慢性子宫内膜炎对生育影响的研究进展

慢性子宫内膜炎是育龄女性高发疾病,临床症状不典型,诊断标准不统一,常被临床医师所忽略。慢性子宫内膜炎降低育龄女性生育能力,可导致女性不孕风险升高,胚胎着床失败,妊娠活产率降低,与不明原因不孕、复发性流产、反复体外受精-胚胎移植失败有关,严重影响育龄女性生殖健康。子宫内膜微生物感染是慢性子宫内膜炎的主要病因,不同患者宫内微生物感染种类不一。宫内微生物环境改变可引起炎症反应、免疫活性细胞种类变化、促炎性细胞因子分泌升高及子宫内膜妊娠相关调节因子表达异常,使子宫内膜容受性降低,妊娠期免疫耐受减弱,干扰受精卵着床,影响胚胎植入,不利于着床后妊娠的维持,进而导致流产、胎膜早破、早产、宫内感染等妊娠相关疾病。慢性子宫内膜炎经口服抗生素治愈的患者再次妊娠成功率及活产率均显著提升。

Research Progress on the Effect of Chronic Endometritis on Fertility

Chronic endometritis is a high incidence disease in women of childbearing age. The clinical symptoms are not typical, and the diagnostic criteria are not unified. This disease is often ignored clinically. Chronic endometritis reduces the fertility of women of childbearing age, which can lead to the high risk of infertility, embryo implantation failure and lower live birth rate. It is related to unexplained infertility, recurrent abortion and repeated IVF-ET failure, which seriously affects the reproductive health of women of childbearing age. Endometrial microbial infection is the main cause of chronic endometritis. Different patients may have different types of intrauterine microbial infection. The change of intrauterine microbial environment can cause the inflammatory reaction, the changes in the types of immune active cells, the increased secretion of pro-inflammatory cytokines and the abnormal expression of endometrial pregnancy related regulatory factors. These factors and responses can reduce endometrial receptivity, weaken the immune tolerance during pregnancy, interfere with the implantation of fertilized eggs and affect the embryo implantation. The outcomes are the maintenance failure of pregnancy after implantation, abortion, premature rupture of membranes, premature delivery, intrauterine infection and other pregnancy-related diseases. Patients who have been cured by oral antibiotics can get the improved success rate of re-pregnancy and the rate of live births.