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02 June 2020, Volume 36 Issue 6 Previous Issue    Next Issue

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Anatomical structure of uterus and physiological changes of endometrium during periimplantation. LIU Meng-ying，LYU Zhong-xian 2020, 36(6): 483-487.  DOI: 10.19538/j.fk2020060102 Abstract ( )   The uterus is basically composed of luminal epithelium，glands，stroma and myometrium.Under the coordination of estrogen and progesterone，the periimplantation endometrium undergoes establishment of the uterine receptivity and decidualization so as to provide fertile soil for embryo implantation and placental development.In assisted reproductive technology programs，there are plenty of approaches to evaluating the quality of embryos.However，endometrial abnormalities are considered to be one of the limiting factors that need to be overcomed urgently.This article explores the physiological changes and molecular basis of the periimplantation endometrium based on the uterine anatomy，with a view to provide reference and guidance for clinical assisted reproduction diagnosis and treatment.

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Diagnosis and treatment of infertile women with chronic endometritis. XIONG Yu-jing，XU Yan-wen 2020, 36(6): 488-491.  DOI: 10.19538/j.fk2020060103 Abstract ( )   Chronic endometritis（CE）is an infectious and inflammatory condition of endometrium which often shows subtle clinical disturbances.CE was reported to be associated with infertility and adverse pregnancy outcomes.The golden standard for CE diagnosis was histologic finding of multiple plasmacytes infiltration in endometrial stroma.Oral antibiotic treatment was the first line treatment of CE，which may improve the pregnancy outcome，but those with persistent CE were insensitive to antibiotics.

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Clinical management and prognosis of infertile patients with endometrial polyps. GU Fang 2020, 36(6): 491-495.  DOI: 10.19538/j.fk2020060104 Abstract ( )   Endometrial polyps（EPs）is one of the most common benign endometrial lesions and may affect the success rate of conception，or reslut in infertility，through mechanical obstruction and inflammatory stimulation.The primary tool for initial diagnosis of endometrial polyps is transvaginal ultrasonography and the standard diagnostic tool is hysteroscopy and guided biopsy.Polypectomy has been proven to increase success rates of spontaneous conception and assisted reproductive technology（ART）in infertile patients.However，it is still controversial whether surgical removal of EPs is a routine procedure before ART treatment.Prevention of postoperative recurrence and management of newly diagnosed endometrial polyps during controlled ovarian stimulation are the main challenging problems，so a series of clinical and basic scientific research are urgently needed to provide more convincing evidence for clinical management of polyps.

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Diagnostic standard and clinical management of thin endometrium in assisted reproductive technology. SHAO Xiao-guang，WEI Han 2020, 36(6): 496-500.  DOI: 10.19538/j.fk2020060105 Abstract ( )   Thin endometrium refers to the endometrium less than 7mm.The causes include  functional，pathological and unexplained factors.It may usually be found due to the drug side effects，intrauterine adhesion and myometrium lesions.To clarify the etiology and repair the endometrium is the implementation condition of embryo transfer.It is difficult to unify the etiology diagnosis and targeted treatment for recurrent thin endometrium，so combination therapy would be recommended.

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Clinical treatment of infertility caused by endometrial injury. SONG Tian-ran，SUN Hai-xiang 2020, 36(6): 500-504.  DOI: 10.19538/j.fk2020060106 Abstract ( )   The uterus is an essential organ for the establishment and maintenance of pregnancy.Endometrial damage will lead to infertility and recurrent abortion.Intrauterine adhesions are the most common form of endometrial damage.The main purpose of treatment is to restore the shape of the uterine cavity and the integrity and receptivity of the endometrium，so as to improve the outcome of pregnancy.At present，the comprehensive treatment with hysteroscopy as the core is an effective treatment，but the recurrence rate is still very high，especially in the patients with severe intrauterine adhesions.This article reviews the progress in the clinical treatment of infertility caused by intrauterine adhesions.

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Etiology and treatment of endometrial cavity fluid occurring during embryos transfer in assisted reproductive techniques. LIU Jing，QUAN Song 2020, 36(6): 504-507.  DOI: 10.19538/j.fk2020060107 Abstract ( )   Endometrial cavity fluid（ECF）is a common phenomenon during the process of assisted reproductive techniques（ART）， which is associated with controlled ovarian stimulation（COS），hydrosalpinx，genital malformation，endometritis and so on.ECF affects the growth and development of embryos and the receptivity of endometrium，which results in the failure of embryos implantation.In this review，we summarize the etiology and treatment of ECF in order to know the effects of ECF on the outcome of ART during the period of embryos tansfer.

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Endometrial peristalsis wave and embryo implantation. XU Bin，LI Yan-ping 2020, 36(6): 507-512.  DOI: 10.19538/j.fk2020060108 Abstract ( )   Endometrial peristalsis wave（EPW）plays an important role in the physiological function and the course of embryo implantation.Transvaginal ultrasonography is the most commonly used and economic method to measure EPW.In the normal unpregnant uterus，the frequency，direction and amplitude of EPW display different changs in different phases of  menstrual cycle，which is in consistent with reproductive functions of uterus.EPW activity is higher in controlled ovarian hyperstimulation cycle than natural cycle.Hyperperistalsis before embryo transfer significantly decreases the chance of pregnance during in vitro fertilization（IVF）.Administration of progesteron，phloroglucinol and atosiban can promote embryo imlantation and improve pregnancy outcomes of IVF by inhibiting EPW，especially in patients with repeated implantation failure.More randomized controlled trials are needed to test the effectiveness.The machenism of EPW is unclear and deserves further studies.

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Treatment principles of infertility with uterine fibroids. SHI Yi-fu，LI Juan-qing 2020, 36(6): 512-516.  DOI: 10.19538/j.fk2020060109 Abstract ( )   Infertility with uterine fibroids is clinically common，but the main and secondary causes and treatments of infertility with fibroids are different.Regarding the management principles of this disease，attention should be paid to the collection of medical history，understanding of the effects of infertility and uterine fibroids on pregnancy，delivery and perinatal outcome.As for the management of uterine fibroids，emphasis on minimally invasive technology，advice on use of power morcellation for giant uterine fibroids，and mastering medicine treatment for causes or symptoms are important.Of course，we aslo should attach importance to accurate use of assisted reproduction techniques and psychological rehabilitation counseling.Relevant treatment must follow the principle of individualization.

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Management of infertility in women with adenomyosis. LENG Jin-hua，SHI Jing-hua 2020, 36(6): 516-519.  DOI: 10.19538/j.fk2020060110 Abstract ( )   Adenomyosis is a gynecological benign disease that affects women's fertility and quality of life.It is often associated with other sex hormone-dependent diseases such as endometriosis，uterine fibroids，and endometrial polyps.Infertility，miscarriage，and obstetric complications are becoming prominent.The treatment strategies for infertility have become hot research topics in recent years.

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Clinical strategy of infertility combined with uterine malformation. DENG Shan，TIAN Qin-jie 2020, 36(6): 519-523.  DOI: 10.19538/j.fk2020060111 Abstract ( )   Uterine malformation is a spectrum of congenital uterine morphological and functional anomalies caused by abnormal development，fusion，or（and）absorption of bilateral Mullerian ducts in the female reproductive system during the 6-20 weeks of the embryo.Common types represented by the septate uterus are often associated with an increased risk of obstetric complications such as recurrent miscarriage，preterm delivery，and fetal malpresentation，but there is no sufficient evidence to support its association with primary infertility.With the exception of "uterine agenesis" as a definite factor of uterine infertility，other types of uterine malformation tend to maintain good reproductive outcome，and it is prudent to rule out the nonuterine causes of infertility before metroplasty is profermed.Hysteroscopic septal incision is currently only recommended for patients with recurrent miscarriages and recurrent implantation failures.