Pharmacological and non-pharmacological interventions for improving endometrial receptivity in infertile patients with polycystic ovary syndrome: a comprehensive review of the available evidence

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Stefano Palomba , Flavia Costanzi , Donatella Caserta , Amerigo Vitagliano
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Abstract

Direct and indirect evidence suggests that endometrial receptivity may play a crucial role in the reduced fertility rate of women with polycystic ovary syndrome (PCOS). Various pharmacological and non-pharmacological strategies with potential effects on endometrial receptivity in patients with PCOS have been proposed. The aim of this study was to summarize the rationale and the clinical and experimental evidence of interventions tested for improving endometrial receptivity in infertile patients with PCOS. A systematic review was conducted by consulting electronic databases. All interventions with a potential influence on endometrial receptivity in infertile patients with PCOS were evaluated, and their main biological mechanisms were analysed. In total, 24 interventions related to endometrial receptivity were identified. Notwithstanding a strong biological rationale, no intervention aimed at improving endometrial receptivity in women with PCOS is supported by an adequate body of evidence, limiting their use in clinical practice. Further high-quality research is needed in this field to limit potentially ineffective and unsafe add-on treatments in infertile patients with PCOS.
改善多囊卵巢综合征不孕患者子宫内膜接受能力的药物和非药物干预措施:现有证据综合评述
直接和间接的证据表明,子宫内膜接受能力可能在多囊卵巢综合征(PCOS)妇女生育率降低的过程中起到关键作用。人们提出了各种可能对多囊卵巢综合症患者子宫内膜接受能力产生影响的药物和非药物疗法。本研究旨在总结为改善多囊卵巢综合征不孕患者子宫内膜接受能力而测试的干预措施的原理、临床和实验证据。本研究通过查阅电子数据库进行了系统性回顾。对所有可能影响多囊卵巢综合症不孕患者子宫内膜接受能力的干预措施进行了评估,并分析了其主要生物学机制。总共确定了 24 项与子宫内膜受孕率有关的干预措施。尽管这些干预措施具有很强的生物学依据,但没有一项旨在改善多囊卵巢综合症女性子宫内膜受孕能力的干预措施得到充分的证据支持,这限制了它们在临床实践中的应用。该领域需要进一步开展高质量的研究,以限制对多囊卵巢综合症不孕患者进行可能无效和不安全的附加治疗。
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来源期刊
Reproductive biomedicine online
Reproductive biomedicine online 医学-妇产科学
CiteScore
7.20
自引率
7.50%
发文量
391
审稿时长
50 days
期刊介绍: Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.
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