Microvillous relief of endometrial epitheliocytes and infertility in peritoneal endometriosis

详细

Objective. To estimate the role of hormone-dependent changes of the microrelief of endometrial epitheliocytes in pathogenesis of infertility associated with peritoneal endometriosis.

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Methods. The endometrium of rats with normal estrous cycle, of rats androgenized in the neonatal period and those to whom folliculin and progesterone was given after ovarioectomy as well as the endometrium of 9 women in late secretory phase with infertility and peritoneal endometriosis (rAFS stage I-II) was studied with the use of scanning electron microscopy.

Results. Microvilli were found in the endometrial epitheliocytes of rats at the stage of proestrus conditioned by the influence of estrogens. At the metestrus stage when estrogen level decreases and that of progesterone increases microvilli are reduced. The estrogen-dependent character of the microvilli formation and the progesterone-dependent process of their reduction was reproduced in ovariectomized rats. Microvilli are seen in the androgen-sterile rats on the background of tonic estrogen hypersecretion and progesterone deficiency. Microvilli are seen in the endometrial epitheliocytes at late secretory phase in all patients with infertility and peritoneal endometriosis.

Conclusions. The persistence of microvillous relief of endometrial epitheliocytes in late secretory phase of the cycle is indicative of the deficiency of endometrial secretory transformation, deficiency of the ovarian function in peritoneal endometriosis and may result in a disorder of the ovicell implantation and infertility.