AIM: The effect of platelet-rich autoplasma on endometrial thickness and receptor sensitivity to estrogen and progesterone. MATERIALS AND METHODS: This prospective clinical study included 200 patients. The participants in the study were divided into two groups. The first control group received hormone replacement therapy (HRT). The second study group received an intrauterine infusion of platelet-rich autoplasma (PRP group). On the 19th day of the menstrual cycle, an ultrasound examination was performed to assess endometrial thickness, as well as an immunohistochemical analysis to determine receptor sensitivity to estrogen and progesterone. RESULTS: In the course of the study, we found that the use of platelet-rich autoplasma increased the thickness of the endometrium by 0.85 mm; the average thickness of the endometrium in the group who received PRP therapy was 8.25 (8.25-8.61) mm; and in the group of patients who only received HRT, it was 7.40 (7.34-7.65) mm. The sensitivity of receptors to estrogen in the experimental group increased by 3.5, in the experimental group it was 75.00 (71.43-74.22), and in the control group it was 71.50 (67.05-70.85). The sensitivity of receptors to progesterone also increased by 9.0, in the experimental group it was 95.0 (91.4-93.8), and in the control group it was 86.0 (83.47-86.27). CONCLUSION: Due to the action of platelet factors, PRP therapy has a positive effect on the endometrium, increasing its thickness and improving its receptivity. Therefore, it can be concluded that this method can find great practical application to improve the outcomes of assisted reproductive technology programs.
- Klíčová slova
- infertility, platelet-rich autoplasma, thin endometrium,
- MeSH
- dospělí MeSH
- endometrium * diagnostické zobrazování metabolismus účinky léků MeSH
- estrogeny MeSH
- lidé MeSH
- plazma bohatá na destičky MeSH
- progesteron * MeSH
- prospektivní studie MeSH
- receptory pro estrogeny metabolismus MeSH
- receptory progesteronu metabolismus MeSH
- trombocyty metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- estrogeny MeSH
- progesteron * MeSH
- receptory pro estrogeny MeSH
- receptory progesteronu MeSH
INTRODUCTION: Hysteroscopy with biopsy is a common diagnostic and therapeutic method in gynaecology. Its use is preceded by ultrasound examination. The success rate of predicting intrauterine findings based on ultrasound has not been assessed in the Czech Republic for a long time. In the meantime, there have been technological improvements in ultrasound devices. METHOD: Patients indicated for hysteroscopy underwent ultrasound examination and their medical history was recorded. The percentage agreement between ultrasound and histopathological findings was assessed. The secondary goal was to find an easier way of describing ultrasound findings in gynaecological practice. RESULTS: The study comprised 255 patients. In 15 cases, endometrial carcinoma was confirmed by hysteroscopy and histopathological examination. Of these, malignancies were suspected based on previous ultrasound scans in 11 patients. In 95 cases, intrauterine polyps were detected. The success rate for predicting polyps by ultrasound examination was 65.1%. The agreement between ultrasound and hysteroscopic/histopathological findings was 72%. The secondary goal of making the description of the uterine cavity easier was not fulfilled. The prediction percentages for the criteria were low. The incidence of pathological findings in ultrasound findings labelled as anechogenic was 4.8%, suggesting a high negative predictive value. CONCLUSION: In spite of the better resolution of new ultrasound devices, their predictive value remains limited. Findings that are suspicious in ultrasound should be confirmed by hysteroscopy with biopsy.
- Klíčová slova
- comparison, histology, hysteroscopy, ultrasound,
- MeSH
- biopsie MeSH
- časná detekce nádoru MeSH
- dospělí MeSH
- endometrium diagnostické zobrazování patologie MeSH
- hysteroskopie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nádory dělohy diagnostické zobrazování patologie MeSH
- nádory endometria diagnostické zobrazování patologie MeSH
- postmenopauza MeSH
- premenopauza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- srovnávací studie MeSH
OBJECTIVE: To evaluate the reliability of vaginal sonography and hysteroscopy based on the histopathologic finding in menopausal women. To compare the findings in a group of asymptomatic women with the findings in patients with a clinical symptomatology of endometrial disease. DESIGN: A retrospective study. SETTING: Department of Obstetrics and Gynecology, University Hospital, Olomouc. METHODS: Diagnostic hysteroscopy with targeted biopsy was performed in 186 menopausal women who were referred to our department either on the basis of clinical symptoms or only on the basis of a suspected ultrasound finding. The ultrasound and hysteroscopic findings were compared with the final histopathologic diagnosis and their reliability was evaluated. The findings were evaluated separately for asymptomatic and symptomatic patients. RESULTS: In all asymptomatic and in 88% symptomatic patients vaginal sonography showed endometrial thickness higher than 5 mm. In 10 patients (14%) sonographic finding suggested possibility of a malignant process. The most frequent finding at hysteroscopy was endometrial polyp, which was found in more than a half of asymptomatic women. In two patients (5%) hysteroscopic findings were suspected for malignancy. Histopathologic examination confirmed malignant tumour in 6 patients (7%). Accordance with the histopathologic finding was more often seen in hysteroscopy than in vaginal sonography. CONCLUSION: The main advantage of vaginal sonography in menopausal women is a relatively easy detection of suspicious findings on the endometrium, especially in asymptomatic patients. Hysteroscopy, on the contrary, enables to visualize the endometrial cavity and mainly the targeted biopsy. Even if the number of malignant endometrial diseases is not high (6% in asymptomatic patients) the combination of vaginal sonography and hysteroscopy is optimal for the detection of pathological findings on the endometrium.
OBJECTIVE: The verification of the predicive part of the vaginal ultrasonography in diagnostics of cancer of endometrium with the help of comparison of vaginal sonography finding (through the mediation EMI--endometrium/myometrium index) with relevant histological results. DESIGN: Clinical prospective study. SETTING: Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk University and Faculty Hospital, Brno. METHODS: In this work we included 200 patients--on one hand the patients with the symptoms (pre- and perimenopauzal irregular bleeding and postmenopauzal bleeding), on the other hand the patients without symptoms, but with the suspicious ultrasonography find (suspicious or positive EMI). Each of the patients included in this study underwent the ultrasonography examination witch determined EMI and then the endometrial biopsy or the diagnostic hysteroscopy with sampling the material. The determined value EMI was compared with the histological result. RESULTS: On the basis of the results of this work we found out the possibility utilization of the vaginal ultrasonography as the prebioptic method in diagnostics cancer of endometrium through the mediation of determined EMI. The sensitivity of the method, however, is lowered by the next diseases of uterus (especially uterine myoma) that cause wrong negativity of EMI with connection with increased thickness of uterus in the region body of uterus. CONCLUSION: We can expect a high sensitivity of EMI in patients with diseases of endometrium, if there is by ultrasonography examination verified uterus with smooth border without uterine myoma. This examination acquires a special significance as the pre-bioptic and along with the preventive method the timely catch first of all in patients without symptoms, but with one or more risk factors for rise to cancer of endometrium.
- MeSH
- dospělí MeSH
- endometrium diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- myometrium diagnostické zobrazování MeSH
- nádory dělohy diagnostické zobrazování MeSH
- nádory endometria diagnostické zobrazování MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To compare the changes of sonographic features of endometrium throughout natural and artificial cycles in which oral estrogen-progesterone substitution were used in the same group of patients and discuss their clinical significance. DESIGN: A prospective study. SETTING: Dept. of Obstetrics and Gynaecology, University Hospital, Olomouc. METHODS: In 24 women with regular menstrual cycle ovulation was detected (LH, sonography) and the following sonographic features: endometrial thickness, echogenity and pulsatility index (PI) of uterine artery were evaluated in the late proliferative, early and mid secretory phase. The same sonographic examination was performed in the artificial cycle with oral estrogen-progesterone substitution used for endometrial preparation for transfer of cryopreserved-thawed embryos. RESULTS: In the late proliferative phase of the natural cycle the thickness of endometrium was higher than in the arteficial cycle (p=0.05). Triple-line echogenity prevailed in both cycles. The PI in natural cycle was lower (p=0.01) on the side of the growing Graafian follicle compared to the other side and lower (p=0.05) than in the artificial cycle. In the secretory phase there were no differences in endometrial thickness within cycles. Homogenous hyperechoic endometrium prevailed in both cycles and the lowest PI was found on the 7th day both after ovulation and after initiation of progesterone substitution. CONCLUSION: Progesterone addition after endometrial preparation with estrogen should be instituted when the endometrium thickness reached at least 9mm and isoechoic or triple line echogenity is found.
- MeSH
- aplikace orální MeSH
- dospělí MeSH
- endometrium diagnostické zobrazování účinky léků MeSH
- estradiol aplikace a dávkování analogy a deriváty MeSH
- fertilizace in vitro MeSH
- konjugované estrogeny (USP) aplikace a dávkování MeSH
- kryoprezervace * MeSH
- lidé MeSH
- menstruační cyklus MeSH
- přenos embrya * MeSH
- progesteron aplikace a dávkování MeSH
- pulzatilní průtok MeSH
- těhotenství MeSH
- ultrasonografie dopplerovská MeSH
- uterus krevní zásobení MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- estradiol MeSH
- konjugované estrogeny (USP) MeSH
- progesteron MeSH
OBJECTIVE: One of the most important factors contributing to developing of the breast cancer is a female organism exposure to estrogens. Thickness and structure of endometrium in postmenopausal women is a sign of the hormonal status. The goal of the study was to investigate whether there is a difference in the endometrial thickness and quality in postmenopausal women with breast cancer. DESIGN: Prospective cohort study. SETTING: Ultrasound Unit, 2nd Department of Obstetrics and Gynecology, Medical School and Medical Teaching Hospital of L. Pasteur, Kosice, Slovakia. MATERIAL AND METHODS: Endometrial thickness was measured by transvaginal ultrasonography in 21 patients with histologically verified breast cancer and was compared with a group of 26 well women. We assessed the thickness of endometrium, the size of uterus and the endometrium/myometrium index. RESULTS: Despite the fact there existed a difference between these two groups (the average thickness of 3.6 mm and 2.9 mm), the result was not statistically applicable to show a correlation with a benign or malignant breast tissue. CONCLUSION: The results may support the theory of breast cancerogenesis in correlation with estrogen influence or increased incidence of estrogen receptors, respectively. As definitive statistical result can not be stated due to a limited group of patients, more investigation might be necessary in the future. The study dealing with a similar problem was not found in available publications.
- MeSH
- endometrium diagnostické zobrazování patologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prsu patologie MeSH
- postmenopauza * MeSH
- prospektivní studie MeSH
- ultrasonografie MeSH
- uterus diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- děložní krvácení diagnóza diagnostické zobrazování etiologie MeSH
- dilatace a kyretáž * MeSH
- dospělí MeSH
- endometrium diagnostické zobrazování patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- dospělí MeSH
- endometrium diagnostické zobrazování MeSH
- leiomyom diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory dělohy diagnostické zobrazování MeSH
- polypy diagnostické zobrazování MeSH
- senioři MeSH
- ultrasonografie MeSH
- uterus diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Ultrasound examination of endometrium thickness and texture (triple-line, homogenous, hyperechogenic) did not help us to predict the implantation after embryo transfer. However, in patients stimulated with GnRH analogues and hMG the endometrium was significantly higher than in patients stimulated with clomiphene citrate and hMG. Triple-line endometrium was more common in women stimulated with GnRH analogues and hMG than in those stimulated with clomiphene citrate and hMG.
- MeSH
- endometrium cytologie diagnostické zobrazování účinky léků MeSH
- fertilizace in vitro * MeSH
- hormon uvolňující gonadotropiny agonisté MeSH
- implantace embrya * MeSH
- klomifen farmakologie MeSH
- lidé MeSH
- menotropiny farmakologie MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- hormon uvolňující gonadotropiny MeSH
- klomifen MeSH
- menotropiny MeSH
