Expression level of nuclear steroid hormone receptors in endometrium influence on female reproductive function

Abstract

Background. In recent years, rate of hyperplastic processes of reproductive system that relate to the common genital pathology in women of all age groups increased and ranges from 17 to 59% of all gynecological pathology. Recent studies have shown that the functional state of the endometrium is determined by the number of endometrial tissue receptors to corresponding steroid hormones.

Objective. To explore the state of steroid hormones receptors in endometrial hyperplasia in compare with ultrasound, hysteroscopy and histological and hormonal background data research to improve diagnosis and recovery endometrium state.

Methods: medical history analysis, clinical laboratory analysis, ultrasound diagnostics, hysteroscopy, histological methods. Hormones levels (FSH, LH, prolactin, estradiol, free testosterone), and expression of estrogen and progesterone receptors in the stroma and glands was evaluated by Histochemical score.

Results. 50 women of 23–52 years with hyperplasia of endometrim, were divided into 3 randomized groups: I – 20 women with primary infertility, II – 13 women with secondary infertility, III – 17 women without infertility. Early sexual activity was almost twice as often observed in the first two groups of women (respectively 61.54%, 60.00%) against 29.41% in the third group. Gynecological history was weighed almost all three groups of women with chronic bilateral salpingoophoritis, obesity (I gr. – 85%, II in December. – 76.92%, III gr. – 76.47%). Uterine leiomyoma found in every second woman III gr. – 9 (52.94%, p <0.05), 3 women (15%). At primary infertility there was US endometrial hyperplasia in every from four women, endometrial thickness less than the corresponding day of the cycle, which may indicate a lack of estrogen effect on the endometrium. In secondary infertility hyperplasia was detected in 14.29% of cases, in the third group – 7.14%. Estrogen (more) and progesterone (less) receptors level inhibition on the background of the hypoestrogenemia, hyperprolactinemia, hyperandrogenemia were detected.

Conclusions

1. Risk factors for endometrial hyperplasia were: early sexual life, chronic salpingoophoritis, uterine leiomyoma.
2. Estrogen and progesterone receptor inhibition were detected on the background of the hypoestrogenemia, hyperprolactinemia, hyperandrogenemia in patients with endometrial hyperplasia.