Ayla BATU ÖZTÜRK, İlker KARA, Savaş AKTAŞ

Polikistik over sendromunda uterus değişiklikleri

Polikistik over sendromu, reprodüktif çağdaki kadınların yaklaşık %20’sini etkileyen metabolik endokrin bir hastalık olup bu hastalığın etiyopatogenezi henüz tam olarak bilinmemektedir. Bu hastalarda hipotalamus-hipofiz-over aksındaki değişikliklerin subfertilite, infertilite ve erken gebelik kayıplarına yol açtığı raporlanmıştır. Literatürde, bu kompleks sendromda saptanan klinik bulguların overde gözlenen yapısal, fonksiyonel ve metabolik değişikliklerle ilişkisi üzerine çok fazla çalışma bulunmasına rağmen, hastalığın olası uterus disfonksiyonu üzerindeki mekanizmaları henüz net olarak açıklanamamıştır. Bunun yanı sıra, polikistik over sendromunda spontan, ovülasyon indüksiyon tedavileri ve yardımcı üreme teknikleri ile oluşan gebeliklerde spontan abortus ve erken gebelik komplikasyonlarının normal popülasyona göre fazla olduğu da bildirilmektedir. Bu nedenle polikistik over sendromunda meydana gelen uterin değişikliklerin tanımlanması ve buna yönelik farklı tedavi yaklaşımlarının geliştirilmesi, bu hastalarda yaşam kalitesinin iyileştirilmesi, reprodüktif çağdaki kadınlarda gebelik ve sağlıklı yeni doğan oranlarının arttırılması açısından literatüre önemli katkılar sağlayacaktır. Bu derlemede, polikistik over sendromunda uterus dokusunda meydana gelen moleküler, fonksiyonel ve yapısal değişiklikler özetlenmeye çalışılmıştır. Ayrıca bu hastalarda subfertilite, infertilite ve erken gebelik komplikasyonlarının azaltılmasında uterin disfonksiyonun göz önüne alınması gereken, önemli bir konu olduğu vurgulanmaya çalışılmıştır.

Anahtar Kelimeler:

Polikistik over sendromu, uterus, endometriyum, miyometriyum

Uterine changes in polycystic ovary syndrome

Polycystic ovary syndrome is a metabolic endocrine disease which affects approximately 20% of women who are at reproductive age. However, the etiopathogenesis of this disease is still unclear. It has been reported that changes in the hypothalamus-pituitary-ovarian axis in the polycystic ovary syndrome patients lead to subfertility, infertility and early pregnancy loss. Although there are many studies in the literature about the connection between the clinical findings in this complex syndrome and the structural, functional and metabolic changes observed in the ovary, the mechanisms of the disease on possible uterine dysfunction is poorly understood. Besides, it has been reported that spontaneous abortion and early pregnancy complications are higher in spontaneous pregnancies and pregnancies with ovulation induction treatments and assisted reproductive techniques in polycystic ovary syndrome compared to the normal population. Therefore, the definition of uterine changes in polycystic ovary syndrome and the development of different treatment approaches for polycystic ovary syndrome will shed light to understand the etiopathogenesis of the disease. Particularly such contributions will help to understand how to improve the quality of life in these patients, increasing the pregnancy rates and healthy newborn rates in women of reproductive age. In this review, we summarized the molecular, functional and structural changes that occur in the uterine tissue in polycystic ovary syndrome. Moreover, it is emphasized that uterine dysfunction is an important matter which should be considered in reducing subfertility, infertility and early pregnancy complications in these patients.

Keywords:

Polycystic ovary syndrome, uterus, endometrium, myometrium,

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