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Abstract：
Introduction There have been numerous studies on the anovulatory factor, leading to infertility in women with polycystic ovary syndrome (PCOS); however, studies on the endometrium factor causing infertility in PCOS women are scarce. While hysteroscopy can accurately diagnose endometrial disorders such as endometrial polyps, it may be ineffective in detecting probable endometrial pathologies due to different hormonal habitats in these patients. Materials and methods Sixty patients with PCOS-related infertility were included in the study. All participants underwent hysteroscopic examination followed by endometrial biopsy and histopathological examination. The clinical and hormonal profiles of two main subgroups, that is, (a) normal endometrium (N), which included proliferative endometrium and secretory endometrium on histology, and (b) disordered endometrium (D), which included disordered endometrium on histology, were compared. Results There was no correlation between hysteroscopic and histopathological findings of PCOS infertile women. In the subgroup analysis of the two main histological types, that is, normal (proliferative and secretory) and disordered (disordered endometrium), age (28.70±4.66 vs. 32.9±5.61, p=0.012) and duration of amenorrhea (5.49±2.43 vs. 7.82±2.93, p=0.008) were significantly higher in the disordered group. There was a statistically nonsignificant higher BMI in the patients of the disordered endometrium group. Conclusion These findings suggest that endometrial biopsy and histopathological evaluation along with hysteroscopy should be desired in women with PCOS-related infertility, especially if they are in the late reproductive age group and have a longer duration of amenorrhea, regardless of endometrial thickening. This approach is essential to diagnose and treat endometrial disorder, which can be an additional cause of infertility, recurrent implantation failure, and recurrent pregnancy loss, in addition to ovulatory dysfunction.
摘要：
引言有许多关于无排卵因子的研究，导致多囊卵巢综合征（PCOS）女性不孕；然而，关于导致PCOS妇女不孕的子宫内膜因素的研究很少。虽然宫腔镜可以准确诊断子宫内膜息肉等子宫内膜疾病，由于这些患者的激素环境不同，因此在检测可能的子宫内膜病变方面可能无效。材料与方法60例PCOS相关性不孕症患者纳入研究。所有参与者均接受宫腔镜检查，然后进行子宫内膜活检和组织病理学检查。两个主要亚组的临床和激素概况，也就是说,（a）正常子宫内膜（N），组织学上包括增生性子宫内膜和分泌性子宫内膜，和（b）子宫内膜紊乱（D），其中包括组织学上的子宫内膜紊乱，进行了比较。结果PCOS不孕妇女宫腔镜检查结果与组织病理学结果无相关性。在两种主要组织学类型的亚组分析中，也就是说,正常（增生和分泌）和无序（子宫内膜紊乱），年龄(28.70±4.66vs.32.9±5.61，p=0.012）和闭经持续时间（5.49±2.43vs.紊乱组的7.82±2.93，p=0.008）显着升高。子宫内膜紊乱组患者的BMI在统计学上无统计学意义。结论这些研究结果表明，子宫内膜活检和组织病理学评估以及宫腔镜检查是PCOS相关性不孕症女性的理想选择。特别是如果他们处于生育年龄晚期并且闭经持续时间较长，无论子宫内膜增厚。这种方法对于诊断和治疗子宫内膜疾病至关重要，这可能是不孕的另一个原因，复发性植入失败，和反复怀孕的损失，除了排卵障碍。
