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改善多囊卵巢综合征不孕患者子宫内膜容受性的药物和非药物干预措施：现有证据的综合综述

Pharmacological and non-pharmacological interventions for improving endometrial receptivity in infertile patients with polycystic ovary syndrome: a comprehensive review of the available evidence.

作者信息

Palomba Stefano, Costanzi Flavia, Caserta Donatella, Vitagliano Amerigo

机构信息

Unit of Gynaecology, Department of Medical-Surgical Sciences and Translational Medicine, University 'Sapienza' of Rome, Sant'Andrea Hospital, Rome, Italy.

Unit of Gynaecology, Department of Medical-Surgical Sciences and Translational Medicine, University 'Sapienza' of Rome, Sant'Andrea Hospital, Rome, Italy; University 'Sapienza' of Rome, Sant'Andrea Hospital, Rome, Italy.

出版信息

Reprod Biomed Online. 2024 Dec;49(6):104381. doi: 10.1016/j.rbmo.2024.104381. Epub 2024 Jul 20.

DOI:10.1016/j.rbmo.2024.104381
PMID:39454320
Abstract

Direct and indirect evidence suggests that endometrial receptivity may play a crucial role in the reduced fertility rate of women with polycystic ovary syndrome (PCOS). Various pharmacological and non-pharmacological strategies with potential effects on endometrial receptivity in patients with PCOS have been proposed. The aim of this study was to summarize the rationale and the clinical and experimental evidence of interventions tested for improving endometrial receptivity in infertile patients with PCOS. A systematic review was conducted by consulting electronic databases. All interventions with a potential influence on endometrial receptivity in infertile patients with PCOS were evaluated, and their main biological mechanisms were analysed. In total, 24 interventions related to endometrial receptivity were identified. Notwithstanding a strong biological rationale, no intervention aimed at improving endometrial receptivity in women with PCOS is supported by an adequate body of evidence, limiting their use in clinical practice. Further high-quality research is needed in this field to limit potentially ineffective and unsafe add-on treatments in infertile patients with PCOS.

摘要

直接和间接证据表明，子宫内膜容受性可能在多囊卵巢综合征（PCOS）女性生育率降低中起关键作用。已提出各种对PCOS患者子宫内膜容受性有潜在影响的药物和非药物策略。本研究的目的是总结为改善PCOS不孕患者子宫内膜容受性而进行的干预措施的理论依据以及临床和实验证据。通过查阅电子数据库进行了系统评价。评估了所有对PCOS不孕患者子宫内膜容受性有潜在影响的干预措施，并分析了其主要生物学机制。总共确定了24种与子宫内膜容受性相关的干预措施。尽管有强有力的生物学理论依据，但尚无足够证据支持旨在改善PCOS女性子宫内膜容受性的干预措施，这限制了它们在临床实践中的应用。该领域需要进一步的高质量研究，以限制PCOS不孕患者中可能无效和不安全的附加治疗。

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