Infertility is a significant medical problem associated with morphological and functional changes in the endometrium and ovarian diseases that can lead to endometrial dysfunction. In this regard, it remains extremely important to study the role of endometrial and ovarian pathology in the development of infertility.
OBJECTIVE
Comparative analysis of endometrial receptivity in young women with endometrial and ovarian factors of infertility.
MATERIAL AND METHODS
We conducted a retrospective study that included 195 patients of reproductive age. Group 1 included patients with endometrial infertility factor (n=97), Group 2 included patients with ovarian infertility factor (n=38), Group 3 included women with a combination of both infertility factors (n=35). The comparison group consisted of women with infertility associated with male factor who were examined before IVF procedure (n=25). For pathomorphologic and immunohistochemical studies, the endometrium was sampled by pipelle biopsy on the 19th—22nd day of the menstrual cycle during the expected implantation window period.
RESULTS
Analysis of the results of the pathomorphologic study revealed different degrees of impaired development of pinopodes and delayed secretory transformation of the endometrium in patients of the three groups. Immunohistochemical study revealed a significant decrease in the expression level of estrogen receptors (ER) and increase in the expression of progesterone receptors (PR) in the glandular compartment in all studied groups compared to the comparison group, as well as a decrease in the expression level of ER in the stromal compartment of the endometrium in patients of groups 1 and 3.
CONCLUSION
One of the leading causes of implantation disorders in patients with endometrial and ovarian infertility factors is impaired maturation of pinopodes, delayed secretory transformation of the endometrium and displacement of the implantation window, as well as decreased expression of ER and increased expression of PR in glandular compartments in patients of the studied groups compared to the morphological control group, decreased expression of ER in the stromal compartment, in patients of groups 1 and 3.