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子宫内膜异位症(endometriosis,EMs)与不孕症密切相关,其可从卵泡发育、排卵、运输、受精、着床、受精卵发育等各个环节影响正常妊娠,导致不孕。EMs主要通过影响卵子质量间接影响胚胎质量,从而引起种植率下降。卵子质量下降可能与EMs患者卵子发育的微环境(卵泡液)氧化应激反应相关,此外与线粒体能量代谢及DNA复制减少相关。EMs可从细胞形态、基因转录到蛋白分子调节方面的异常导致内膜容受性下降,从而影响胚胎的着床。多项荟萃分析指出合并EMs将降低体外受精的临床结局。辅助生育技术之前是否需要切除内膜样囊肿目前仍存争议,需就具体情况而定。
Endometriosis (EMs) is closely related to infertility. It can affect normal pregnancy from infertility, follicular development, ovulation, transport, fertilization, implantation, fertilized egg development and other aspects. EMs mainly affect the embryo quality indirectly by affecting the egg quality, which leads to the decrease of the planting rate. Decreased egg mass may be associated with the oxidative stress response of the oocytes in EMs, which is related to the oxidative stress in the microenvironment (follicular fluid). The abnormalities of EMs from cellular morphology and gene transcription to the regulation of protein molecules lead to decreased endometrial receptivity, which affects embryo implantation. A number of meta-analyzes indicate that the combination of EMs will reduce the clinical outcome of in vitro fertilization. The need for resection of endometrioid cysts prior to assisted reproductive technology is still controversial and depends on the specific circumstances.