Uterine Biopsies Research Articles

Is platelet-rich plasma effective in treating uterine inflammation in jennies inseminated with cryopreserved donkey semen?

Despite frozen donkey semen demonstrating high quality after thawing and achieving suitable pregnancy rates in mares, it yields unsatisfactory results in jennies, likely due to a stronger uterine inflammatory response. This study assessed the effects of platelet-rich plasma (PRP) on uterine inflammation and pregnancy rates in jennies inseminated with frozen donkey semen. Estrous cycles from 11 jennies were assigned to three groups: Control (CTR, n = 22) with no treatment; Single PRP infusion (S-PRP, n = 22) administered 30 h after ovulation induction, prior to artificial insemination (AI); and Double PRP infusion (D-PRP, n = 21) with the first infusion at 30 h after ovulation induction and the second 4 h after AI. Insemination was performed with frozen donkey semen (1 billion sperm) deposited deeply in the uterine horn immediately after ovulation. Endometrial edema, intrauterine fluid (IUF), uterine vascularization, and endometrial cytology were evaluated pre-AI (TCt) and post-AI (6, 24, and 48 h). Uterine biopsies were taken at T48 for histopathological and collagen evaluation. Peripheral blood samples were collected on D5 for serum progesterone measurement, and pregnancy was evaluated via ultrasonography on D14. Data were analyzed using GLMMs, ANOVA, Friedman, and Kruskal-Wallis tests in SAS and GraphPad Prism, with significance set at p < 0.05. The S-PRP group showed less IUF accumulation than the CTR group at T6. Other parameters showed no significant differences among the groups. Cytology revealed a high percentage of inflammatory cells at T6 in all groups, which decreased in subsequent evaluations. In the CTR group, neutrophil percentages were similar to TCt at T24, while treated groups reached this similarity only by T48. Eosinophil percentages increased over time only in the treated groups. Pregnancy rates showed no differences among the groups (CTR: 0 %, S-PRP: 0 %, D-PRP: 10 %). Results indicate that PRP treatments were ineffective in modulating uterine inflammation and did not enhance pregnancy rates in jennies inseminated with frozen donkey semen.

Seminal plasma uterine priming alters uterine transcriptomics and negatively impacts embryo growth and uterine artery resistance but not offspring liver transcriptomics in beef cattle.

Seminal plasma uterine priming is important for pregnancy and offspring phenotype in mice and swine; however, impacts on the uterus of the dam and her offspring in cattle are unknown. We sought to determine the effects of seminal plasma uterine priming at estrus on uterine transcriptomics, early gestation (days 35, 40, and 45) embryo morphometrics, mid- to late-gestation (days 140 to 220) uterine artery hemodynamics, birth morphometrics, and liver transcriptomics in offspring at 30 d of age. Multiparous Angus-based commercial beef cows were randomly assigned to receive treatment at estrus: 0.5mL pooled seminal plasma in the uterine body (n = 31, seminal plasma primed) or no treatment (n = 31, control). Seven days later a subset of cows (n = 4/treatment) underwent uterine biopsies, and the remaining cows underwent embryo transfer. Embryo crown-rump length and uterine artery hemodynamics were measured during gestation using ultrasonography. Morphometrics of the calf were collected within 24h of parturition. Liver biopsies were collected at 30 d of age. Data were analyzed by analysis of variance (ANOVA) in a completely randomized design for the effect of treatment. Myosin heavy chain I (JSP.1) was downregulated [Benjamin-Hochberg adj P (BH) ≤ 0.05] and ABO alpha 1-3-N-acetylgalactosaminyltransferase and alpha 1-3-galactosyltransferase (ABO) was upregulated (BH adj P ≤ 0.05) in the uterus of seminal plasma primed cows 7 d after treatment. Embryo crown-rump length was less (P < 0.05) in seminal plasma primed cows. Mid- to late-gestation (days 140 to 220) uterine artery resistance was increased (P < 0.05) in seminal plasma primed cows. Seminal plasma priming did not alter birth weights or curve-crown-rump length, but heart girth was increased (P < 0.05) in offspring from seminal plasma primed cows. There were no differentially expressed genes (BH adj P ≤ 0.05) in offspring liver at 30 d of age; however, myosin light chain, phosphorylatable, fast skeletal muscle (MYLPF) was absent in all liver samples from calves from seminal plasma primed cows. In contrast, vomeronasal 1 receptor bosTauV1R414 (BOSTAUV1R414) was present in 6 of the 7 liver samples from calves from seminal plasma primed cows. Seminal plasma uterine priming alters uterine transcriptomics, negatively impacts early gestation embryo growth, and mid- to late-gestation uterine artery resistance suggesting downstream vascular anomalies. However, these in utero conditions did not impact offspring from birth to 30 d of age.

Development of an equine endometrial histology scoring system to complement the Kenney-Doig scale.

Kenney-Doig scale is considered the international standard method for classifying uterine biopsies in mares; however, its objectivity has been questioned by various studies. In the present study, we analysed the degree of agreement between two pathologists when assessing the same set of 201 uterine biopsies, obtaining a slight to moderate level of agreement (κ = .34/κw = .57). Subsequently, we developed a numerical scale based on the evaluation of histological parameters, including inflammation, fibrosis, glandular density and lymphatic lacunae. Partial scores were summed to obtain a fifth parameter called Summation. The correlation between both scales was demonstrated (p < .0001), and their combined use resulted in a notable increase in the degree of agreement between the two pathologists (κ = .53/κw = .67).

389 Impact of a Controlled Internal Drug Release device on circulating and local concentrations of progesterone

Abstract Controlled Internal Drug Release (CIDR) devices have become an important component of reproductive management programs in many beef herds. When a CIDR is inserted into a cow, circulating concentrations of progesterone mimic a functional corpus luteum. Some data, however, suggest that concentration of progesterone following insertion of a CIDR might have negative consequences on fertility in Bos indicus animals. Therefore, the objective of this study was to determine the impact of a CIDR device on circulating and uterine tissue concentrations of progesterone. A blood sample and a uterine biopsy were collected from non-suckled postpartum cycling Brahman cows (n = 10; Cycling) during the midluteal stage. A blood sample and a uterine biopsy were also collected from non-suckled postpartum cycling Brahman cows (n = 9; CIDR) after a CIDR had been in place for 5 d. To collect uterine biopsies from CIDR cows, the uterine biopsy tool was placed inside a plastic covering, both were passed into the cervix of the cow before the tool was extended through the covering and into the uterus. After the biopsy was collected, the tool was carefully removed to prevent sample contamination. Blood samples were centrifuged, and serum was collected to determine concentrations of progesterone. Uterine biopsies were snap frozen until extraction. Biopsies were weighted, thawed, and homogenized in assay buffer. Samples were then extracted with methyl tert-butyl ether and resuspended in assay buffer. Serum concentrations are reported as ng/mL and uterine concentrations are reported as ng/g. Statistical analysis was performed using the GLM procedure in SAS with treatment (CIDR vs Cycling), tissue type (uterine vs serum) and their interaction included in the model. There was a significant effect of treatment (P = 0.0062), tissue (P = 0.0063) and a treatment by tissue interaction (P = 0.0068). Animals with a CIDR had greater concentrations of progesterone than Cycling animals (274.77 vs 4.37 ng, respectively). Uterine samples had greater concentrations of progesterone than serum samples (274.40 vs 4.74 ng, respectively). These increased concentrations of progesterone were mainly from CIDR uterine samples (543.24 ng/g) which had greater (P &amp;lt; 0.001) concentrations of progesterone compared with all other samples, which did not differ from each other (P &amp;gt; 0.98; CIDR Serum 6.29 ng/mL, Cycling Serum 3.2 ng/mL, and Cycling Uterus 5.54 ng/g). In summary, CIDRs increased circulating concentrations of progesterone sufficient to keep animals from exhibiting estrus, and were not different from cows in the midluteal stage of their cycle. Local concentrations in uterine tissue; however, were significantly greater when a CIDR was in place compared with uterine tissue collected during the midluteal phase. The implications of these significantly greater concentrations of progesterone in uterine tissue warrant further investigation.

Does the Uterine Ozone Therapy Alter the Transcript Profile of Anti- and Proinflammatory Genes in Mares With Endometritis?

This study aimed to evaluate the localised effects of intrauterine ozone therapy on endometrial recovery in mares with endometritis. Our investigation assessed changes in gene expression profiles of anti-inflammatory (IL-1RA and IL-10), proinflammatory (IL-R1B3i and TNFα) and pleiotropic (IL-6) cytokines, along with detailed histological measurements of epithelial and endometrial thickness and the glandular area ratio. Twenty mares were assigned to a 2 × 2 factorial design based on endometritis diagnosis and treatment (control or 42 μg/mL ozone insufflation), resulting in four groups: NC (negative for endometritis/control), NO (negative/ozone), PC (positive/control) and PO (positive/ozone). Oestrus was induced with 2 mg of oestradiol benzoate on Days -1, 1 and 3, plus 1 mg on Day 5. Day 0 marked the initial uterine treatment, followed by insufflations on Days 1 and 2 with O3 (ozone) or O2 (control). Uterine biopsies were taken before treatment on Day 0 and Day 6 for histological analysis and gene expression assessment. Data were analysed using a statistical model that included endometritis status, treatment type, biopsy times (D0 and D6) and their interactions, analysed with Proc Glimmix. Regardless of treatment or endometritis status, significant biopsy effects (p < 0.01) indicated increased epithelial height and endometrial thickness in Day 6 samples. Analysis of IL-1 and TNFα revealed a significant interaction (p < 0.05) among endometritis, treatment and biopsy, with higher IL-1B3i expression on Day 6 in the PC group. The treatment effect (p < 0.04) showed a higher frequency (p < 0.01) of animals with positive modulation in the PC group (66.7%) versus the PO group (0.0%). An interaction effect (p = 0.08) between endometritis and treatment resulted from higher IL-1RA expression on Day 6 in the PC group compared to the PO group. Biopsy effect was significant for IL-10 (p < 0.01), indicating higher values in the second sample associated with tissue repair. In the short-term evaluation, ozone therapy did not influence endometrial morphology and may modulate cytokine expression, specifically the reduction in IL-1 and TNFα levels. Therefore, this therapy appears to be a safe and potentially effective treatment for modulating the inflammatory response in mares with endometritis.

Intra-uterine injection of amnion-derived acellular bioscaffold product in mares, a description of systemic and intra-uterine effects over 21 days

Amnion-derived acellular bioscaffold (ADABP) products demonstrate interesting anti-inflammatory and healing properties which could be beneficial for intrauterine use. The objective of this study was to evaluate the safety of intrauterine injection of ADABP on systemic and uterine health. The study design randomly assigned subjects to one of two groups, control mares (n = 3) which received 3 mL injection of sterile saline in the base of each uterine horn, and treatment mares (n = 9) which received 3 mL of ADABP in the base of one uterine horn and 3 mL injection of sterile saline in the base of the other uterine horn. The leukogram had no significant effect of group and no group by day interaction. The serum biochemistry panel had no effect of group on any of the parameters examined. There were no significant differences in uterine culture or uterine biopsy results. The data suggests intrauterine injection of ADABP has no negative systemic or uterine effects.

Comparison of the Jackson Uterine Biopsy Forceps with a Fabricated Model of Human Bronchoscopy Biopsy Device for Uterine Biopsy in Bovines

Background: Uterine biopsy is considered as the most conclusive and efficient method for diagnosis of subclinical endometritis especially to evaluate further reproductive efficiency. Methods: The present study was conducted at ULF and FRDS, Mannuthy to compare the efficacy of two devices in obtaining histopathological samples for the diagnosis of subclinical endometritis (SCE) in crossbred dairy cows at 30 and 40 days postpartum. The two devices used were the Jacksons uterine biopsy forceps (Jorvet, USA) and a slimmer stainless-steel biopsy forceps with a circular cupped jaw, fabricated similar to human bronchoscopy biopsy device. Result: The Jacksons uterine biopsy forceps was used in 35 cows to collect the samples. Manoeuvring this forceps through the cervix was found to be difficult and only in 16 out of the 35 animals (45.71%) collection for both days was successful, while in 14 animals (40%) samples could be collected only on day 30 of observation and in remaining 5 animals (14.29%) no samples could be collected on both the days of observation. In those animals where samples could be procured, bigger jaw of the Jacksons forceps resulted in larger sample size which may slightly delay healing. The fabricated biopsy forceps was used in 10 animals and because of its slim structure, it was possible to collect samples in all of them (100%). The smaller jaw ensured that the sample obtained was smaller and thus minimalizing tissue damage, contamination with blood and possibly promoting a swifter healing. Tissue sections were examined for pathological changes in the endometrium involving surface epithelium, lamina propria, endometrial glands and vascular inflammatory status. The samples obtained using the modified forceps provided sufficient data for the diagnosis of SCE similar to the traditional device. Thus, the fabricated uterine biopsy forceps, which is comparatively much cheaper, can be used with more ease in indigenous/crossbred cows and heifers which have smaller cervices.

Insights into the role of PGF2α in canine periparturient myometrium.

Parturition in dogs is subjected to complex hormonal regulation, with the involvement of prostaglandin F2α (PGF2α) still not fully understood. To investigate uterine inertia (UI), the most prevalent maternal reason for dystocia in the bitch, a better understanding of undisturbed uterine, especially myometrial function, is crucial. Our aim was to gain deeper insights into the role of PGF2α in the canine parturient myometrium. Uterine biopsies were obtained during medically indicated cesarean sections. To test for stimulatory effects of PGF2α in vitro, circular and longitudinal myometrial layer tissue strips were challenged with 50pM, 0.5µM, and 50µM PGF2α. Prostaglandin-endoperoxide synthase 2 (PTGS2) and PGF2α-receptor (PTGFR) mRNA expressions were compared between primary UI (PUI) and obstructive dystocia (OD) samples in isolated parturient myometrium. PTGFR protein expression was assessed in full thickness uterine samples. PGF2α concentrations were analyzed in canine interplacental tissue around term. In the organ bath, the contractile response to PGF2α was limited to the circular layer at the highest dosage. Correspondingly, PTGFR immunohistochemical staining was significantly stronger in the circular layer (p ≤ 0.01). PTGS2 gene expression did not differ between PUI and OD, whereas PTGFR gene expression could not be quantified. Local uterine PGF2α concentrations correlated negatively with serum P4 levels and were the highest during prepartum luteolysis while being significantly lower in PUI. Conclusively, despite the significant increase in local PGF2α concentrations at birth, confirming the interplacental tissue as a production site, our results suggest that PGF2α might affect uterine contractility during labor, mainly indirectly.

Association of Uterine Tissue Innervation and Peripheral Nerve Density with Adenomyosis Related Pain. A Systematic Review.

Adenomyosis is associated with dysmenorrhea and chronic pelvic pain; however, the triggering mechanisms of painful stimuli and the role of uterine nerve fibers in the manifestation of pain remain poorly understood. The objective of this study was to systematically review the role of uterine nerve fibers' presence and density in the occurrence of pain in patients with adenomyosis. An electronic search was performed using the Embase, PubMed/Medline, and Cochrane databases. We included all studies from inception to November 2023. A total of ten studies that compared uterine biopsies samples of women with and without adenomyosis were included. The biomarker antiprotein gene product 9.5 was decreased or absent in the endometrium of most included women with adenomyosis. None of the included studies observed a difference in neurofilament (NF) staining between the adenomyosis and non-adenomyosis groups. Studies that assessed nerve growth factor (NGF) staining were heterogeneous in design. One study reported no difference in immunohistochemistry staining in any endometrial layer between the adenomyosis and non-adenomyosis groups, while another reported increased staining in the adenomyosis functional endometrial layer, and a third study reported overexpression of NGF, synaptophysin (SYN), and microtubule-associated protein 2 mRNA in focal adenomyosis alone. Preliminary data from poor-quality studies suggest an increase in the uterine density of nerve fibers in patients with adenomyosis. Well-designed studies are essential to assess the cause-and-effect relationship between uterine nerve fibers and pain in patients with adenomyosis.

Endometrial expression of antimicrobial peptides as markers of subclinical endometritis in mares.

Endometritis is a major cause of subfertility in mares. Multiparous old mares are more susceptible to developing endometritis given that ageing is associated with an altered immune response and with inadequate physiological uterine clearance after breeding, which can lead to degenerative changes in the endometrium. Molecules such as antimicrobial peptides (AMPs) have been proposed as endometritis markers in the equine species. Cross-sectional. To investigate the endometrial expression of defensin-beta 4B (DEFB4B), lysozyme (LYZ) and secretory leukocyte peptidase inhibitor (SLPI) genes in mares either affected or not by subclinical endometritis, due to the role of these AMPs in the immune response to bacteria and inflammatory reactions. Endometrial biopsy for histopathological and gene expression examinations was performed on 26 mares. The inclusion criteria for the normal mare group (NM, N = 7) were 2-4 years of age, maiden status, no clinical signs of endometritis and a uterine biopsy score of I, while for mares affected by subclinical endometritis (EM, N = 19) the inclusion criteria were 10-22 years of age, barren status for 1-3 years, no clinical signs of endometritis and a uterine biopsy score between IIA and III. A significantly higher expression of LYZ (NM: 0.76 [1.84-0.37] vs. EM: 2.78 [5.53-1.44], p = 0.0255) and DEFB4B (NM: 0.06 [0.11-0.01] vs. EM: 0.15 [0.99-0.08], p = 0.0457) genes was found in endometritis mares versus normal mares. Statistically significant moderate positive correlations were found between the level of expression of LYZ gene and both the age (r = 0.4071, p = 0.039) and the biopsy grade (r = 0.4831, p = 0.0124) of the mares. The study investigated a limited number of genes and mares, and the presence/location of the proteins coded by these genes was not confirmed within the endometrium by IHC. If the results of this study are confirmed, LYZ and DEFB4B genes can be used as markers to identify mares that are affected by subclinical endometritis.

Postpartum Uterine Diseases; Diagnostic Approaches and Management in Farm Animals: A Review

Postpartum uterine infections results from uterine contamination with bacteria during parturition. The postpartum environment of the uterine lumen supports the growth of a variety of aerobic and anaerobic bacteria. There are a number of risk factors for post-partum uterine disease in dairy cattle; cows having dystocia, retained placenta, twins or stillbirths and various metabolic disorders are more likely to develop uterine disease. Inflammation of the uterus slows down the process of involution in the uterus and delays the onset of activities of the ovaries leading to economic loss due to systemic illness, loss of milk and meat production and marked drop in fertility. Pyometra, metritis, clinical and subclinical endometritis are some of the most important illnesses during the postpartum period. A variety of methods such as uterine palpation, ultrasonographic features of the uterus, vaginoscopy, endometrial cytology, uterine culture, and uterine biopsy has been reported to identify postpartum diseases. Prevention of postpartum uterine disease would be better than cure, for both the animals and the economy. Thus, early diagnosis or predictions of uterine infections are important for effective postpartum management.

Postpartum Uterine Diseases; Diagnostic Approaches and Management in Farm Animals; A Review

Postpartum uterine infections result from uterine contamination with bacteria during parturition. The postpartum environment of the uterine lumen supports the growth of a variety of aerobic and anaerobic bacteria. There are a number of risk factors for post-partum uterine disease in dairy cattle; cows having dystocia, retained placenta, twins or stillbirths and various metabolic disorders are more likely to develop uterine disease. Inflammation of the uterus slows down the process of involution in the uterus and delays the onset of activities of the ovaries leading to economic loss due to systemic illness, loss of milk and meat production and marked drop in fertility. Pyometra, metritis, clinical and subclinical endometritis are some of the most important illnesses during the postpartum period. A variety of methods such as uterine palpation, ultrasonographic features of the uterus, vaginoscopy, endometrial cytology, uterine culture, and uterine biopsy has been reported to identify postpartum diseases. Prevention of postpartum uterine disease would be better than cure, for both the animals and the economy. Thus, early diagnosis or predictions of uterine infections are important for effective postpartum management.

Predictive value of body mass index (BMI) and determination of optimum cut-off point in the diagnosis of endometrial hyperplasia in pre-menopausal women with abnormal uterine bleeding.

The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study. This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons. The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). Thebody mass index(BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively. BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

Endometrial mRNA expression of key inflammatory genes and progesterone receptor in uterine tissue of bitches with endometritis

Our study aimed to evaluate the gene transcription of Cyclooxygenase 1 (COX1), cytokines (Interleukin 6 [IL6], Interleukin 8 [IL8], and Leukemia Inhibitory Factor [LIF]), and Progesterone Receptor (PR) in clinically healthy bitches with a normal endometrium and with endometritis, without the presence of cystic endometrial hyperplasia. Forty-eight mixed breed bitches in dioestrus were used. Uterine biopsies were collected for diagnosis of a normal endometrium (n=15), and endometritis (n=30). Three samples were excluded from the study (two bitches with cystic endometrial hyperplasia and one bitch with atrophy). Samples were collected by cytobrush to quantify mRNA by qPCR. Data were analyzed using a generalized mixed model. COX1, IL6, and IL8 mRNA expression in bitches with endometritis was significantly higher than in a normal endometrium (P=0.0002, P=0.002, and P=0.003, respectively). In contrast, LIF and PR mRNA expression in bitches with endometritis was significantly lower than with a normal endometrium (P=0.006 and P=0.001, respectively). IL6 (AUC 0.67) was the most favorable biomolecular marker for predicting endometritis in bitches. There was an evident change in the mRNA expression of COX1, cytokines, and PR in clinically healthy bitches with a normal endometrium and endometritis without cystic endometrial hyperplasia. These results suggest that biomolecular markers such as COX1, IL6, IL8, LIF, and PR could help diagnose endometritis in a bitch.

D&C has the best concordance between preoperative and postoperative grades among morbidly obese endometrial cancer patients.

Endometrial cancer is diagnosed by obtaining uterine biopsies by pipelle, dilatation and curettage (D&C), or hysteroscopy. In 15%-25% of the cases, the preoperative and postoperative grades do not match. This discrepancy may carry significant clinical and prognostic consequences. We aimed to assess how body mass index (BMI) affects preoperative and postoperative grade mismatches and whether biopsy methods mitigate this effect. We conducted a retrospective review of patients with endometrial cancer who underwent surgery at our center between 2014 and 2022. We stratified patients into six classes of BMI based on the WHO classification. Preoperative and postoperative grades were compared for concordance with regards to patient BMI and sampling method. A total of 158 patients were included, diagnosed by pipelle (n = 99), hysteroscopy (n = 15), or D&C (n = 44). For all methods, every unit increase in BMI increased the odds of having a gap between histology grades by 5.2%. In the pipelle group, the odds of a larger gap between the histology grades was 62% higher than that of women in the other groups. Among the D&C group, the odds of having a bigger difference between histology grades were 91.8% lower compared to the other groups. Patients with BMI over 30 had nearly 50% discrepancy when diagnosed with pipelle or hysteroscopy, but less than 10% with D&C. Increasing BMI is associated with decreasing concordance between preoperative and postoperative grades in endometrial cancer, especially when it exceeds 30. This effect is much less pronounced, however, when the diagnostic method is D&C.

Tru-cut placental site trophoblastic tumor biopsy: A novel way for diagnosis. Case report

Background: A Placental Site Trophoblastic Tumor (PSTT) is a rare form of gestational trophoblastic disease and usually manifests itself with abnormal uterine bleeding and elevated β-hCG serum levels even months or years after any antecedent pregnancy event. Typically, tumors are confined into the uterus and secrete lower levels of β-hCG compared with other Gestational Trophoblastic Neoplasia (GTN). They can be detected sonographically like heterogeneous solid mass in the uterine cavity with minimal to high vascularization, but sometimes they develop into myometrium without endometrial involvement. To the best of our knowledge, uterine biopsy is the only way to make a reliable diagnosis, but for these reasons sometimes Dilation and Curettage (D&amp;C) or hysteroscopy are not exhaustive. Their final diagnosis is histopathological and often very difficult due to their rarity, thus many times they directly present metastasis symptoms (mainly pulmonary) or paraneoplastic syndromes. Case presentation: A 37-year-old woman with the purpose of a second pregnancy, after seven weeks of amenorrhea, complained irregular bleeding and metrorrhagia. The patient underwent transvaginal ultrasound (US) and a lesion of 50 mm was found in myometrium, its echostructure was inhomogeneous and richly vascularised (CS4) with rear acoustic reinforcement. It was associated with slightly elevated serum levels of β-hCG. The patient performed a hysteroscopy with simultaneous tru-cut biopsy of the lesion under US guidance and a placental site trophoblastic tumor was diagnosed by histological examination. Conclusion: In this paper we suggest a novel method to perform the PSTT diagnosis. A tru-cut core biopsy allows a deep and precise biopsy with less invasivity and low risk of bleeding or uterine damage. Our case study shows that the employment of this novel technique can help in the diagnosis through a targeted sampling of the myometrium even in those cases in which the endometrial cavity is not involved.

Effects of 17β-estradiol on the uterine luteolytic cascade in bovine females at the end of diestrus

In cattle, 17β-estradiol (E2) is essential for triggering luteolysis via the synthesis of prostaglandin F2α (PGF2α). We aimed to evaluate the effects of E2-treatment on day 15 of the estrous cycle on the transcript abundance of genes involved in the PGF2α synthetic cascade. Nelore heifers (N = 50) were subjected to a hormonal protocol for the synchronization of ovulation. Between days 14 and 23 after estrus, the area (cm2) and blood perfusion (%) of the corpus luteum (CL) and progesterone (P4) plasma concentrations were evaluated daily. On day 15, the heifers were assigned to the Control (2 mL of pure sesame oil, N = 21) or Estradiol group (1 mg of E2 diluted in 2 mL of sesame oil, N = 23). After the treatments at 0 h, uterine biopsies were collected at times 1.5 h (C1.5h, N = 8 and E1.5h, N = 10) or 3 h (C3h, N = 8 and E3h, N = 11); and blood samples were obtained from 0, 3, 4, 6 and 7 h for the measurement of 13,14-dihydro-15-keto-PGF2α (PGFM) concentrations by ELISA. Transcript abundance was determined by RT-qPCR and protein abundance of ESRβ and OXTR was determined by Western Blotting. The Estradiol group showed greater (P < 0.05) concentrations of PGFM at 6 and 7 h compared to the Control group. A progressive decrease in plasma P4 concentrations characterized a hastened functional luteolysis, followed by structural luteolysis in the Estradiol group (P < 0.05). Among the treatment groups, no significant difference was detected for the abundance of PRKCα, PRKCβ, AKR1B1, PTGS2 and ESRα transcripts (P > 0.05). Estradiol treatment decreased the abundance of PLA2G4A, AKR1C4, and ESRβ both 1.5h and 3h after treatment (P < 0.05). The relative expression of PGR and OXTR was greater in E3h compared to the C3h (P > 0.05). Protein abundance did not differ between treatment groups at either experimental times (P > 0.05). Overall, E2 promoted an increase in PGFM concentrations and the hastening of functional and structural luteolysis in Nelore heifers through the upregulation of PGR and OXTR, demonstrating for the first time that the expression of these receptors within 3 h after E2 stimulus was associated with triggering luteolysis in cattle.

Tin hair analysis in poly symptomatic patients with Essure® implant

Objective: Essure® is a permanently implanted contraceptive device withdrawn from the market in 2018 because of adverse effects associated with this device, including gynecological disorders and extrapelvic symptoms. After surgical removal device, examination of uterine biopsies showed the frequent presence of tin resulting from implant degradation. In this context, the biological monitoring of tin metal in implanted patients becomes an issue of capital importance since hair is the best matrix to reveal long-term metallic exposure. Methods: The aim of this retrospective study was to compare hair chromium, nickel and tin levels in 10 Essure® implanted patients (aged 50±2 years old) presenting with adverse events, in particular psychosomatic manifestations, with 25 healthy non implanted volunteers’ group (aged 47± 4 years old). Hair chromium, nickel and tin analyses were performed on a 7800 ICP-MS inductively coupled plasma mass spectrometer. Results: For the group of healthy subjects, all tin concentrations in hair (25/25) were below the quantification limit of 0.1 µg/g, with 2 concentrations above the detection limit of 0.07 µg/g. Similarly, all nickel and chromium concentrations (25/25) were below the quantification limit, with 2 Cr concentrations and one Ni concentration above the detection limit of 0.1 µg/g. In the implanted group, subjects had mean hair concentrations of nickel and tin of 0.94+0.39 µg/g and 0.25 ± 0.17 µg/g respectively. All subjects (10/10) had chromium concentrations below the limit of quantification. For nickel and tin assays in hair above the quantification thresholds, there were positive correlations between (a) nickel or tin concentrations and the duration of device implantation (correlation coefficient of 0.79 for tin and 0.44 for nickel) and between (b) tin concentration and the multiplicity of extra-pelvic symptoms (correlation coefficient of 0.76), with (c) no correlation observed between nickel concentration and symptom multiplicity. Conclusion: Tin seems to be an important factor involved in the physio pathogenesis of extra pelvic symptoms in patients with the Essure® medical device. In this context, the hair tin analysis is a useful tool in the monitoring of patients with Essure® implants.

Consistency of endometrial receptivity array and histologic dating of spatially distinct endometrial samplings: a prospective, blinded study

To compare the consistency of endometrial receptivity array (ERA) and histologic dating among 3 spatially distinct endometrial samples obtained during a cycle of exogenous estrogen and progesterone. Prospective blinded study. University practice. Twelve patients undergoing a mock frozen embryo transfer cycle. Endometrial biopsy was performed in a manner that provided a spatially organized endometrial specimen, corresponding to the fundus, middle, and lower segment. Each of these 3 sections was further divided into immediately adjacent specimens for ERA and histology. Consistency of the ERA and histology results among fundal, mid, and lower endometrial biopsy specimens. The ERA showed variability in outcome among different patients but dated all specimens originating from the same patient identically. Histologic dating showed variability between patients as well as between different locations within the uterus. When comparing average dating results for each patient, we saw a positive correlation between histologic and ERA dating (Spearman Rho= 0.45); however, this did not reach statistical significance. The ERA results from upper, mid, and lower uterine biopsy specimens were identical for each autologous biopsy, whereas histologic dating showed variability with an average standard deviation of 0.71days. The increased heterogeneity of histologic dating is likely to be attributed to the subjectivity of the test. Furthermore, we did not observe a consistent lag or advancement in histologic or ERA dating between the fundal or lower uterine biopsies. Overall, cliniciansshould be reassured that endometrial tissue will return consistent ERA results independent of the location within the uterus in which it was obtained.

Increased Risk of Breast Fibroadenomas Among Obese and Postmenopausal Women With Uterine Fibroids.

Introduction Uterine fibroids and breast fibroadenomas are common female benign neoplasms that are similarly derived from a single clonal origin and are modulated by estradiol concentration in blood. However, the association between these neoplasms has not yet been explored. Hence, this study aims to investigate the relationship between uterine fibroids and breast fibroadenomas. Methods A total of 199 women (cases: 72 women with uterine fibroids, control: 127 women without uterine fibroids) were included in this study. Ultrasound was used to screen for uterine fibroids, and both ultrasound and biopsy were utilized to diagnose breast fibroadenomas. Logistic regression analysis was used to investigate the association between uterine fibroids and breast fibroadenomas and the factors associated with the relationship. Results Women with uterine fibroids have more than two times higher odds of having breast fibroadenomas among older women (p=0.03), more than twofold increased odds of breast fibroadenomas among obese females (p=0.05), and higher odds of having breast fibroadenomas among postmenopausal transition participantgroups (OR=9.6; 95% CI 1.98-30.14; p-value=0.005). Conclusion The association between uterine fibroids and breast fibroadenomas is significantly pronounced among older, obese, and postmenopausal women. This relationship might be driven by the indirect stimulation of estrogen hormone receptors via adipose tissue or other lifestyle as well as genetic factors. Therefore, further larger prospective studies considering these factors are needed to replicate the current findings.