.17 ng/l;  < 0.10). Preliminary findings suggest that ET may be increased in women who develop LPDFs, in association with reduced luteal phase progesterone and inhibin A, during the transition to menopause. Continued research is required to confirm these findings.

摘要

本研究旨在验证以下假设

随着女性向更年期过渡,功能性黄体期优势卵泡(LPDF)的发育与子宫内膜生长增加有关。对生殖中期(MRA;18 - 35岁,n = 10)和生殖后期(ARA;45 - 55岁,n = 16)的排卵女性的子宫内膜厚度(ET)、卵泡发育和激素分泌情况进行了特征分析。在一个卵泡期间隔内,每1 - 3天进行一次经阴道超声检查,以量化ET和直径≥2 mm的卵泡大小。每次就诊时采集血液样本,检测孕酮、雌二醇、抑制素A、卵泡刺激素和黄体生成素。在MRA组中,有典型LPDF的女性与无LPDF的女性相比,ET较低(8.87 vs. 10.1 mm),同时黄体期雌二醇水平较高(91.1 vs. 48.8 ng/l)。在ARA组中,有典型LPDF的女性与无LPDF的女性相比,黄体期子宫内膜生长更大(12.0 vs. 10.4 mm),同时孕酮(10.7 vs. 13.8 μg/l;LPDF效应P < 0.1)和抑制素A(35.6 vs. 51.17 ng/l;P < 0.10)水平较低。初步研究结果表明,在向更年期过渡期间,出现LPDF的女性ET可能增加,同时黄体期孕酮和抑制素A水平降低。需要进一步研究来证实这些发现。

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