Features of the implantation capacity of the endometrium after conservative myomectomy

Abstract

DOI: 10.52705/2788-6190-2024-04.1-14
УДК: 618.14/.15 -007.42 – 079.4 -085.361:[615.385:611- 018.52:547.99]

Determination of the level of estrogen and progesterone receptor expression in the endometrial tissue during the implantation window in women with a history of conservative myomectomy is an urgent medical problem of our time.
The objective: to determine the level of expression of estrogen and progesterone receptors in the endometrial tissue and to find out their relationship with the presence of PTSD in women of reproductive age with recurrent uterine leiomyoma.
Materials and methods. Group I (main) – 108 patients with myectomy of submucosal uterine leiomyoma according to the developed method and PTSD. Group II (comparison) – 102 patients with myectomy of submucous leiomyoma of the uterus by the traditional method with PTSD. Group III (control) -– 30 patients with PTSD without a diagnosis of leiomyoma in the history, planning a pregnancy (with a successful pregnancy in the history, which ended in childbirth). To detect estrogen and progesterone receptors in the endometrium, an immunohistochemical method was used using the En Vision imaging system with diaminobenzidine.
Results. It was found that the level of ER expression increases in leiomyoma recurrence after CME with concomitant diagnosis of PTSD. Along with an increase in the level of ER expression in endometrial cells, the expression of PR decreases. It was found that the amount of PR in the main group decreases by 38.3% in endometrial hyperplasia without atypia, by 46.3% in atypical endometrial hyperplasia and by 20.4% in endometrial polyps compared to the control group of women. The analysis of the results shows a relationship between the form of hyperplasia and the receptor phenotype of the endometrium in leiomyoma recurrence after CME and PTSD. It was found that the greatest changes are observed in the main group. The correlation between PTSD and estrogen and progesterone receptor expression in women with reproductive plans and recurrent matuca leiomyoma was shown.
Conclusions. Increased expression of estrogen receptors and decreased expression of progesterone receptors in women with reproductive plans and recurrent uterine leiomyoma and PTSD leads to impaired endometrial implantation capacity and, as a result, to failure to become pregnant or to terminate it at a short term.