Utero-tubal sperm transport and its impairment in endometriosis and adenomyosis
Utero-tubal sperm transport and its impairment in endometriosis and adenomyosis
复制标题
DOI：
10.1196/annals.1389.036
复制
发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Kaufmann, Manfred
中科院分区：
文献类型：
--
作者：
Kissler, Stefan;Zangos, Stephan;Kaufmann, Manfred
子宫由不同的平滑肌层组成，具有不同的功能。首先，月经碎片在月经时排出。第二，精子在排卵前阶段运输以最大限度地提高生育能力，第三，人类胚胎在植入过程中放置在适当的环境中。子宫内膜异位症是一种妇科疾病，导致严重的疼痛症状，如月经期间的剧烈疼痛（痛经），慢性盆腔疼痛，性交期间的疼痛（性交困难）和异常子宫出血。此外，子宫内膜异位症往往与女性不孕症，并表现出巨大的损害，在子宫收缩的生理，可以记录的子宫输卵管闪烁造影（HSSG）的体内检查方法。此外，子宫内膜异位症与80-90%的子宫腺肌病患者有关，我们的数据清楚地表明，当通过磁共振成像（MRI）可以检测到至少一个子宫腺肌病病灶时，精子运输受到增生的干扰，当检测到弥漫性子宫腺肌病累及所有子宫肌层时，精子运输能力完全丧失。因此，发育不良与自然妊娠率降低显著相关。因此，我们建议在每次无菌检查中使用MRI和HSSG。
The uterus is composed of different smooth muscle layers that serve various functions. First, menstrual debris is expulsed at the time of the menses. Second, sperm is transported in the preovulatory phase to maximize fertility, and third, the human embryo is placed in an adequate setting during implantation. Endometriosis is a gynecologic disorder leading to severe pain symptoms such as severe pain during menstruation (dysmenorrhea), chronic pelvic pain, pain during sexual intercourse (dyspareunia), and abnormal uterine bleeding. Besides, endometriosis is often associated with female infertility and exhibits a massive impairment in the physiology of uterine contractility that can be documented by the in vivo examination method of hysterosalpingoscintigraphy (HSSG). In addition, endometriosis is associated in 80-90% of subjects with adenomyosis and our data clearly indicate that sperm transport is disturbed by hyperperistalsis when at least one focus of adenomyosis can be detected via magnetic resonance imaging (MRI) and turns into dysperistalsis (a complete failure in sperm transport capacity) when diffuse adenomyosis affecting all myometrial uterine muscle layers is detected. Hence, dysperistalsis is significantly associated with reduced spontaneous pregnancy rates. We therefore recommend MRI and HSSG in every sterility workup.