Endometrial receptive status in patients of reproductive age with diffuse and focal adenomyosis

Abstract

Introduction Endometriosis ranks second place in the structure of infertility. The development of endometrial dysfunction is one of the infertility factors, which affects the degree of decrease in the receptive abilities of endometrium and subsequent implantation.Purpose of the study was to reveal morpho-functional state of receptivity and nidation ability of endometrium in patients of reproductive age with diffuse and nodal forms of adenomyosis.Materials and methods The study included 104 patients, which were divided into 2 groups. The first group consisted of 30 patients with a diffuse form of adenomyosis, second group included 30 patients with a nodal form. The patients underwent aspiration biopsy of endometrium in the middle secretory phase. The level of ER and PR expression in the glandular and stromal compartments of endometrium was assessed, the percentage and degree of maturity of pinopodes were determined.Results The analysis of ER and PR number in the stromal and glandular components of endometrium in patients with diffuse adenomyosis revealed an increase in the secretion of ER in the glandular cells in contrast to patients of the comparison group. Significant differences in the expression of ER and PR in glandular cells were verified among observed with the nodal form of adenomyosis. The immunohistochemical reaction with antibodies to ER and PR in the nodal form of adenomyosis was significantly higher than in diffuse form. Both in the first and second groups, a decrease in the formation ability of pinopodes on the superficial epithelium was noted.Discussion Adenomyosis leads to damage of the morpho-functional state and receptive abilities of the endometrium. In the nodal form the degree of detected disorders was significantly higher.Conclusion The nodal form of adenomyosis is more common in patients of younger reproductive age and is associated with a higher prevalence of endometrial dysfunction. This is especially important for the selection of adequate modern therapy in order to maintain and improve reproductive function.