Abstract
Objective : To study endometrial estrogen and progesterone immunoexpression in different phases of menstrual cycle, in cases of dysfunctional uterine bleeding and infertility. A comparative analysis was also done for calculating ER & PR expression, between two methods: quick score and percentage of immunopositive cells. Methods : Endometrial biopsies from 107 clinically diagnosed DUB cases and 23 infertile patients were included in the study. Tissue sections were analyzed for different phases of menstrual cycle and immunoexpression of ER & PR receptors was calculated in glandular epithelium and stromal cells, using percentage of positively stained cells and Quick score method. Endometrial sections of hysterectomy specimens of uterovaginal prolapse cases were used as control sections. Result : In the present analysis, secretory endometrium was the commonest finding histopathologically. Mean total ER & PR expression in cases of DUB was statistically higher in the proliferative phase using both methods (p<0.05). Mean total ER expression difference in both the phases of infertility cases was not statistically significant by the observation of percentage of positively stained cells. However, quick score revealed significant difference between both receptor expression in infertile patients. Conclusion: The percentage of positive cells for ER and PR expression plays a more determinant role in studying ER and PR expression in cases of DUB and infertility as compared to quick score. DOI: 10.21276/APALM.1374
Highlights
Infertility and dysfunctional uterine bleeding (DUB) together form the most common presenting complaint in obstetrics and gynaecology OPDs
60% of control cases were in proliferative phase and 40% were in secretory phase
Our study suggests that mean Quick score for estrogen receptor (ER) expression in glandular, stromal and in total was higher in proliferative phase in infertility cases while the mean total progesterone receptor (PR) expression Quick score was higher in the secretory phase
Summary
Infertility and dysfunctional uterine bleeding (DUB) together form the most common presenting complaint in obstetrics and gynaecology OPDs. Infertility is more of a social problem, whereas DUB is one of the most bothering complaints for any female, both mentally and physically. A common point, shared by these two conditions is that their prompt diagnosis and timely treatment can significantly raise the living standards of the patient. Dysfunctional uterine bleeding is defined as bleeding not associated with an organic cause in women of child bearing age.[1] Anovulatory cycles play an aetiological role in about 90% of cases of DUB. Infertility is termed when a couple fails to achieve pregnancy after 1 year of unprotected and regular intercourse.[2] Changing lifestyle of people has gradually increased the incidence of infertility
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