Hysteroscopic, morphofunctional and immunohistochemical endometriun features in women with uterine leiomyoma after different types of organ-preserving treatment





uterine leiomyoma, endometrium, uterine artery embolization, conservative myomectomy, hysteroscopic resection


Uterus leiomyoma is the most common benign tumor that takes one of the leading places in the structure of gynecological pathology. According to different authors proportion of this disease in the infertility structure is 48–55.3%, in the structure of pregnancy miscarriage – 14–18%, in pregnancy and childbirth complications – 10–30%. Uterus leiomyoma reduces in vitro fertilization results from 29% to 9% in cases of submucous nodus localization, lowers pregnancy rate to 28.2% against 63.4% after hysteroscopic node resection.

The authors performed a study to improve the efficiency of uterine fibroids treatment through the development of methods to improve the functional state of the endometrium after use of different types of organ-preserving surgery.

Following data were received after various types of organ saving surgical procedures: patients with normal endometrium structure (73.33%) dominated at first group. Endometrial hypoplasia was found in 20% cases of the identified pathology. Endometrial fibro-glandular type polyps were found in 6.67% of cases. The main features of this group were uneven focal estrogen receptor down regulation, disturbance of natural killer cells CD16 and CD56 and CD45 expression, compared to the control group. Immunohistochemical study showed positive expression of CD138 (plasma) in 25% of cases in endometrium of women after uterine artery embolization, indicating the presence of chronic endometritis in this group. Immunohistochemical studies of endometrium in the third group showed high level expression of inflammatory markers (CD45, CD16 and CD56). It was detected a significant increase in expression of the proliferation marker Ki-67 in endometrial stroma in the IIIb group, indicating a potential risk of hyper proliferation against a background of inflammatory process of the endometrium.

Thus, endometrium changes after organ saving surgical treatment of uterine leiomyoma, such as uterine artery embolization, conservative myomectomy, hysteroscopic resection of node determines the need for the prevention of endometrial dysfunction after surgery.

Author Biographies

Т. Д. Задорожна, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

MD, professor, head of the pathomorphology laboratory

Н. О. Редько, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

Researcher at the Endocrine Gynecology Department

Т. Ф. Татарчук, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, chief of the Endocrine Gynecology Department

Н. В. Косей, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

MD, chief researcher at the Endocrine Gynecology Department

С. М. Килихевич, Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine

PhD, researcher of the pathomorphology laboratory


  1. Grishin, I.I. Uterine artery embolization. New technologies in operative gynecology and obstetrics. In the manuscript rights. Moscow (2014).
  2. Cohan, E.A., Demura, T.A., Vodyanoj, V.Y. “Molecular and morphological aspects of the endometrium receptivity disorders in chronic endometritis.” Pathology Archives, 3(2012): 1–17.
  3. Petrov, Y.A. “Hysteroscopy informative in the diagnostics of chronic endometritis in the early reproductive losses.” Fundamental Studies, 1(2012): 85–88.
  4. Shurshalina, A.V. “Chronic endometritis: modern views on the problem.” Consilium medicum Ukraina, 9(2011): 2–3.
  5. Shcherbakova, L.A., Gustovarova, T.A., Ivanyan, A.N. “Clinical and morphological aspects of submucous uterine fibroids in women of reproductive age.” The Russian Obstetrician-Gynecologist Messenger, 1(2012).
  6. Vasylchenko, L.A. Justification for principles of ovarian dysfunction prevention in women with large uterine leiomyoma after uterine artery embolization. In the manuscript rights. Kyiv (2015).
  7. Kosei, N.V. Uterine leiomyoma (clinic, pathogenesis, diagnostics and treatment). In the manuscript rights. Kyiv (2009).
  8. Protas, R.V. Reproductive health in women after uterine artery embolization of uterine leiomyomas. In the manuscript rights. Kyiv (2013).
  9. AAGL Practice Report. “Practice Guide lines for Management of Intrauterine Synechiae.” Journal of Minimally Invasive Gynecology, 1 (Vol. 17) (2010): 1–7.
  10. AAGL Practice Report. “Practice Guidelines for the Diagnosis and Management of Submucous Leiomyomas.” Journal of Minimally Invasive Gynecology, 19(2012): 152–171.
  11. Banu, N.S., Gaze, D.C., Bruce, H. “Markers of muscle ischemia, necrosis, and inflammation following uterine artery embolization in the treatmen to symptomatic uterine fibroids.” Am J Obstet Gynecol, 196(2007): 213.
  12. Bradley, L.D. “Hysteroscopic Resection of Myomas and Polyps.” Hysteroscopy, 19(2008): 221–239.
  13. Choby, B.A. “Endometrial biopsy.” Gynecology And Female Reproductive System Procedures, 2015.
  14. Ciavattini, A., Giuseppe, J.D., Stortoni, P., et al. “Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction.” Obstetrics and Gynecology International, 2013. DOI: 10.1155/2013/173184
  15. Cicinelli, E., Resta, L., Nicoletti, R., et al. “Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis.” Hum Reprod, 20(5) (2005): 1386–1389.
  16. Evans-Hoeker, E.A., Young, S.L. “Endometrial Receptivity and Intrauterine Adhesive Disease.” Semin Reprod Med, 32(2014): 392–401.
  17. Gupta, J.K., Sinha, A., Lumsden, M.A. “Uterine artery embolization for symptomatic uterine fibroids.” Cochrane Database Syst Rev, 5(2012): 1–44.
  18. Hardeman, S., Decroisette, E., Marin, B. “Fertility after embolization of the uterine arteries to treat obstetrical hemorrhage: a review of 53 cases.” Fertil Steril, 94(2010): 2574–2579.
  19. Horng, H.-C., Wen, K.-C., Su, W.-H. “Review of myomectomy.” Taiwanese Journal of Obstetrics & Gynecology, 51(2012): 7–11.
  20. Katsumori, T., Kasahara, T., Tsuchida, Y. “Amenorrhea and resumption of menstruation after uterine artery embolization for fibroids.” International Journal of Gynecology and Obstetrics, 103(2008): 217–212.
  21. Mara, M., Horak, P., Kubinova, K., et al. “Hysteroscopy after uterine fibroid embolization: evaluation of intrauterine findings in 127 patients.” J Obstet Gynaecol Res, 38(5) (2012): 823–831.
  22. March, C.M. “Management of Asherman’s syndrome.” Reproductive Bio Medicine Online, 23(2011): 63–76.
  23. Mohan, P., Hamblin, M.H., Vogelzang, R.L. “Uterine Artery Embolization and Its Effecton Fertility.” J Vasc Interv Radiol, 24(2013): 925–930.
  24. Muñoz, J.L., Jiménez, J.S., Hernández, C. “Hysteroscopic Myomectomy: Our Experience and Review.” Journal of the Society of Laparoendoscopic Surgeons, 7(2003): 39–48.
  25. Munro, M.G. “Uterine Leiomyomas,Current Concepts: Pathogenesis, Impacton Reproductive Health, and Medical, Procedural, and Surgical Management.” Obstetrics and Gynecology Clinics of North America, 38(4) (2011): 703–731.
  26. Munro, S.K., Farquhar, C.M. “Epigenetic regulation of endometrium during the menstrual cycle.” Molecular Human Reproduction, 5 (Vol. 16) (2010): 297–310.
  27. Naji, A.Z. “Enhance and Prove Diagnosis of Chronic Endometritis with CD- 138 Immunostain.” Medical Journal of Babylon, 3 (Vol. 9) (2012).
  28. Pisco, J.M., Duarte, M., Bilhim, T., et al. “Pregnancy after uterine fibroid embolization.” Fertil Steril, 95(2011): 1121.
  29. Dariushnia, S.R., Nikolic, B., Stokes, L.S., Spies, J.B. “Quality Improvement Guidelines for Uterine Artery Embolization for Symptomatic Leiomyomata.” J Vasc Interv Radiol, 25(11) (2014): 1737–1747.
  30. Rackow, B.W., Taylor, H.S. “Submucosal uterine leiomyoma shave a global effect on molecular determinants of endometrial receptivity.” Fertil Steril, 6 (Vol. 93) (2010): 2027–2034.
  31. Di Spiezio Sardo, A., Mazzon, I., Bramante, S., et al. “Hysteroscopic myomectomy: a comprehensive review of surgic altechniques.” Human Reproduction Update, 2 (Vol. 14) (2008): 101–119.
  32. Shokeir, T., El-Shafei, M., Yusef, H., Allam, A.F., Sadek, E. “Submucuos myoma and their implications in the pregnancy rates of patients with otherwise unexplained primary infertility undergoing hysteroscopic myomectomy: a randomized matched control study.” Fertil Steril, 94(2010): 724–729.
  33. Jayakrishnan, K., Menon, V., Nambiar, D. “Submucous fibroids and infertility: Effect of hysteroscopic myomectomy and factors influencing outcome.” Journal of Human Reproductive Sciences, 6(2013): 35–38.
  34. Zaporozhan, V.M., Fetesku, S.A., Marichereda, V.G. “Analysis of the functional state of dendritic cells CD56+, CD83 +, CD1A+ and markers of apoptosis BCL2, CVC in hyperplasia of endometrium.” Journal of Health Sciences, 8 (Vol. 4) (2014): 131–138.



How to Cite

Задорожна, Т. Д., Редько, Н. О., Татарчук, Т. Ф., Косей, Н. В., & Килихевич, С. М. (2015). Hysteroscopic, morphofunctional and immunohistochemical endometriun features in women with uterine leiomyoma after different types of organ-preserving treatment. REPRODUCTIVE ENDOCRINOLOGY, (26), 42–48. https://doi.org/10.18370/2309-4117.2015.26.42-48



Tumors and pretumoral pathology