控制性超促排卵高雌激素环境对早期胎盘发育及功能的影响

Effects of controlled ovarian hyperstimulation high estrogen environment on early placental development and function

摘要

辅助生殖技术已成为现代医学治疗不孕不育症的重要技术手段.控制性超促排卵是辅助生殖的关键技术之一,其可促使多枚卵子成熟,以提高辅助生殖周期的成功率.但这一技术使母体在妊娠早期产生高水平的雌激素,进而导致子代不良妊娠结局的发生风险升高.胎盘发育及功能异常是导致胎儿死亡、胎儿生长受限和出生缺陷等不良妊娠结局的重要原因之一.该研究的课题组前期探索提示,控制性超促排卵高雌激素可影响子宫自然杀伤细胞的密度和成熟度,这可能是高雌激素环境致胎盘形态异常,进而导致不良妊娠结局风险升高的重要原因.该文将重点综述控制性超促排卵高雌激素环境与胎盘发育及功能异常的相关性,并进一步论述其发生的可能相关机制,为临床防治因母体高雌激素环境所致的胎盘功能异常相关的不良妊娠结局提供重要的理论依据.

Abstract

Assisted reproductive technology has become an important technical means for the treatment of infertility in modern medicine. Controlled ovarian hyperstimulation is one of the key technologies of assisted reproduction, which can promote the maturation of multiple eggs to improve the success rate of assisted reproductive cycles. However, this technology causes the mother to produce high levels of estrogen in early pregnancy, which in turn increases the risk of adverse pregnancy outcomes in the offspring. Abnormal placental development and function is one of the important causes of adverse pregnancy outcomes such as fetal death, fetal growth restriction and birth defects. The research team's preliminary exploration suggests that controlled ovarian hyperstimulation high estrogen can affect the density and maturity of uterine natural killer cells, which may be an important reason for the high estrogen environment to cause abnormal placental morphology, thereby increasing the risk of adverse pregnancy outcomes. This article will focus on reviewing the correlation between controlled ovarian hyperstimulation high estrogen environment and abnormal placental development and function, and further discuss the possible related mechanisms of its occurrence, providing important theoretical basis for the clinical prevention and treatment of adverse pregnancy outcomes related to abnormal placental function caused by maternal high estrogen environment.

关键词

辅助生殖技术 / 控制性超促排卵 / 雌激素 / 子宫自然杀伤细胞 / 胎盘 / 核因子κB通路

Key words

assisted reproductive technology / controlled ovarian hyperstimulation / estrogen / uterine natural killer cell / placenta / nuclear factor kappa-B pathway

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基金资助

国家自然科学基金面上项目(82271734)