国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (4): 336-340.

• 综述 • 上一篇    下一篇

机械刺激改善反复着床失败患者子宫内膜容受性机制的研究进展

侯志金,孟昱时   

  1. 650101  昆明医科大学第二附属医院生殖医学科
  • 收稿日期:2020-03-12 修回日期:2020-04-19 出版日期:2020-07-15 发布日期:2020-07-15
  • 通讯作者: 孟昱时,E-mail:13708704452@163.com E-mail:13708704452@163.com
  • 基金资助:
    云南省教育厅科学研究基金项目(2019Y0358);云南省科技计划项目[2017FE467(-181)]

Research Progress in the Mechanism of Mechanical Stimulation to Improve Endometrial Receptivity in Patients with Repeated Implantation Failure

HOU Zhi-jin,MENG Yu-shi   

  1. Department of Reproductive Medicine,The Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China
  • Received:2020-03-12 Revised:2020-04-19 Published:2020-07-15 Online:2020-07-15
  • Contact: MENG Yu-shi,E-mail:13708704452@163.com E-mail:13708704452@163.com

摘要: 子宫内膜对胚胎的接受能力即子宫内膜容受性,具备良好的子宫内膜容受性是胚胎移植成功的关键因素之一。子宫内膜容受性差是导致反复着床失败患者胚胎移植成功率低的难题。近年来,许多专家学者探索了各种方法改善子宫内膜容受性,其中多项研究表明,机械刺激可以改善反复着床失败患者的子宫内膜容受性,从而提高妊娠率。机械刺激子宫内膜是指在胚胎移植前使用刮匙、活检管或宫腔镜等工具对子宫内膜进行人为损伤,从而诱导子宫内膜在自我修复过程中发生一系列变化以改善子宫内膜容受性的一种方法。有较多学者从不同角度对机械刺激改善子宫内膜容受性的机制进行了研究,但至今仍未达成相对统一的认识。本文从机械刺激后离子通道的改变、基因表达、血管生成、炎症机制、干细胞的修复作用等方面, 讨论机械刺激改善子宫内膜容受性的机制及其研究进展。

关键词: 机械刺激;, 子宫内膜;, 胚胎移植;, 治疗失败;, 不育, 女(雌)性;, 妊娠结局

Abstract: Endometrial receptivity, the acceptability of endometrium to embryo, is one of the key factors of successful embryo transfer. The poor endometrial receptivity is a big problem that leads to the low success rate of embryo transfer in those patients with repeated implantation failure. Recently, many experts and scholars have explored various methods to improve endometrial receptivity. A number of studies have shown that mechanical stimulation can improve endometrial receptivity in patients with repeated implantation failure and thus increase the pregnancy rate. Mechanical stimulation of endometrium is a method to induce a series of changes of endometrium in the process of self-healing by artificial injury using curette, biopsy tube or hysteroscopy before embryo transfer, by which improve the endometrial receptivity. Many scholars have studied the mechanism of improving endometrial receptivity by mechanical stimulation from different perspectives, but they have not reached a consistent understanding. In this paper, we discussed the possible mechanism of endometrial mechanical stimulation and research progress, including the changes of ion channels, gene expression, angiogenesis, inflammation and the repair of stem cells.

Key words: Mechanical stimulation;, Endometrium;, Embryo transfer;, Treatment failure;, Infertility, female;, Pregnancy outcome