medjournalМедицинский журналMedical Journal1818-426XБелорусский государственный медицинский университет10.51922/1818-426X.2023.4.36medjournal-18Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESЭндометриальные факторы как причина бесплодия и имплантационных неудач при синдроме поликистозных яичниковEndometrial factors as a cause of infertility and implantation failures in polycystic ovary syndromeКирилловаЕ. Н.KirillovaE. N.ПавлюковаС. А.PavlukovaS A.УО «Белорусский государственный медицинский университет»Belarus202317062025043648Copyright © Кириллова Е.Н., Павлюкова С.А., 20252025Кириллова Е.Н., Павлюкова С.А.Kirillova E.N., Pavlukova S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medjournal.ejournal.by/jour/article/view/18

В настоящее время бесплодие является одной из наиболее прогрессирующих и актуальных проблем здоровья населения. Эндометриальная структура и рецептивность относятся к наиболее значимым факторам, необходимым для успешной имплантации эмбриона и развития гестации. Тем не менее имеющиеся данные о регуляции функции эндометрия и его структуры в условиях гормонального и метаболического дисбаланса недостаточны. Это обусловливает необходимость для более глубокого изучения эндометрия в данных направлениях. В обзоре проведен анализ генетических и эпигенетических изменений в эндометриальной ткани, изложены современные представления о клеточном и тканевом уровнях регуляции нормального эндометрия и их изменениях у пациенток с синдромом поликистозных яичников (СПКЯ). Рассмотрены также современные диагностические маркеры нарушения регуляции эндометрия, структурных и морфологических нарушений, рецепторных и пострецепторных эффектов гормонов в условиях гиперандрогении и метаболического дисбаланса, а также возможные механизмы развития предраковых и раковых заболеваний эндометрия. Однако отмечено, что требуются дальнейшие исследования, направленные на разработку четких диагностических алгоритмов и терапевтических воздействий, направленных на улучшение репродуктивных исходов у пациенток с СПКЯ.

Infertility is one of the most increasing health problems of the population. Endometrial structure and receptivity are among the most significant factors for successful embryo implantation and pregnancy development. Nevertheless, the available data on the regulation of endometrial function and its structure in conditions of hormonal and metabolic dysbalance are insufficient. This makes it necessary for deeper research of the human endometrium in these fields. In the review we analyzed the genetic and epigenetic changes of the endometrial tissue, presented modern ideas about the cellular and tissue levels of regulation of normal endometrium and their changes in patients with polycystic ovarian syndrome (PCOS). Modern diagnostic markers of endometrial dysregulation are also considered. However, it is noted that further research is required to develop clear diagnostic algorithms and therapeutic effects aimed at improving reproductive outcomes in PCOS.

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The authors declare that there are no conflicts of interest present.