Morphological features of endometrial pinopodia formation during the luteal phase in women with previous unsuccessful implantation
Keywords:infertility, pinopodia, endometrium, ciliated cells, secretory cells
Pinopodia of the receptive endometrium is one of the prerequisites for successful embryo implantation.
Study objective: to analyze the morphological changes of the endometrium in infertile women, in particular to investigate the apical surface of epithelial cells and pinopodia formation.
Materials and methods. 12 patients with a history of previous implantation failure were examined. Patients underwent hysteroscopy with biopsy under intravenous anesthesia on 20–24th day of the menstrual cycle. Morphological structure of pinopodia on the surface of the endometrial epithelium was evaluated by scanning electron microscopy.
Results. Apical surface of epitheliocytes was damaged in 16.7% studied biopsies. Morphological picture and maturity of the endometrial glands did not correspond to the actual day of the menstrual cycle in 41.7% biopsies. Degree of glands maturity in these patients was low, so there was a delay in the menstrual cycle. Ultrastructural examination showed clear changes in the structure of secretory and ciliary cells in 33.3%. On the apical surface of the secretory cells there was no or small number of microvilli; cilia of eyelashes were shortened or sometimes fused together. Pinopodia as a one of the most important components of implantation was detected in only 50% of patients. Only in 33.3% of participants visualized fully developed, mature pinopodia. Conclusions. Analysis of own data showed that in the endometrium of women with previous unsuccessful implantation there are certain morphological changes, which are physiologically manifested by a delay in the luteinizing phase of the menstrual cycle and, possibly, as a result mismatch of endometrial structure and embryo maturity. Time of pinopodia onset in participants varied from 20 to 24 days of the menstrual cycle. It is necessary to improve the design and conduct further research to study the association between the expression of receptivity markers and ultrastructural structure.
Boyarskiy, K.Y., Gaidukov, S.N., Palchenko, N.A. “Modern view of the problem of thin endometrial receptivity in ART programs: literature review.” Problems of reproduction 4 (2013): 51–60.
Buyanova, S.N., Yudina, N.V., Gukasian, S.A. “Prognostic significance of ultrasound examination in women with uterine fibroids at the stage of pregnancy planning.” Russian Bulletin of Obstetricians and Gynecologists 16 (2016): 61–7.
Abdulaev, R.Y., Grabar, V.V., Lysenko, T.P., Safonov, I.N. Doppler ultrasonography in gynecology. Kharkiv. New word (2009): 104 p.
Niauri, D.A., Gzgzyan, A.M., Kvetnoy, I.M. “Immunohistochemical characteristics of endometrial receptivity in IVF cycles.” Obstetrics and gynecology 9 (2014): 44–50.
Leviashvili, M.M., Demura, T.A., Mishieva, N.G. “Evaluation of endometrial receptivity in patients with unsuccessful in vitro fertilization programs in history.” Obstetrics and gynecology 4 (2012): 65–9.
Dubchak, A.Y., Zadorozhna, T.D., Milievskyi, O.V., Dovgan, O.I. “Morphological and immunohistochemical features of the endometrium during the ‘window of implantation’ in women with infertility on the background of chronic inflammatory diseases of the internal genital organs.” Women's Health 6 (2015): 178–81.
Kosei, N.V., Zadorozhna, T.D., Zakharenko, N.F. “Morphofunctional and immunohistochemical characteristics of different clinical and pathogenetic variants of uterine leiomyoma.” Pathology 3 (2017): 319–25.
Semeniuk, L.M., Demyanenko, L.V., Larina, O.V., Voronkova, N.M. “Optimization of pre-pregnancy training of women with chronic cervicitis and dyshormonal ectopia of the cervix on the background of ovulatory dysfunction.” Collection of scientific works of the Association of Obstetricians and Gynecologists of Ukraine 2 (2017): 230–5.
Parnytska, O.I. “Violation of the formation of the ‘implantation window’ in patients with hyperplastic processes of the endometrium.” Pathology 3 (2013): 12–5.
Akulenko, L.V., Manukhin, I.B., Macharashvili, T.K., Ibragimova, E.O. “Prospects for the use of a comprehensive assessment of clinical and morphological data in the diagnosis and pregravid preparation of patients with chronic endometritis.” Attending physician 5 (2015): 72–6.
Siusiuka, V.G., Ostrovskyi, A.I., Razygraeva M.A. “The role of screening ultrasound diagnostics in assessing the state of the endometrium.” In: materials of the XXIX International Congress with a course of endoscopy “New technologies of gynecological diseases in diagnosis and treatment”, June 7–10, 2016. Moscow. MEDI Expo (2016): 73–5.
Yarotskyi, M.Y., Semeniuk, L.M. “On the question of optimizing the restoration of the receptor potential of the endometrium of patients with a history of polycystic ovary syndrome and habitual miscarriage.” Women's Health 1 (2016): 162–6.
Aunapuu, M., Kibur, P., Järveots, T., et al. “Changes in Morphology and Presence of Pinopodes in Endometrial Cells during the Luteal Phase in Women with Infertility Problems: A Pilot Study.” Medicina (Kaunas) 10.54.5 (2018). DOI:10.3390/medicina54050069
Choby, B.A. “Endometrial biopsy.” In: Pfenninger’s procedures for primary care, 4th ed. Elsevier eBook on VitalSource (2019): 879–87.
Qiong, Z., Jie, H., Yonggang, W., et al. “Clinical validation of pinopode as a marker of endometrial receptivity: A randomized controlled trial.” Fertil Steril 108 (2017): 513–7. DOI: 10.1016/j.fertnstert.2017.07.006
Kosei, N., Zakharenko, N., Herman, D. “Endometrial polyps in women of reproductive age: clinical and pathogenetic variations.” Georgian medical news 12.273 (2017): 16–22.
Maybin, J.A., Critchley, H.O. “Menstrual physiology: implications for endometrial pathology and beyond.” Hum Reprod Update 21.6 (2015): 748–61.
Okada, H., Tsuzuki, T., Shindoh, H., et al. “Regulation of decidualization and angiogenesis in the human endometrium: mini review.” J Obstet Gynaecol Res 40.5 (2014): 1180–7. DOI: 10.1111/jog.12392
Revel, A. “Defective endometrial receptivity.” Fertil Steril 97.5 (2012): 1028–32. DOI: 10.1016/j.fertnstert.2012.03.039
Sharma, A., Kumar, P. “Understanding implantation window, a crucial phenomenon.” J Hum Reprod Sci 5.1 (2012): 2–6.
Stepniak, A., Czuczwar, P. “3D Power Doppler vascular indices as a novel technique in assessing the outcome of minimally invasive techniques in uterine fibroids treatment.” Prz Menopauzalny 16.4 (2017): 118–21. DOI: 10.5114/pm.2017.72755
Sudoma, I., Goncharova, Y., Zukin, V. “Optimization of cryocycles by using pinopode detection in patients with multiple implantation failure: preliminary report.” Reproductive BioMedicine Online 22 (2011): 590–6.
Nosenko, E.N., Saenko, A.I., Parnitskaya, O.I., et al. “The particularities of pinopodes formation in endometrium depending on availability of chronic inflammatory and hyperproliferative processes in HIM in women good responders with unsuccessful attempts of assisted reproductive technology (ART) in anamnesis.” Modern problems of science and education 6 (2014).
Kasius, J.C., Broekmans, F.J., Sie-Go, D.M., et al. “The reliability of the histological diagnosis of endometritis in asymptomatic IVF cases: a multicenter observer study.” Hum Reprod 27.1 (2012): 153–8. DOI: 10.1093/humrep/der341
Veropotvelyan, P.M., Tsekhmystrenko, I.S. “Clinical view of the ineffectiveness of IVF problem with endometrial receptivity.” Reproductive endocrinology 33 (2017): 32–9. DOI: 10.18370/2309-4117.2017.33.32-39
Copyright (c) 2021 Ю.Г. Антипкін, О.О. Литвак, О.Г. Курик, Г.П. Пасічник, Ю.М. Бондаренко
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.