The hormonal control of endometrial receptivity:: estrogen (E2) and progesterone
The hormonal control of endometrial receptivity:: estrogen (E2) and progesterone
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DOI：
10.1016/s0165-0378(98)00019-9
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发表时间：
1998-08-01
影响因子：
3.4
通讯作者：
Bulletti, C
中科院分区：
文献类型：
--
作者：
de Ziegler, D;Fanchin, R;Bulletti, C
虽然卵巢产生的已鉴定物质的数量稳步增加，但值得注意的是，单独使用外源性雌激素（E-2）和孕酮（P）可以在卵巢衰竭或缺失的妇女中启动最佳子宫内膜容受性。早期的工作表明，在子宫内膜启动的仅E-2阶段的可接受持续时间中存在明显的回旋余地。随后，外源性孕酮诱导了一系列转化，重现了月经周期中的经典发现。子宫内膜腺体的分泌变化在孕酮给药的第4天和第6天之间最明显（理想周期的第18-20天，其中孕酮暴露开始于第15天），从孕激素暴露的第10天（第24天）开始，子宫内膜间质的蜕膜前变化明显。与早期的观点相反，即使血浆E-2与孕酮比率的最大变化也不能改变腺体或间质的子宫内膜形态。最近人们认识到，E-2和孕酮也影响子宫收缩力。据推测，过高的E-2水平可能会增加子宫收缩力，并对体外受精（IVF）的着床率产生不利影响。外源性孕酮已被证明具有子宫舒张作用，并假设胚胎移植（ET）前补充孕酮可改善IVF的容受性。(C)1998爱思唯尔科学爱尔兰有限公司保留所有权利。
While the number of identified substances produced by the ovary increases steadily, it remains remarkable that the sole use of exogenous estrogen (E-2) and progesterone (P) can prime optimal endometrial receptivity in women whose ovaries have failed or are absent. Early work showed that a marked leeway existed in the acceptable duration of the E-2-only phase of endometrial priming. Subsequently, a sequence of transformations are induced by exogenous progesterone that reproduces classical findings made in the menstrual cycle, Secretory changes in endometrial glands are best seen between the 4th and 6th day of progesterone administration (day 18-20 of an ideal cycle where progesterone exposure starts on day 15), Predecidual changes of the endometrial stroma are apparent starting on the 10th day of progesterone exposure (day 24). Contrary to earlier belief, even maximal alterations in the plasma E-2 to progesterone ratio fails to alter the endometrial morphology of either glands or stroma. More recently it has been recognized that E-2 and progesterone also affect uterine contractility. It has been postulated that excessively high levels of E-2 may increase uterine contractility and adversely affect implantation rates in in-vitro fertilization (IVF). Exogenous progesterone has been shown to exert utero-relaxing effects and it has been hypothesised that progesterone supplementation before embryo transfer (ET) may improve receptivity in IVF. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.