子宫内膜息肉合并不孕的临床研究进展

摘要/Abstract

摘要： 子宫内膜息肉（endometrial polyps，EP）是造成女性生育能力降低的一个常见因素，同时也是影响人工助孕过程中胚胎种植的一个独立因素。雌激素过度暴露、慢性炎症刺激或细胞增殖/凋亡失衡等都可能与其发病机制相关。EP导致不孕的机制目前仍不明确，可能与EP在宫腔内形成占位机械性干扰胚胎着床以及造成子宫内膜微环境发生改变有关。EP恶变的概率很低，多数情况下，直径＜1 cm的EP有自行消退的可能，可以选择期待治疗。而对于不孕女性，首选宫腔镜下子宫内膜息肉切除术（transcervical resection of polyp，TCRP），可以提高不孕患者的自然妊娠率和辅助生殖成功率。对于在控制性超促排卵（controlled ovarian hyperstimulation，COH）过程中新诊断的EP患者，目前尚没有一种特定的推荐治疗方案。相关临床研究表明，TCRP后行冻融胚胎移植（frozen-thawed embryo transfer，FET）可以提高临床妊娠率。

关键词: 子宫内膜, 息肉, 不育, 女（雌）性, 治疗, 妊娠率

Abstract: Endometrial polyps (EP) are a common cause of reduced fertility in women and an independent factor affecting embryo implantation via artificial assisted techniques. Excessive exposure to estrogen, chronic inflammatory stimuli, or cell proliferation/apoptosis imbalance may be associated with its pathogenesis. The mechanism by which EP causes infertility is still unclear, and may be related to the formation of mechanical interference in the implantation of embryos in the uterine cavity and the alteration of the microenvironment of the endometrium. The probability of malignancy is very low. In most cases, EP with diameter ＜1 cm has the possibility of self-resolving, and you can choose expectant treatment. For infertile women, the choice of transcervical resection of polyp (TCRP) can improve the natural pregnancy rate and assisted reproductive success rate of infertile patients. There is currently no specific treatment regimen recommended for EP patients newly diagnosed during controlled ovarian hyperstimulation (COH). Related clinical studies have shown that frozen-thawed embryo transfer (FET) after TCRP can improve clinical pregnancy rate.

Key words: Endometrium, Polyps, Infertility, female, Therapy, Pregnancy rate

王洋鑫，李萌，卢美松. 子宫内膜息肉合并不孕的临床研究进展[J]. 国际妇产科学杂志, 2019, 46(2): 220-224.

WANG Yang-xin，LI Meng，LU Mei-song. Progress in Clinical Research of Endometrial Polyps with Infertility[J]. Journal of International Obstetrics and Gynecology, 2019, 46(2): 220-224.

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