Clinical and morphological features of the endometrium in infertility in women referred for IVF

I n t r o d u c t i o n . Infertility in women is being a difficult social and medical problem for resolving, especially in the case of a chronic endometritis diagnosis with a variant of so called “thin” endometrium.

A i m . To study the clinical and morphological features of the endometrium in infertility in women referred for in vitro fertilization (IVF).

Ma t e r i a l s a n d m e t h o d s . The clinical data and results of immunohistochemical examination of the endometrium were studied in 181 women aged 30 [22; 38] years who were referred for IVF and gave birth. The causes of reproductive dysfunction were thin endometrium (group 1, 64 patients), fallopian tube obstruction (group 2, 55 women) and male factor infertility (group 3, 62 cases). The examination of patients included ultrasound imaging. In Pipelle biopsies of the endometrium before the IVF procedure, the number of pinopodia in the epithelium was assessed, the expression of HLA-DR and estrogen and progesterone receptors (ERs and PRs, respectively) was measured using immunohistochemistry. Nonparametric statistical tests were used.

R e s u l t s . In women with infertility referred for IVF, a low percentage of endometrial pinopodia in the epithelium was detected in the secretory phase of the cycle. The lowest expression rates of HLA-DR, ERs and PRs were found in the endometrium of patients with tubal obstruction. At the same time, patients with thin endometrium had relatively high expression rates of ERs and PRs in the epithelium. The expression of ERs and PRs in endometrial stromal cells did not have statistically significant differences in pairwise comparisons.

Сo n c l u s i o n . In patients with thin endometrium, the formation of pinopodia has a high diagnostic significance for the receptive status confirmed by the ERA test, and does not depend on the PRs expression in the epithelium and stroma

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