Cakiroglu Yigit, Tiras Bulent, Franasiak Jason, Seli Emre
Acibadem Mehmet Ali Aydinlar University.
Acibadem Maslak Hospital Assisted Reproductive Techniques Unit, Istanbul, Turkey.
Curr Opin Obstet Gynecol. 2023 Jun 1;35(3):254-262. doi: 10.1097/GCO.0000000000000863. Epub 2023 Feb 22.
Endometrial hypoproliferation refers to the failure of the endometrium to reach optimal thickness during fresh or frozen embryo transfer cycles in women undergoing infertility treatment with in-vitro fertilization (IVF). This review discusses the treatment options for endometrial hypoproliferation.
Apart from factors related to the embryo quality, ultrasonographic findings associated with the endometrium, such as endometrial thickness, endometrial pattern and subendometrial blood flow, are considered key factors associated with the outcome of assisted reproductive treatment. To date, a consensus has not been reached regarding the definition of thin endometrium, while thresholds of 6, 7 or 8 mm have been used in the literature. Strategies to increase endometrial thickness can be reviewed in three groups: endocrine approaches, vitamins & supplements, and new experimental therapeutic interventions. Some of the recently introduced experimental therapeutic interventions such as platelet-rich plasma injection, stem cell treatment and tissue bioengineering are exciting potential therapies that need to be further studied.
Despite a large number of publications on the topic, diagnosing and treating endometrial hypoproliferation remains a challenge. Well designed studies are needed to establish a widely accepted endometrial thickness cut-off value below which endometrial hypoproliferation is diagnosed and to generate meaningful data that would allow an evidence-based discussion of available therapeutic options with patients.
子宫内膜增殖不足是指接受体外受精（IVF）治疗不孕症的女性在新鲜或冷冻胚胎移植周期中，子宫内膜未能达到最佳厚度。本综述讨论了子宫内膜增殖不足的治疗选择。
除了与胚胎质量相关的因素外，与子宫内膜相关的超声检查结果，如子宫内膜厚度、子宫内膜形态和子宫内膜下血流，被认为是与辅助生殖治疗结果相关的关键因素。迄今为止，关于薄型子宫内膜的定义尚未达成共识，而文献中使用的阈值为6、7或8毫米。增加子宫内膜厚度的策略可分为三类：内分泌方法、维生素和补充剂以及新的实验性治疗干预措施。一些最近引入的实验性治疗干预措施，如富血小板血浆注射、干细胞治疗和组织生物工程，是令人兴奋的潜在疗法，需要进一步研究。
尽管关于该主题有大量出版物，但诊断和治疗子宫内膜增殖不足仍然是一项挑战。需要设计良好的研究来确定一个广泛接受的子宫内膜厚度临界值，低于该值可诊断为子宫内膜增殖不足，并生成有意义的数据，以便与患者进行基于证据的现有治疗选择讨论。
