Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu 88400, Malaysia.
Int J Mol Sci. 2023 Jul 27;24(15):12026. doi: 10.3390/ijms241512026.
Endometrial receptivity is a state of the endometrium defined by its readiness for embryo implantation. When the receptivity of the endometrium is impaired due to hyperandrogenism or androgen excess, this condition can lead to pregnancy loss or infertility. Hyperandrogenism encompasses a wide range of clinical manifestations, including polycystic ovary syndrome (PCOS), idiopathic hirsutism, hirsutism and hyperandrogaenemia, non-classical congenital adrenal hyperplasia, hyperandrogenism, insulin resistance, acanthosis nigricans (HAIR-AN), ovarian or adrenal androgen-secreting neoplasms, Cushing's syndrome, and hyperprolactinaemia. Recurrent miscarriages have been shown to be closely related to elevated testosterone levels, which alter the endometrial milieu so that it is less favourable for embryo implantation. There are mechanisms for endometrial receptivity that are affected by excess androgen. The HOXA gene, aVβ3 integrin, CDK signalling pathway, MECA-79, and MAGEA-11 were the genes and proteins affect endometrial receptivity in the presence of a hyperandrogenic state. In this review, we would like to explore the other manifestations of androgen excess focusing on causes other than PCOS and learn possible mechanisms of endometrial receptivity behind androgen excess leading to pregnancy loss or infertility.
子宫内膜容受性是指子宫内膜为胚胎着床做好准备的状态。当由于高雄激素血症或雄激素过多而导致子宫内膜容受性受损时，这种情况可能导致妊娠丢失或不孕。高雄激素血症涵盖了广泛的临床表现，包括多囊卵巢综合征（PCOS）、特发性多毛症、多毛症和高雄激素血症、非典型先天性肾上腺增生、高雄激素血症、胰岛素抵抗、黑棘皮病（HAIR-AN）、卵巢或肾上腺雄激素分泌性肿瘤、库欣综合征和高催乳素血症。反复流产已被证明与升高的睾酮水平密切相关，这会改变子宫内膜环境，使其不利于胚胎着床。有一些机制会受到过多雄激素的影响。HOXA 基因、aVβ3 整合素、CDK 信号通路、MECA-79 和 MAGEA-11 是在高雄激素状态下影响子宫内膜容受性的基因和蛋白质。在这篇综述中，我们希望探讨雄激素过多的其他表现，重点关注除 PCOS 以外的其他原因，并了解雄激素过多导致妊娠丢失或不孕的子宫内膜容受性背后的可能机制。
