The endometrium during and after ovarian hyperstimulation and the role of segmentation of infertility treatment
The endometrium during and after ovarian hyperstimulation and the role of segmentation of infertility treatment
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DOI：
10.1016/j.beem.2018.09.003
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发表时间：
2019-02-01
影响因子：
7.4
通讯作者：
Polyzos, Nikolaos P.
中科院分区：
文献类型：
--
作者：
Montoya-Botero, Pedro;Polyzos, Nikolaos P.
控制性超排卵（COH）是辅助生殖技术（ART）的重要组成部分，导致体外受精（IVF）的妊娠率大幅增加。然而，尽管COH在增加卵泡数量和获得的卵母细胞数量方面具有明显的益处，允许延长胚胎培养并能够选择最佳质量的胚胎进行移植，但一些报告表明超生理激素水平确实可能在子宫内膜水平上具有不利影响。目前的文章修订的病理生理机制，通过卵巢刺激可能会产生负面影响子宫内膜容受性。此外，分析的证据解释如何分割IVF治疗可以让我们克服过度刺激对子宫内膜容受性的有害影响。延迟胚胎移植可以在随后的周期中在更生理的子宫环境中进行，改善子宫内膜容受性，降低子宫收缩力，减少过早黄体化的影响，并允许根据反应水平进行个性化刺激。(C)2018由Elsevier Ltd.出版
Controlled ovarian hyperstimulation (COH) is a crucial part of assisted reproductive technologies (ART) that resulted in a substantial increase in pregnancy rates from in vitro fertilization (IVF). However, in spite of the apparent benefit of COH on an increase in the number of follicles and the number of oocytes retrieved, allowing for extended embryo culture and enabling the selection of the best quality embryo for transfer, several reports has shown that the supraphysiologic hormonal levels may indeed have a detrimental effect at the endometrial level. The current article revises the pathophysiological mechanisms through which ovarian stimulation may negatively affect endometrial receptivity. Also, the evidence is analyzed explaining how segmentation of IVF treatment may allow us to overcome the deleterious effects of hyperstimulation on endometrial receptivity. Deferred embryo transfer may be performed in a more physiologic uterine environment in a subsequent cycle, improve endometrial receptivity, decrease uterine contractility, diminishes the impact of premature luteinization and allow individualized stimulation according to the level of response. (C) 2018 Published by Elsevier Ltd.