Ultrastructural aspects of endometrium in infertile women with septate uterus
Ultrastructural aspects of endometrium in infertile women with septate uterus
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DOI：
10.1016/s0015-0282(16)58208-9
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发表时间：
1996-04-01
影响因子：
6.7
通讯作者：
Dorta, M
中科院分区：
文献类型：
--
作者：
Fedele, L;Bianchi, S;Dorta, M
目的：评估子宫纵隔和原发性不孕患者的子宫内膜表面形态，试图阐明子宫内膜异常是否与苗勒管畸形女性不孕的发病机制有关。设计：在周期排卵前阶段（当卵泡>通过超声检查确定 17 mm，E(2) 水平 >200 pg/mL [SI 单位换算系数，3.671]）。从每位患者身上获取两个样本，一个来自覆盖隔膜的子宫内膜，另一个来自子宫侧壁的子宫内膜。所有标本均通过扫描电子显微镜检查。主要结果指标：仅分析来自隔膜覆盖层和相应子宫侧壁的子宫内膜样本中的腺口数量、纤毛细胞与非纤毛细胞比率以及纤毛细胞上的纤毛数量。结果：在 5 名患者中，隔膜子宫内膜相对于子宫侧壁子宫内膜显示出以下有缺陷的排卵前变化：腺体数量减少口、不规则的非纤毛细胞和罕见的微绒毛、纤毛细胞上的纤毛发生不完全以及纤毛细胞与非纤毛细胞的比例降低（1:52 +/- 11 与 1:21 +/- 8）。结论：我们的结果表明覆盖畸形子宫隔膜的子宫内膜对排卵前激素变化的敏感性降低。这可能在纵隔子宫患者原发性不孕症的发病机制中发挥作用。
Objectives: To evaluate the endometrial surface morphology in patients with septate uterus and primary infertility in an attempt to throw light on the question of whether endometrial anomalies are involved in the pathogenesis of infertility in women with mullerian malformations.Design: Endometrial biopsies were performed in eight women with septate uterus and primary infertility during hysteroscopy scheduled in the preovulatory phase of the cycle (when a follicle > 17 mm was identified by ultrasonography and E(2) levels were >200 pg/mL [conversion factor to SI unit, 3.671]). Two samples were obtained from each patient, one from endometrium covering the septum and the other from endometrium lining the lateral wall of the uterus. All specimens were examined by scanning electron microscopy.Main Outcome Measures: The number of glandular ostia, the ciliated:nonciliated cell ratio, and the number of cilia on ciliated cells mere analyzed in endometrial specimen from both the covering of the septum and the corresponding uterine lateral wall.Results: In five patients septal endometrium showed the following defective preovulatory changes with respect to endometrium of the lateral uterine wall: a reduced number of glandular ostia, irregular nonciliated cells with rare microvilli, incomplete ciliogenesis on ciliated cells, and decrease in the ciliated:nonciliated cell ratio (1:52 +/- 11 versus 1:21 +/- 8).Conclusions: Our results indicate a decrease in the sensitivity of endometrium covering the septa of malformed uteri to preovulatory hormonal changes. This could play a role in the pathogenesis of primary infertility in patients with septate uterus.