Pathogenesis of Implantation Incompetence of Endometrium in Endometriosis-Associated Infertility

Study Objective: To expand the idea of the pathogenesis of implantation incompetence of endometrium in women with endometriosis-associated infertility. Study Design: open perspective comparative study. Materials and Methods. The study enrolled 78 women. The study group included 32 patients with endometriosis genitalis externa (EGE) and infertility; the comparison group included 33 patients with EGE who used their reproductive function not more than 3 years before the study and who were not diagnosed with infertility; the group of morphological control made 13 fertile women without EGE. The subject of the study was endometrium biopsy material obtained on day 5–7 of menstruation, following the peak blood concentration of luteinizing hormone during the expected implantation window. Study Results. When patients with endometriosis-associated infertility were compared to fertile women with EGE, we noted increased expression of GATA2 — 1.6-fold, GATA6 — 1.7-fold, SF-1 — 1.5-fold and reduced HOXA10 expression by 2.9 times (p < 0.05 in all cases) in stroma of infertile women. When patients with endometriosis-associated infertility were compared to fertile women without EGE, we recorded statistically significant (р < 0.05) increase in expression of GATA2 in stroma (2.5-fold) and glands (2.2-fold), GATA6 and SF-1 in stroma (2-fold in both cases), and reduced HOXA10 expression both in stroma (3.6-fold) and glands (2.8-fold). Conclusion. Pathogenesis of implantation incompetence of endometrium in endometriosis-associated infertility is caused by impaired endometrium receptivity because of aberrant expression of transcription factor affecting local hormonal balance. Keywords: endometriosis-associated infertility, implantation incompetence of endometrium

Frequency of the Causes of Postmenopausal Bleeding, Results of a Tertiary Referral Center in Turkey

<p><strong>OBJECTIVE:</strong> In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.</p><p><strong>STUDY DESIGN:</strong> For the purpose, a total number of 200 women with postmenopausal bleeding were included in the study. Medical records regarding history, physical examination, and endometrium biopsy of these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.</p><p><strong>RESULTS:</strong> Most frequent histopathologic diagnosis of the women with postmenopausal bleeding were established as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies, our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.</p><p><strong>CONCLUSION:</strong> Although endometrial atrophy is the most frequent cause, postmenopausal bleeding should promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlying cause. We found that premalignant and malignant lesions were related to the patients’ BMI (body mass index), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.</p>

Laser polarization-variable autofluorescence of the network of optically anisotropic biological tissues: Diagnostics and differentiation of early stages of cancer ofcervix uteri

This research presents the results of investigation of laser polarization fluorescence of biological layers (histological sections, cytological smears) in the task of diagnostics and differentiation of early stages of cancer: Dysplasia — cervical microinvasive carcinoma of cervix uteri. The analytical conditions of polarization-optimal probing of biological layers were determined basing on the model of linear birefringence and dichroism of birefringent (fibrillar, porphyrin) networks. The technique of polarization-variable laser autofluorescence was developed and experimentally tested. The objective criteria (statistical moments) of differentiation of histological sections autofluorescent images of endometrium biopsy and cytological smears of it mucous coat were defined. The operational characteristics (sensitivity, specificity, accuracy) of this technique were determined concerning the positions of probative medicine, and clinical efficiency.