Abstract
Objective: To investigate morphological changes in the endometrial epithelial cells of patients with infertility problems. Materials and methods: Endometrial biopsies were obtained from 10 women who have undergone several unsuccessful in vitro fertilisation (IVF) procedures. Endometrial biopsies were performed between luteinizing hormone surge days LH+6 to +10 of the natural menstrual cycle. Each sample was divided into three parts, which were processed for histological, transmission (TEM), and scanning electron microscopy (SEM) investigations. Results: Histological investigations demonstrated significant alterations in the apical part of epithelial cells of one patient; in four patients, the gland maturity was low, not matching the cycle day, and thus a phase lag had developed. By TEM examination, we ascertained changes in secretory and ciliated cells in three patients (decreased amount or missing microvilli, irregular cilia in ciliated cells). SEM examination found pinopodes in five patients: three samples contained fully developed pinopodes—larger and completely smooth, with only some wrinkles; one sample contained regressing small pinopodes, with wrinkled surfaces; and one sample had both developed and regressing pinopodes. Conclusions: To conclude, our study shows that the endometrium of patients with poor IVF outcome has either significant changes in the morphology or the endometrial maturation is inhibited and a phase lag often develops. Our study shows that endometrial pinopodes are found throughout the mid-luteal phase up to day LH+10.
Highlights
IntroductionEurope is the continent with the lowest fertility [1], and infertility is a common medical problem present in about 10% of couples of reproductive age in most European countries
Infertility is a condition that affects a couple and is defined as the lack of conception after an arbitrary period of 12 months with regular sexual intercourse and without using any contraception.Europe is the continent with the lowest fertility [1], and infertility is a common medical problem present in about 10% of couples of reproductive age in most European countries
About 70% of the cases of infertility in couples have been caused by the female factor, 25% by the male factor, and in 5% of the couples, infertility problems are seen in both partners [3]
Summary
Europe is the continent with the lowest fertility [1], and infertility is a common medical problem present in about 10% of couples of reproductive age in most European countries. Merely every second infertile couple seeks medical advice [2]. Both the female’s and male’s medical problems may lead to a couple’s infertility. In about 80% of cases, the medical cause for infertility can be identified, and in about 20% of couples, the reason for infertility remains unexplained [3]. About 70% of the cases of infertility in couples have been caused by the female factor, 25% by the male factor, and in 5% of the couples, infertility problems are seen in both partners [3]. Female infertility is mainly caused by tubal factor infertility, impaired endometrial function, and endocrine dysfunctions
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