ABSTRACT
The structure of the endometrium in women diagnosed with endometriosis was compared to matched normal controls, using the electron microscope [EM]. The study was conducted at Ain-Shams University Obstetrics and Gynecology Hospital in the period between March 1999 and March 2001. The endometriosis group included 18 patients diagnosed to have endometriosis with mean age 39.2 +/- 1.3 years. In 11 patients the diagnosis was based on laparoscopic findings of moderate to severe endometriosis, in 7 patients the diagnosis was based on laparoscopy together with histopathology of pelvic nodules. The control group comprised 9 women in the reproductive age undergoing hysterectomy for benign gynecological conditions not involving the endometrium, the mean age for this group was 41.5 +/- 2.1 years, in 7 women the indication for hysterectomy was uterine descent and 2 for subserous fibroids of the uterus, in these 2 patients there was no complaint of abnormal uterine bleeding. None of the women included in this study had used steroidal contraceptives or intrauterine device in the lest 6 months before specimen collection. Only endometrium showing normal histology was included in the study. Compared with the normal, the endometrium from women affected by endometriosis showed abnormal features. The secretory cells had more numerous and longer microvilli. In the cytoplasm, there were more secretory granules and mitochondria. The rougie endoplasmic reticulum [RER] was more promirent and with dilated cisternae. Lipid droplets and electron dense particles were frequently seen. The cilia of ciliated, cells were increased, and elongated remarkably. The basement membrane was markedly tortuous. This might be the origin of endometriosis and the cause of infertility. The effect of these morphological differences on implantation needs further study
Subject(s)
Humans , Female , Endometriosis/ultrastructure , Microscopy, Electron , WomenABSTRACT
To evaluate the long term effects of an IUD on the human endometrium and find the possible contraceptive mechanism of IUD, histologic, histochemical and ultrastructural studies of human endometrial biopsies from 44 normal controls and 178 IUD wearers were made. Histologic findings included interstitial hemorrhage, inflammatory reaction, hyperplasia, atrophy, focal necrosis and squamous metaplasia. However, all of these findings were either infreqnent or insignificant except for inflammatory reaction. Histochemica1, enzymatic and ultrastructural findings were a1so unremarkable. The most significant finding, was asynchronism between cyclic dating and endometrial histologic dating, showing delayed endometrial maturation in the majority of IUD users. In summary, IUD insertion brings about mild and little histologic alteration in the human endometrium, but the inflammatory reaction and asynchronous endometrial matruation may play some role in the antifertility actifertility action of an IUD.