Prostaglandin and the corpus luteum of pregnancy.

PIP: Prostaglandins can cause pregnancy to be terminated through any of the following mechanisms: 1) direct luteolytic effect of prostaglandins on early pregnancy; 2) intense myometrial disloding and expelling of the embryo; 3) indirect luteolytic effect caused by the removal of possible luteotropical support of the conceptus due to direct action of prostaglandin; and 4) direct interference of prostaglandin on early placental production of progesterone and other hormones. The present study was conducted to determine the histopathological changes in the corpora lutea taken out during abdominal tubal ligation of 30 women within 1 to 4 hours after abortion. 15-methyl PGF2a was administered through extraovular route in 15 cases; 15 control cases had hysterectomy and tubal ligation, and ovarian biopsy by abdominal route. Macroscopically, the corpora lutea of the experimental cases appeared congested and at times, hemorrhagic; most had clots in the cavity. The ovaries appeared normal and comparable to those of the controls. The rectus sheath, uterus and fallopian tubes exhibited vascular congestion. Microscopically, the granulosa lutein cell of the experimental group seemed either irregular or indistinct, with the cytoplasm exhibiting a large number of vacuolation, and the nuclei showing Pyknotic, karyorrhetic or karyopyknotic changes. It was suggested that the degenerative changes in the corpora lutea were due to the prostaglandins' lowering of the level of progesterone and the termination of early pregnancy.^ieng

Hysterosalpingographic changes due to long term effect of intrauterine device.

PIP: The incidence of pelvic inflammatory disease associated with the use of intrauterine devices (IUD) was studied. Hysterosalpingography was done 15 days after IUD removal on 100 women who had worn an IUD from 6 to 36 months. 10% of the cases showed bilateral tubal blockage, 5% had 1 tube blocked, and 85% showed both tubes patent. The incidence of blockage seemed to increased with the increase in the times of IUD retention. In the 85% where there was no tubal blockage, there was a minimal amount of cellular infiltration in the endometrium. It was concluded that cases who have a marked degree of inflammatory cell infiltration are likely to develop ascending infection to the Fallopian tube, which may lead to permanent involvement of the tubal structure.^ieng

Role of histamine release - a possible mechanism of action of intrauterine contraceptive device.

PIP: The histamine content of the endometrium was estimated in 50 women who were wearing an intrauterine device and in 48 control women. Histological examinations were conducted in both groups. The histamine content was higher among IUD users during all phases of the menstrual cycle. Histologically, endometria which had been exposed to the devices showed leucoytic infiltration and hyperestrogenism. A possible mechanism of action of the IUD is proposed, based on these biochemical and histological changes.^ieng

Histological changes in the ovary under the effect of oral contraceptive.

PIP: Changes in ovarian morphology were studied in 32 sterilization patients who had previously taken combined oral contraceptives for 1-8 months. In their gross appearance the ovaries either appeared to be inactive postmenopausal organs or they had many atretic inactive follicles devoid of corpora lutea. Histological investigation of the ovaries revealed: 1) flattening of epithelium of cyst wall; 2) increased fibrosis of the atretic follicles; 3) granulosa cells in the process of disintegration; 4) luteinization of follicular cyst; 5) vacuoles present in the luteinized cells; 6) hypercellularity of ovarian cortex; 7) fibrosis of ovarian cortex; 8) increased vascularity; 9) hyaline material inside the degenerating maturing follicles; 10) increase in the edema fluid of the ovary; and 11) atretic follicles at various phases of degeneration.^ieng

Effect of nor-ethisterone enanthate (SH 393) on the structure of the endometrium and on the cervical mucus.

PIP: A study of the effects of norethisterone enanthate (SH 393) on the endometrium and cervical mucus is presented. 50 women were given a monthly injection of 200 mg SH 393 in 3 series. Withdrawal bleeding at Month 1 was regular, though irregular bleeding occurred at Months 2 and 3 in 90% of the cases. Dyspepsia was the most frequent complaint (12%). Endometrial histology showed both proliferative and secretorial changes in 1 patient 1 month after injection. Biopsies taken in the 2nd and 3rd months usually showed a hypoplastic endometrium with straight tubular glands and no evidence of secretion. Stroma were compact with scanty cytoplasm and some glands showed cystic dilatation. Changes in the cervical mucus revealed a negative ferning pattern in 46 of the 70 cases and some leucocytic infiltration. It is concluded that endometrial suppression and changes in the cervical mucus are main cause s of the antifertility effect of SH 393.^ieng