Abstract
Context: Cyclic changes of endometrial arteries are well established but possible cyclic changes of lymphatic and venous vessels have not been fully documented. There are no published morphological reports to support cyclic changes of endometrial lymphatic and venous vessels. Objective: Using cryosections of human endometrium, this study aimed to unveil possible cyclic changes of lymphatic and venous vessels. We previously reported cyclic changes of lymphatic vessels in human endometrium using D2-40. Design: A total of 16 cases representing menstrual, proliferative and mid and late secretary phase were studied. For Immunocytochemical staining, lymphatic vessel endothelial hyaluronan receptor 1 and von Willebr and factor were used for lymphatic and venous vessels, respectively. We used polyclonal LYVE-1 in this study, which revealed more lymphatic vessels than using D2-40. Results: Residual lymphatic and venous vessels were present in menstrual basalis. In Day 5 - 9 endometrium, there were sparse lymphatic vessels but were numerous growing venous vessels in thin proliferating functionalis. In Day 14 - 22 endometrium, there were scattered lymphatic vessels and numerous venous vessels in functionalis. In Day 25 - 26 endometrium, there were many dilated lymphatic vessels and numerous dilated, disintegrating venous vessels in upper functionalis than lower functionalis. Conclusion: The above findings support that lymphatic vessels are sparse but venous vessels are numerous in early proliferative functionalis. Lymphatic vessels grow from basalis to thin functionalis. In premenstrual phase, lymphatic vessels proliferate from lower to upper functionalis, and both lymphatic and venous vessels disintegrate for shedding by this immunocytochemical study using lymphatic and venous markers. Thus, all lymphatic, venous and arterial vessels undergo menstrual cyclic changes and shed for menstruation.
Highlights
The cyclic changes of endometrial arteries have been well established but similar changes of venous and lymphatic vessels have not been documented [1]-[3]
[7] but more investigators agree that some lymphatic vessels are present in human endometrium: one group reported that lymphatic vessels were present in functionalis in 62% of the samples [8], and another group reported that endometrial lymphatic vessels were observed in basalis alone using a lymphatic vessel immunocytochemical marker [9]
A collapse of the arterial and glandular systems predominates in the functionalis whereas both arteries and endometrial glands are thought to remain unchanged in the basalis throughout the menstrual cycle [2]
Summary
The cyclic changes of endometrial arteries have been well established but similar changes of venous and lymphatic vessels have not been documented [1]-[3]. [7] but more investigators agree that some lymphatic vessels are present in human endometrium: one group reported that lymphatic vessels were present in functionalis in 62% of the samples [8], and another group reported that endometrial lymphatic vessels were observed in basalis alone using a lymphatic vessel immunocytochemical marker [9]. Morphogenesis of lymphatic and venous vessels is associated with endometrial arteries, and lymphatic and venous vessels may be closely coordinated with cyclic changes of spiral arteries of the functionalis. This coordinating morphogenesis is the main objective of this study
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