The problem of infertility due to endometrial hypoplasia is very relevant, due to the difficulty of diagnosing because of lack of uniform morphometric and immunohistochemical criteria for this condition.
OBJECTIVE
To assess the state of endometrium of patients with endometrial hypoplasia and infertility using morphometry and microscopy taking into account the severity expression of estrogen, progesterone receptors, VEGF, CD34, LIF, and LIFR.
MATERIAL AND METHODS
The morphometric, immunohistochemical and statistical analysis of endometrial samples of 34 women with infertility due to thin endometrium and 29 healthy fertile women ware carried out.
RESULTS
The fibroplastic transformation of the stroma in women with infertility was recorded 1.9 times more often. A significant decrease of the relative number of abundant pinopodia in the group of women with infertility was found. Immature pinopodia in the group of women with thin endometrium were recorded almost 10 times more often, and mature ones — 4 times less than in fertile women. A microscopic immunohistochemical test indicated a decrease by 43% of progesterone receptor’s expression by stromal cells in women with thin endometrium, as well as in VEGFR-3 expression by 48% and 84%, both by gland cells and stromal cells. The number of capillaries in the field of view in women with fine endometrium was reduced by 2 times.
CONCLUSION
In women with thin endometrium and infertility, there are a decrease of the area of the integumentary epithelium with pinopodia, with the predominance of their immature forms; moderately reduced expression of estrogen receptors by stromal cells, a decrease LIF expression and an increase in LIFR expression by glands and stroma, decrease in the level of VEGF and CD34 expression, indicating a violation of endometrial receptivity and neoangiogenesis processes, which subsequently lead to a decrease in endometrial height and inferior cytotrophoblast invasion.
