Guo Fei, Huang Yufan, Fernando Taniya, Shi Yingli
Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, China.
Department of Pharmacy, Mindong Hospital, Fujian Medical University, Ningde, 355000, Fujian, China.
Reprod Sci. 2022 Dec;29(12):3335-3345. doi: 10.1007/s43032-022-00845-x. Epub 2022 Jan 10.
Anovulation is the most prominent cause of infertility in polycystic ovary syndrome (PCOS) patients. Although ovulation can be corrected pharmacologically, the number of pregnancies remains low. Even if excellent embryos are transferred by IVF, it does not change the high miscarriage rate of PCOS patients. These facts collectively indicate that there is a disorder of endometrial development and receptivity to the embryo in PCOS patients, including the decrease of receptive ability, inhibition of embryo adhesion, undersupply of energy, poor blood perfusion, and pro-inflammatory status in the endometrium. However, it has never received the same attention as ovulatory dysfunction. Here we list some alternations of endometrial receptivity in women with PCOS, discuss the underlying intricate mechanisms, and try to find out the possible therapeutic targets, which may bring new perspectives to those who are able to provide high-quality embryos.
无排卵是多囊卵巢综合征(PCOS)患者不孕的最主要原因。尽管可以通过药物治疗纠正排卵,但妊娠率仍然较低。即使通过体外受精(IVF)移植优质胚胎,也无法改变PCOS患者的高流产率。这些事实共同表明,PCOS患者存在子宫内膜发育和胚胎接受性障碍,包括接受能力下降、胚胎黏附抑制、能量供应不足、血液灌注不良以及子宫内膜的促炎状态。然而,它从未像排卵功能障碍那样受到同等关注。在此,我们列出PCOS女性子宫内膜接受性的一些变化,讨论其潜在的复杂机制,并试图找出可能的治疗靶点,这可能为那些能够提供优质胚胎的人带来新的视角。