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控制性促排卵(COS)致内分泌环境的改变是影响子宫内膜容受性的医源性因素。研究显示COS中孕激素水平增高可致围排卵期和排卵后子宫内膜分泌期改变提前;且COS高血清类固醇水平可影响子宫内膜基因表达及分泌因子的变化,从而改变子宫内膜上皮-基质层的发育,影响胚胎着床。预防卵泡期孕激素水平上升,降低卵泡期雌激素水平及COS高反应是改善COS子宫内膜接受性的关键。有文献报道采用高纯度人绝经期促性腺激素(hMG-HP)促排卵,提前扳机及微刺激等预防措施可降低卵泡期孕激素水平上升的发生,若孕激素水平已升高至危险阈值,可考虑全部胚胎冷冻,待以后行冻融胚胎移植(FET);但这些措施的临床有效性尚需更多研究加以证实。
Control ovulation induction (COS) to endocrine changes in the environment is endometrial receptivity of iatrogenic factors. Studies have shown that increased levels of progesterone in COS can lead to early changes in the endovascular and ovarian endometrial secretions; and that the levels of COS high serum steroids can affect the changes of endometrial gene expression and secretion factors, thereby changing the endometrial epithelium- The development of the stroma, affecting embryo implantation. Prevention of follicular progesterone levels rise, lower follicular phase estrogen levels and high response to COS is to improve the endometrial receptivity of the key. It has been reported in the literature that high-purity human menopausal gonadotropin (hMG-HP) ovulation induction, early triggering and micro-stimulation and other preventive measures can reduce the rise of follicular progesterone levels, if the progesterone level has risen to a dangerous threshold, All embryos can be frozen until embryo transfer (FET) is frozen and thawed; however, the clinical validity of these measures needs more studies to confirm.