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Endometrial morphometry in users of intrauterine contraceptive devices and women with ovulatory dysfunctional uterine bleeding: a comparison with normal endometrium.

Abstract：

:Copper-bearing intrauterine contraceptive devices (IUCD) are commonly associated with menorrhagia. They cause certain morphological changes in the endometrium. These have been extensively reported and the mechanisms of menorrhagia have been investigated in a number of studies. By contrast, ovulatory dysfunctional uterine bleeding has not been as widely studied and mechanisms of menorrhagia in these patients are still not well understood. In this study, we examined endometrial morphometry in a group of women using IUCD, a group of women with ovulatory dysfunctional bleeding, and a control group of women with entirely normal cycles. There was increased leukocytic infiltration of the endometrium in both groups of women with menorrhagia compared to control cases. In addition, IUCD use was associated with greater luteal phase glandular epithelial height, supporting the concept of a secretory function defect in glandular epithelium. Possible links are postulated between static morphometric observations and dynamic biochemical changes. :Researchers conducted endometrial morphometry on 23 women suffering from menorrhagia and ovulatory dysfunctional uterine bleeding, 23 users of a copper releasing IUD, and 45 healthy women (controls) to compare their endometrial histology. Cases and controls were patients at Royal Prince Alfred and King George V Hospitals in Sydney, Australia. The endometria of IUD users had many more plasma cells than normal endometria (median, 0.3/1000 stromal cells vs. 0; p 0.05). 12 biopsies from IUD-exposed endometria had no plasma cells at all. Almost all of the remaining biopsies had less than 2/1000 stromal cells. Endometrial gland epithelial height in IUD-exposed users was much greater than that in normal users (26.9 vs. 20.3 mcm; p 0.01). The difference was exclusively due to a change in the secretory phase (29.4 vs. 20.3 mcm; p 0.01), suggesting that there was a secretory function defect in glandular epithelium. All other parameters were not significantly different between IUD users and normal subjects. Women who suffered from menorrhagia and ovulatory dysfunctional bleeding had many more infiltrating leukocytes in their endometrium than those with a normal endometrium (41.1/1000 vs. 30.1/1000; p 0.05). These leukocytes tended to be lymphocytes. All other parameters were not significantly different between menorrhagia sufferers with ovulatory dysfunctional bleeding and normal subjects. Endometrial morphometry of dysfunctional bleeders and of IUD users was not significantly different. These findings suggest that IUD use and ovulatory dysfunctional bleeding may be associated with static morphometric observations and dynamic biochemical changes.

journal_name

Contraception

journal_title

Contraception

authors

Wang IY,Russell P,Fraser IS

doi

10.1016/0010-7824(95)00040-h

subject

Has Abstract

pub_date

1995-04-01 00:00:00

pages

243-8

issue

eissn

0010-7824

issn

1879-0518

pii

001078249500040H

journal_volume

pub_type

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Endometrial morphometry in users of intrauterine contraceptive devices and women with ovulatory dysfunctional uterine bleeding: a comparison with normal endometrium.