Endometrial Blood Research Articles

Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1–3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B (P 0.05). Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.

Localization and correlation between NADPH-diaphorase and nitric oxide synthase isoforms in the porcine uterus during the estrous cycle

Nitric oxide (NO), a highly reactive free radical is involved in vasodilation, neurotransmission, hormone secretion, and reproduction. Since all known nitric oxide synthase (NOS) isoforms possess NADPH-diaphorase (NADPH-d) activity, NADPH-d histochemistry was used as a commonly accepted procedure for NOS identification. The aim of our study was to determine the cellular localization of NADPH-d, eNOS, and iNOS in the porcine uterus and the correlation between NADPH-d and NOS activity in the early, middle, late luteal, and follicular phase of the estrous cycle. Light-microscopic observations of the sections revealed the differential expression of the NADPH-d in the analyzed stages of the estrous cycle. The most intense staining was observed in the luminal epithelium in the late luteal phase and in some groups of the endometrial glands in all studied stages. Positive reaction was also found in the endothelial cells of blood vessels and in the myometrium itself. Immunostaining for eNOS was observed in the luminal and glandular epithelium in all studied stages, but no clear fluctuations were observed. The endothelium of both endometrial and myometrial blood vessels displayed pronounced eNOS immunostaining. Strong iNOS staining was observed in the luminal epithelium in the late luteal and follicular phase and in selected groups of endometrial glands. Thus, only NADPH-d and iNOS undergo cyclic changes in the studied stages of the estrous cycle. The differential expression of NADPH-d/NOS in the porcine uterine horn during the estrous cycle suggests a role for NO in modulating uterine function.

Chemoprevention in the 21st Century: Is a Balance Best or Should Women Have No Estrogen at All?

Twenty years ago, chemoprevention for cancer was a strategy conceived and proven in the laboratory and poised for clinical testing. Today, a selection of agents is now emerging that can reduce breast cancer risk so that remarkably, women will soon have choices in their health care needs. In this issue, I have invited Carol Fabian and Jack Cuzick to present overviews of progress in breast cancer risk reduction. Both individuals have been involved with the evolution of our concepts about hormones and cancer for the past 25 years, so they are well qualified to review their disciplines. This is an important time in health care delivery as there is a requirement not only for effective treatment of disease but also for an expectation of disease prevention (or deferment). Although there has been considerable progress in clinical chemoprevention, there are enormous challenges for the future. Whether these challenges can be resolved will ultimately decide the availability of the menu of medicines for women at risk. I strongly believe that there will be no single answer to chemoprevention in breast cancer. The reason for this statement is illustrated by the fact that two schools of thought have emerged. One choice is to use selective estrogen receptor modulators (SERMs) to prevent multiple diseases in women and the other is to use the aromatase inhibitors to reduce the risk of breast cancer by removing all estrogen. The goal with SERMs is to strike a balance for the patient. The idea that a medicine could be designed to reduce the risk of breast cancer in postmenopausal populations that are being treated for osteoporosis is now a reality. Raloxifene is available to treat and prevent osteoporosis with breast and endometrial safety. Nevertheless, the current scientific challenge with SERMs is to create a new targeted agent. In contrast, the strategy to remove all estrogen will provide optimal prevention of estrogen receptor–positive breast cancer and probably reduced risk of endometrial cancer and blood clots compared with tamoxifen. There is no doubt, based on current clinical experience with aromatase inhibitors, that this is possible. Nevertheless, the application of aromatase inhibitors in healthy women must be balanced against the potential to degrade other estrogen-dependant systems. The key role of estrogen in maintaining bone density is well recognized and can be addressed with prophylactic bisphosphonates, but the role of estrogen in maintaining neural integrity in the CNS may (or may not) accelerate dementia. Further progress in chemoprevention will be dependant upon recognizing the current shortcomings of both approaches. Chemoprevention must be advanced by the critical identification of select populations who really need the medication. We are currently embracing a targeted approach to breast cancer treatment, so why should high-risk populations of women accept anything less from chemoprevention? Regrettably, the two approaches to the chemoprevention of breast cancer have diverged, as there is a current reluctance to compare and contrast the SERM approach of ‘‘is a balance best’’ with the aromatase inhibitor approach of ‘‘no estrogen at all.’’ This may not be a bad thing, since the current SERMs, tamoxifen and raloxifene, are reinventions of older medicines, so the best of a new generation of SERMS needs to be pitted against the best aromatase inhibitor. Unfortunately, the genesis of drug development mandates that this process will take a couple of decades to achieve success. Indeed, the aromatase inhibitors have been used for three decades but only now are we VOLUME 23 d NUMBER 8 d MARCH 1

Effect of Soy-Derived Isoflavones on Hot Flashes, Endometrial Thickness, and the Pulsatility Index of the Uterine and Cerebral Arteries

Females in Asian countries seem to have fewer and milder menopausal symptoms than those in Western countries. Dietary differences could be responsible. The traditional Asian diet is rich in substances of vegetable origin that resemble estrogen structurally. Soy, a dietary staple, is a source of isoflavones, including genistine and daidzine, the metabolic products of which appear to have weak estrogenic as well as antiestrogen activity. This randomized, double-blind, placebo-controlled trial examined the effects of soy-derived isoflavones in 62 postmenopausal women 45 to 60 years of age who were in good general health. Actively treated women received two 1-g tablets daily containing a total of 72 mg of soy-derived isoflavones and were followed up along with placebo recipients for 6 months. Endometrial thickness was measured by ultrasound, and Doppler studies were done of blood flow in the uterine, internal carotid, and middle cerebral arteries on either side. The number of daily hot flushes decreased significantly by approximately 40% in both groups after 30 days and did not change appreciably after that time. There were no significant between-group differences or variations over time for the pulsatility index (PI) in the uterine arteries or for endometrial thickness. None of the participants had uterine bleeding during 6 months of follow up. In addition, there were no differences in the PI of the internal carotid or middle cerebral arteries. Soy-derived isoflavones had no apparent advantage over placebo in reducing hot flushes in postmenopausal women in this randomized 6-month trial. There were no substantial differences in endometrial thickness or blood flow in the uterine, internal carotid, or middle cerebral arteries between the actively treated and placebo groups.

P379: Application of multivariate logistic regression for the sonographic prediction of endometrial cancer: the use of three-dimensional endometrial volume and 3D blood flow indices assessment

P379: Application of multivariate logistic regression for the sonographic prediction of endometrial cancer: the use of three-dimensional endometrial volume and 3D blood flow indices assessment

Endometrial thickness, volume and blood flow for the diagnosis of endometrial carcinoma

Endometrial thickness, volume and blood flow for the diagnosis of endometrial carcinoma

The Effect of HRT on Endometrial Thickness (ET) and Uterine Arterial Blood Flow Assessed by Transvaginal Ultrasound (TVU).

The Effect of HRT on Endometrial Thickness (ET) and Uterine Arterial Blood Flow Assessed by Transvaginal Ultrasound (TVU).

Capillary Blood Flow in the Endometrium and Myometrium of Conscious Sheep: Effect of Catheterization of Uterine Arteries

Measures of capillary blood flow in the uterine tissues of conscious ewes were obtained by the use of microspheres. Total uterine capillary blood flow was significantly greater (P less than 0.01) at oestrus than at day 8 of the oestrous cycle [69.5 +/- (s.e.m.) 11.9, cf. 15.3 +/- 1.2 ml min-1, n = 7], reflecting increases of a similar order in both the endometrium and the myometrium. At these stages of the oestrous cycle, endometrial capillary blood flow constituted 83.6 and 80.5%, respectively, of the total uterine capillary flow. Following the placement of indwelling catheters in each middle uterine artery there was a decrease in the ratio of endometrial to myometrial capillary blood flow for 3-5 days.

Note on the associations between blood groups of the ABO system and neoplasms of the endometrium

The authors consider the distribution of the phenotypes of ABO system in a group of 115 patients with histologically diagnosed endometrial adenocarcinoma and in a random semple of the population. The above group is combined with a larger one taken from the literature in the search for phenotypical correlations. Women of blood group A show a greater susceptibility to this form of cancer than O group women.