Morphological and functional state of the endometrium and its receptivity in patients with ovarian endometriosis

Mikhaleva L.M.

A.P. Avtsyn Research Institute of Human Morphology

ORCID: 0000-0003-2052-914X

Solomatina A.A.

Russian National Research Medical University Named After N.I. Pirogov, Department of Obstetrics and Gynecology

Khovanskaya T.N.

Research Institute of Human Morphology

Chabieva L.B.

City Clinical Hospital No.31 Department of Public Health;
Russian National Research Medical University Named After N.I. Pirogov, Department of Obstetrics and Gynecology

Gracheva N.A.

City Clinical Hospital No.31 Department of Public Health

Chigray L.V.

City Clinical Hospital No.31 Department of Public Health

Mikhalev S.A.

Family Planning and Reproduction Center

Morphological and functional state of the endometrium and its receptivity in patients with ovarian endometriosis

Authors:

Mikhaleva L.M., Solomatina A.A., Khovanskaya T.N., Chabieva L.B., Gracheva N.A., Chigray L.V., Mikhalev S.A.

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Journal: Russian Journal of Human Reproduction. 2020;26(3): 68‑75

DOI: 10.17116/repro20202603168

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To cite this article:

Mikhaleva LM, Solomatina AA, Khovanskaya TN, Chabieva LB, Gracheva NA, Chigray LV, Mikhalev SA. Morphological and functional state of the endometrium and its receptivity in patients with ovarian endometriosis. Russian Journal of Human Reproduction. 2020;26(3):68‑75. (In Russ.)
https://doi.org/10.17116/repro20202603168

Подписка 2025-2 (Russian Journal of Human Reproduction)

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INTRODUCTION

10% of couples of reproductive age worldwide suffer from infertility today.

OBJECTIVE

This article discusses one of the causes of infertility — ovarian endometriosis, morphological and functional pathology of the endometrium and its impaired receptivity. The dynamics of endometrial changes after surgical treatment of endometrioid ovarian cysts is presented.

MATERIALS AND METHODS

The study included 172 patients of reproductive age with endometrioid ovarian cysts, each of whom underwent laparoscopic cystectomy. At the preoperative stage, and also after 3 and 6 months after the operation, the patients underwent endometrial biopsy at the middle stage of the proliferation phase and the secretion phase. The resulting material was processed according to standard histological protocols. Immunohistochemical and morphometric studies were performed on endometrial biopsy samples of 28 patients: the expression level of progesterone (PR) and estrogen receptors (ER) was studied and the percentage of cells containing pinopodia was determined. The calculation of statistical parameters was carried out in the program STATISTICA 64 version 12.

RESULTS

Depending on the prognosis of pregnancy, the sample was divided into 2 groups: first group — women with moderately reduced ovarian reserve and second group — women with significantly reduced ovarian reserve. No statistically significant differences were found between the clinically isolated groups (1st and 2nd groups) in the morphological structure and receptor apparatus of the endometrium. We found that with ovarian endometriosis in the middle stage of proliferation, there is an increase in the levels of expression of ER1 in the glands (p=0.0024), PR in the stroma (p=0.0000) and glands (p=0.0003) of the endometrium. The changes in endometrial receptivity identified in this study remained statistically significant 3 and 6 months after surgery. A statistically significant tendency was found — the number of pinopodia on the apical surface of the endometrium increased over time after cystectomy (significance level for group 1: p=0.0314, for group 2: p=0.0126).

CONCLUSIONS

In patients with ovarian endometriosis, there is a violation of the endometrial receptor apparatus in the form of increased levels of ER1 expression in the glands, PR in the stroma and glands in the middle stage of the proliferation phase, which persist 3 and 6 months after surgical treatment of ovarian endometriosis. Ovarian endometriosis has a negative effect on the formation of pinopodia in the endometrium. With the surgical treatment of ovarian endometriosis in the postoperative period, a gradual restoration of the ability of the endometrium to form pinopodia is observed.

Keywords:

endometriosis

cystectomy

endometrial pathology

immunohistochemistry

estrogen receptors

progesterone receptors

Authors:

Mikhaleva L.M.

A.P. Avtsyn Research Institute of Human Morphology

ORCID: 0000-0003-2052-914X

Solomatina A.A.

Russian National Research Medical University Named After N.I. Pirogov, Department of Obstetrics and Gynecology

Khovanskaya T.N.

Research Institute of Human Morphology

Chabieva L.B.

City Clinical Hospital No.31 Department of Public Health;
Russian National Research Medical University Named After N.I. Pirogov, Department of Obstetrics and Gynecology

Gracheva N.A.

City Clinical Hospital No.31 Department of Public Health

Chigray L.V.

City Clinical Hospital No.31 Department of Public Health

Mikhalev S.A.

Family Planning and Reproduction Center

Received:

12.01.2020

Accepted:

12.02.2020

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