Dunselman G A, Land J A, Dumoulin J C, Bouckaert P X, Evers J L
Department of Obstetrics and Gynaecology, Maastricht University Hospital, The Netherlands.
Hum Reprod. 1988 May;3(4):459-61. doi: 10.1093/oxfordjournals.humrep.a136727.
The reasons for sub-fertility in patients with mild endometriosis remain unclear. Peritoneal fluid constituents may alter tubal transport and embryonic cleavage, with subsequent implantation disturbances. We used an animal model to study the influence of endometrial implants on early embryonic development. In 25 rabbits, endometrium from the right uterine horn was transplanted onto the peritoneum (Experimental group = Group E). In 25 rabbits, fat was transplanted (control group = group C). After a recovery period of 12 weeks the does were mated, and killed 24 h later. In the experimental group the implants had changed into cysts of 5-15 mm in diameter. Histological examination revealed endometrial glands and stroma in every specimen. Periadnexal adhesions did not develop in any animal. No marked differences were found between Groups E and C in embryonic cleavage stage, 24 h after mating. Additional culturing of the embryos for 48 h in a suitable culture medium revealed normal further development of the embryos. Bearing in mind the restrictions of extrapolating a rabbit model to the human, it is suggested that the decreased fecundity in mild endometriosis is not caused by altered early embryonic cleavage rate. The results of this study offer indirect evidence for implantation disturbances as a cause of endometriosis-associated sub-fertility.
轻度子宫内膜异位症患者生育力低下的原因尚不清楚。腹腔液成分可能会改变输卵管运输和胚胎分裂，进而导致着床障碍。我们使用动物模型研究子宫内膜植入物对早期胚胎发育的影响。在25只兔子中，将右子宫角的子宫内膜移植到腹膜上（实验组 = E组）。在另外25只兔子中，移植脂肪（对照组 = C组）。经过12周的恢复期后，母兔进行交配，并在24小时后处死。在实验组中，植入物已变成直径为5 - 15毫米的囊肿。组织学检查显示每个标本中均有子宫内膜腺体和间质。所有动物均未出现附件周围粘连。交配24小时后，E组和C组在胚胎分裂阶段未发现明显差异。在合适的培养基中将胚胎再培养48小时后，显示胚胎进一步正常发育。考虑到将兔子模型外推至人类的局限性，提示轻度子宫内膜异位症患者生育力下降并非由早期胚胎分裂率改变所致。本研究结果为着床障碍是子宫内膜异位症相关生育力低下的原因提供了间接证据。
