The objective of the study was to ascertain if the estradiol-progesterone substitution used for the preparation of endometrium which has been shown to elicit supraphysiological levels of circulating progesterone may also induce demonstrable changes in the ultrastructural morphology of human secretory endometrium which is characterised by three progesteron- dependent structures, the so called postovulatory triad: nuclear or nucleolar channel system, giant mitochondria and subnuclear glycogen. The study was approved by the institutional Ethic Committee and included 24 patients of one IVF centre who signed informed consent. Two sequentional endometrial biopsy specimens were taken on the 5th and 7th day after ovulation in one natural cycle and on the 5th and 7th day after the initiation of progesterone addition in another substituted cycles in the same patient. The surface and glandular epithelial cells were examined under transmission electron microscope (TEM). The appearance of nuclear channel system (NCS), giant mitochondria and glycogen was the same in both natural and substituted cycles, without abnormalities and deformations. Cells with NCS were found, mostly in clusters on discrete parts, in 55 to 70 % of ultrathin sections. The relative number of NCS positive specimens was not statistically different between the cycles or between the day +5 and the day +7 within different type of cycle. Some NCS positivity was detected more often (in 79 % and 66 %, resp.) in substituted cycles than in spontaneous ones. The percentage of NCS positive cells was also higher (median 17 % and 12 %, resp.) in substituted cycles but the differences were not statistically significant. With some caution regarding the inherent limited reproducibility of the TEM findings we can conclude that the oral hormonal substitution used in our setting does not markedly alter endometrial ultrastructural morphology.
Cíl studie: Shrnutí významu apoptózy - regulačního mechanismu v endometriu. Porovnání stupněapoptózy v epitelu a stromatu endometria ve střední sekreci.Typ studie: Literární přehled, klinicko-laboratorní studie.Název a sídlo pracoviště: Gynekologicko-porodnická klinika LF UP a FN, Olomouc, Ústav histologiea embryologie, Gynekologicko-porodnické oddělení Baťovy nemocnice, Zlín.Metodika: Vzorky sekrečního endometria (n=28) byly získány od 14 žen 5. a 7. den po ovulaci.Pacientky zařazené do výzkumu měly více než 12měsíční anamnézu sterility, pravidelný menstruačnícyklus, věk nižší než 40 let, BMI v rozpětí 20-32 a bazální hladinu FSH 5-9 IU/L. Biopsieendometria byly provedeny 5. a 7. den po ovulaci. Materiál byl zpracován rutinním způsobema ke stanovení apoptózy byla zvolena metoda TUNEL.Výsledky: Při porovnání sledovaných vzorků bylo nalezeno signifi kantní zvýšení apoptotickéhoindexu v epitelu endometria 7. den po ovulaci ve srovnání s 5. dnem. Ve stromatu se apoptotickébuňky vyskytovaly sporadicky. Signifi kantně vyšší apoptotický index byl nalezen při srovnáníděložních žlázek kompaktní a spongiózní vrstvy ve prospěch žlázek kompakty.
Objective: Comparison of level of apoptosis in the mid-secretory human endometrium.Design: Clinical-laboratory trial.Setting: Department of Gynecology and Obstetrics, Medical Faculty, Palacký University, FacultyHospital, Olomouc, Department of Gynecology and Obstetrics, Bata Hospital, Zlín.Methods: Samples of secretory endometrium were obtained from 14 women. The women includedin the study had the next criteria: a history of infertility of more than 12 months, regular menstrualcycles, age below 40 and FSH basal level range 5-9 IU/L. Sampling of tissue was performedafter confi rmed ovulation by LH surge and repeated ultrasound examinations. Patterns wereprocessed by routine methods and apoptosis was detected using TUNEL assay.Results: The level of apoptosis in the endometrial epithelial surface was signifi cantly higher onday +7 compared to day +5 after ovulation (P
- MeSH
- endometrium sekrece MeSH
- histocytochemie metody MeSH
- imunochemie metody MeSH
- placenta sekrece MeSH
- plodová voda MeSH
- proteiny MeSH
- těhotenství MeSH
- Check Tag
- těhotenství MeSH
- Publikační typ
- přehledy MeSH
