子宫内膜异位症并发不孕患者子宫内膜超微结构观察

Observations on endometrial ultrastructure of infertile women with mild endometriosis

目的 探讨子宫内膜异位症 (EM )并发不孕患者围着床期子宫内膜的超微结构。方法 选择轻度子宫内膜异位症并不孕患者 10例为研究组 ,已生育妇女 7例作为对照组 ,选择在月经周期第 19～ 2 2天刮取少量子宫内膜 ,进行扫描及透射电镜观察。结果 异位症患者围着床期子宫内膜出现超微结构改变 ,内膜表面腺体开口数少 ,纤毛再生不全 ,分泌细胞表面微绒毛极少 ,子宫内膜着床窗的形态学标记 细胞表面胞饮小泡减少或缺失 ;胞质肿胀疏松 ,有的细胞出现核固缩。结论 异位症患者围着床期在位子宫内膜出现超微结构改变 ,细胞出现轻度变性 。

Objective To investigate the ultrastructure of peri impantation endometrium in infertile women with endometriosis. Methods Ten cases infertile women with mild endometriosis were taken as study group and 7 fertile women as control group. All specimens obtained by endometrial biopsy performed in the peri implantation phase (19～22th day of menstrual cycle) were examined with scanning and transmission electron microscopy. Results Ultrastructural defects in peri implantation endometrium of infertile women with endometriosis were found, namely: a reduced number of glandular ostia, irregular non ciliated cells with rare microvilli, incomplete ciliogenesis on ciliated cells, reduced or non existent specific markers of the implantation window of the endometrium (pinopodes). Swelling and pyknosis in cytoplasm and karyopyknosis in some cells were found. Conclusion Existence of ultrastructural detects in peri implantation endometrium of women with endometriosis and cell degeneration may be a factor resulting in endometriosis associated infertility.