ENDOMETRIAL RECEPTIVITY IN PATIENTS WITH UTERINE MYOMA


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Abstract

Objective. To study endometrial receptivity in infertile women with uterine myoma (UM) without endometrial pathology. Subjects and methods. Ninety-one patients, whose mean age was 33.8±4.4 years, with UM were examined. Their clinical and anamnestic features were studied and their reproductive function was evaluated. Group 1 (n=50) comprised infertile patients with UM. The group was divided into 2 subgroups: A) women with UM and primary infertility (n=32) and B) those with UM and secondary infertility (n=18). Group 2 (n=41) included fertile patients with UM who had a history of pregnancy in the presence of UM. Specimens from 26 patients were immunohistochemically investigated. Results. The study enrolled patients without endometrial pathology, as evidenced by clinical, laboratory, and histological examinations. Their endometrium corresponded to the mid-secretory phase. The number of pinopodia on the endometrial surface did not exceed 20%. Immunohistochemical study of biopsy specimens from the infertile patients with UM showed an imbalance between steroid hormone receptors in the endometrium, by increasing the level of progesterone receptors and decreasing that of estrogen receptors, and hence by disturbing the progesterone/ estrogen receptor ratio index and reducing leukemia inhibitory factor expression. Conclusion. The high progesterone receptor levels in the UM endometrium and tissue give rise to both impaired endometrial receptivity and myoma nodular growth, which may suggest that the mechanisms of pathogenesis of these diseases are common.

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About the authors

E. A KOGAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, Moscow

Email: e_kogan@oparina4.ru

S. I ASKOLSKAYA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, Moscow

Email: s_askolskaya@oparina4.ru

P. N BURYKINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, Moscow

Email: p_burykina@oparina4.ru

N. M FAIZULLINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, Moscow

Email: n_faizullina@oparina4.ru

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