{"title":"子宫腺肌症如何影响子宫内膜容受性?临床和分子见解的最新系统综述","authors":"Takehiro Hiraoka M.D., Ph.D., Yasushi Hirota M.D., Ph.D., Yutaka Osuga M.D., Ph.D.","doi":"10.1016/j.xfnr.2022.11.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p><span>To summarize current knowledge regarding the outcomes of assisted reproductive technology (ART) </span>in patients<span> with adenomyosis, offer insights into the defects in the regulation of endometrial receptivity, and discuss the implications for the clinical management of adenomyosis and infertility.</span></p></div><div><h3>Evidence Review</h3><p>We conducted a comprehensive literature search of PubMed for original and review articles published in English up to June 2022 in the following areas: adenomyosis and infertility; ART; endometrial receptivity; and embryo implantation.</p></div><div><h3>Results</h3><p><span><span>Adenomyosis may have a negative impact on endometrial receptivity, reducing the probability of conception by ART. The severity of adenomyosis seems to be associated with the severity of the impairment in receptivity, and before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed </span>embryo transfer<span> may restore endometrial receptivity. Molecular analyses demonstrated that genes associated with endometrial receptivity are aberrantly expressed in the eutopic endometria of women with infertility with adenomyosis. Hyperproliferation of the endometrial epithelium, impaired </span></span>decidualization<span>, progesterone<span> resistance, altered expression of adhesion molecules<span><span>, a hyperinflammatory microenvironment, chronic </span>endometritis<span>, and abnormal uterine contractility seem to be involved in the impairment of endometrial receptivity.</span></span></span></span></p></div><div><h3>Conclusion</h3><p>Uterine adenomyosis reduces endometrial receptivity via several mechanisms. In addition, data suggest that the etiologic mechanism of adenomyosis is responsible for impaired endometrial receptivity. Before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed embryo transfer may ameliorate the defects in the uterine environment, probably by restoring the expression of genes that are essential for embryo implantation. Further research using animal models should aim to additionally clarify the relationship between adenomyosis and infertility to refine the treatment strategies for women with infertility with adenomyosis.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"How does adenomyosis impact endometrial receptivity? An updated systematic review of clinical and molecular insights\",\"authors\":\"Takehiro Hiraoka M.D., Ph.D., Yasushi Hirota M.D., Ph.D., Yutaka Osuga M.D., Ph.D.\",\"doi\":\"10.1016/j.xfnr.2022.11.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p><span>To summarize current knowledge regarding the outcomes of assisted reproductive technology (ART) </span>in patients<span> with adenomyosis, offer insights into the defects in the regulation of endometrial receptivity, and discuss the implications for the clinical management of adenomyosis and infertility.</span></p></div><div><h3>Evidence Review</h3><p>We conducted a comprehensive literature search of PubMed for original and review articles published in English up to June 2022 in the following areas: adenomyosis and infertility; ART; endometrial receptivity; and embryo implantation.</p></div><div><h3>Results</h3><p><span><span>Adenomyosis may have a negative impact on endometrial receptivity, reducing the probability of conception by ART. The severity of adenomyosis seems to be associated with the severity of the impairment in receptivity, and before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed </span>embryo transfer<span> may restore endometrial receptivity. Molecular analyses demonstrated that genes associated with endometrial receptivity are aberrantly expressed in the eutopic endometria of women with infertility with adenomyosis. Hyperproliferation of the endometrial epithelium, impaired </span></span>decidualization<span>, progesterone<span> resistance, altered expression of adhesion molecules<span><span>, a hyperinflammatory microenvironment, chronic </span>endometritis<span>, and abnormal uterine contractility seem to be involved in the impairment of endometrial receptivity.</span></span></span></span></p></div><div><h3>Conclusion</h3><p>Uterine adenomyosis reduces endometrial receptivity via several mechanisms. In addition, data suggest that the etiologic mechanism of adenomyosis is responsible for impaired endometrial receptivity. Before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed embryo transfer may ameliorate the defects in the uterine environment, probably by restoring the expression of genes that are essential for embryo implantation. Further research using animal models should aim to additionally clarify the relationship between adenomyosis and infertility to refine the treatment strategies for women with infertility with adenomyosis.</p></div>\",\"PeriodicalId\":73011,\"journal\":{\"name\":\"F&S reviews\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"F&S reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666571922000196\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"F&S reviews","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666571922000196","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
How does adenomyosis impact endometrial receptivity? An updated systematic review of clinical and molecular insights
Objective
To summarize current knowledge regarding the outcomes of assisted reproductive technology (ART) in patients with adenomyosis, offer insights into the defects in the regulation of endometrial receptivity, and discuss the implications for the clinical management of adenomyosis and infertility.
Evidence Review
We conducted a comprehensive literature search of PubMed for original and review articles published in English up to June 2022 in the following areas: adenomyosis and infertility; ART; endometrial receptivity; and embryo implantation.
Results
Adenomyosis may have a negative impact on endometrial receptivity, reducing the probability of conception by ART. The severity of adenomyosis seems to be associated with the severity of the impairment in receptivity, and before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed embryo transfer may restore endometrial receptivity. Molecular analyses demonstrated that genes associated with endometrial receptivity are aberrantly expressed in the eutopic endometria of women with infertility with adenomyosis. Hyperproliferation of the endometrial epithelium, impaired decidualization, progesterone resistance, altered expression of adhesion molecules, a hyperinflammatory microenvironment, chronic endometritis, and abnormal uterine contractility seem to be involved in the impairment of endometrial receptivity.
Conclusion
Uterine adenomyosis reduces endometrial receptivity via several mechanisms. In addition, data suggest that the etiologic mechanism of adenomyosis is responsible for impaired endometrial receptivity. Before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed embryo transfer may ameliorate the defects in the uterine environment, probably by restoring the expression of genes that are essential for embryo implantation. Further research using animal models should aim to additionally clarify the relationship between adenomyosis and infertility to refine the treatment strategies for women with infertility with adenomyosis.
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