GÜLNUR KIZILAY ÖZFİDAN, Hakan ÇAKMAK, Aydın ARICI

Endometriosis and implantation

İmplantasyon, embriyonun endometriuma yerleşmesinin gerçekleştiği kompleks bir işlemdir. İnsan endometriumu; endometrial hücreler ve embriyodan kaynaklanan steroid hormonlar ve parakrin faktörlerin etkisi altında, luteal faz süresince embriyoyu kabul etmeye hazır hale gelir. Lösemi inhibitor faktör (LİF) ve interlökin (İL)-11'de dahil olmak üzere, pek çok parakrin faktör implantasyonu etkiler. Bunun yanısıra endometriyumda gelişen pinopodlar, integrinler, HOX genleri ve aynı zamanda oosit kalitesi de implantasyon sonucunu belirler. Endometriosis; yaygın bir jinekolojik hastalıktır ve infertil kadınların yaklaşık %25-50'si endometriosislidir. İnfertiliteye sebep olan mekanizmalar tam olarak anlaşılamamış olmasına rağmen, bu konu hakkındaki genel kanı; normal olmayan folikülogenez, sperm disfonksiyonu, implantasyon başarısızlığı, erken dönem embriyo gelişimine karşı oluşan toksisite, implante olma yeteneği azalmış düşük oosit kalitesinin bazı endometriosisli hastalarda infertiliteye neden olan etkili faktörler olabileceği yönündedir.

Anahtar Kelimeler:

Endometriyoz, Kısırlık, Embriyo implantasyonu, Oosit

Endometriosis ve implantasyon

Implantation is a complex process by which the embryo attaches to the endometrium. The human endometrium becomes receptive to the embryo during the luteal phase of the menstrual cycle under the influence of steroid hormones and paracrine factors originating from endometrial cells and the embryo. Several paracrine factors influencing the implantation include leukemia inhibitory factor (LIF) and interleukin (IL)-11. Moreover, timely development of pinopodes, and expression of integrins and Hox genes in endometrium, and oocyte quality also determines the implantation outcome. Endometriosis is a common gynecologic disorder and estimated that 25 to 50% of infertile women have endometriosis. Although the mechanisms contributing to infertility are poorly understood, accumulating evidence suggests that altered folliculogenesis, sperm dysfunction, impaired fertilization, toxicity against early embryonic development, defective implantation, and poor oocyte quality with decreased ability to implant may be the contributing factors in some endometriosis patients.

Keywords:

Endometriosis, Infertility, Embryo Implantation, Oocytes,

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