子宫内膜异位症子宫内膜容受性受损研究进展

doi:10.12280/gjfckx.20260238

摘要/Abstract

摘要：

子宫内膜异位症（endometriosis，EMs）是导致育龄期女性不孕的常见病因之一，严重威胁女性生殖健康。EMs相关不孕发病机制复杂，现有研究表明子宫内膜容受性受损是导致EMs患者胚胎着床失败的关键因素，其具体机制包括：子宫内膜免疫细胞数量、比例失衡分泌促炎因子，破坏内膜免疫微环境；异位病灶所致雌激素合成增加，孕激素受体表达下调引发孕激素抵抗，导致雌、孕激素信号通路失衡，干扰子宫内膜周期性变化；关键容受性基因表达及表观遗传层面的调控异常，影响子宫内膜基质细胞的正常蜕膜化进程。综述上述机制与EMs子宫内膜容受性受损的关系，为临床改善EMs患者子宫内膜容受性和妊娠结局提供理论依据与新的研究方向。

关键词: 子宫内膜异位症, 胚胎植入, 信号传导, 表观基因组学, 子宫内膜容受性

Abstract:

Endometriosis (EMs) is one of the common causes of infertility in women of reproductive age, posing a serious threat to female reproductive health. The pathogenesis of EMs-related infertility is complex. Current research indicates that impaired endometrial receptivity is a key factor leading to embryo implantation failure in patients with EMs. The specific mechanisms include: an imbalance in the quantity and proportion of endometrial immune cells secreting pro-inflammatory factors, disrupting the endometrial immune microenvironment; increased estrogen synthesis caused by ectopic lesions, downregulation of progesterone receptor expression leading to progesterone resistance, resulting in an imbalance in estrogen and progesterone signaling pathways and interference with cyclical endometrial changes; and abnormal expression of key receptivity genes and dysregulation at the epigenetic level, affecting the normal decidualization process of endometrial stromal cells. This review summarizes the relationship between the aforementioned mechanisms and impaired endometrial receptivity in EMs, providing a theoretical basis and new research directions for clinically improving endometrial receptivity and pregnancy outcomes in patients with EMs.

Key words: Endometriosis, Embryo implantation, Signal transduction, Epigenomics, Endometrial receptivity

吴宇, 马赛花, 吴林玲, 张海娇, 高晔. 子宫内膜异位症子宫内膜容受性受损研究进展[J]. 国际妇产科学杂志, 2026, 53(4): 406-411.

WU Yu, MA Sai-hua, WU Lin-ling, ZHANG Hai-jiao, GAO Ye. Research Progress on Impaired Endometrial Receptivity in Endometriosis[J]. Journal of International Obstetrics and Gynecology, 2026, 53(4): 406-411.

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