Endometrial hyperplasia in women with external genital endometriosis and uterine myoma

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THE AIM OF THE STUDY

Was to examine the morphological features of the endometrium in hyperplasia without atypia in women with infertility associated with external genital endometriosis and uterine myoma.

MATERIAL AND METHODS

A comprehensive morphological study was performed in 142 patients with a histologically verified diagnosis of endometrial hyperplasia. The 1st group included 74 patients with secondary infertility and external genital endometriosis of the I—II degree, the 2nd group — 68 patients with secondary infertility and uterine myoma (intramural and sub-serous form with a node diameter not exceeding 3 cm). Immuno-histochemical and immunofluorescent methods using confocal laser scanning microscopy were used to assess the receptor profile of the endometrium (ER, PR), pro-inflammatory markers (CD8+, CD20+ CD4+, CD138+) and an inhibitor of cyclin-dependent kinases p16^ink4a.

RESULTS

On the basis of clinical and morphological data, endometrial hyperplasia without atypia was associated with chronic endometritis in 83.8% of patients with infertility associated with external genital endometriosis and in 86.8% of patients with infertility and uterine myoma. The positive expression of the inhibitor of cyclin-dependent kinases p16ink4a was verified in 100% of cases in both groups.

CONCLUSION

Endometrial hyperplasia in patients with external genital endometriosis and small uterine myoma is accompanied by chronic endometritis, desynchronization and a decrease in the expression of the endometrial receptor profile, due to the high frequency of intrauterine interventions and inflammatory diseases of uterine cavity walls; that combination determines infertility.

Keywords:

endometrial hyperplasia

external genital endometriosis

uterine myoma

infertility

chronic endometritis

inhibitor of cyclin-dependent kinases p16ink4a

Authors:

Tolibova G.Kh.

Ott Scientific Research Institute of Obstetrics, Gynecology and Reproductology

Tral T.G.

Ott Scientific Research Institute of Obstetrics, Gynecology and Reproductology

Kakhiani M.I.

Ott Scientific Research Institute of Obstetrics, Gynecology and Reproductology

Kogan I.Yu.

Ott Scientific Research Institute of Obstetrics, Gynecology and Reproductology;
St. Petersburg State University

Received:

10.03.2020

Accepted:

03.07.2020

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