Progesterone: a little-known role of the well-known hero
Keywords:endometrial polyp, micropolyps, chronic endometritis, infertility, progesterone
Endometrial polyps and chronic endometritis are two most common causes of unexplained infertility in women of reproductive age.
The aim of our study was to conduct a comparative analysis of the hormonal homeostasis and the state of the receptor apparatus of the endometrium in women of reproductive age with endometrial polyps and micropolyps.
For a research 4 groups of women were chosen: 34 women with endometrial polyps (IA group), 36 patients with endometrial polyps and micropolyps (IB group), 30 women with micropolyps (IІ group) and 30 healthy women (ІІІ group). In all groups of women the content in blood serum for 3–5 day of a menstrual cycle of gonadotropic hormones (follicle-stimulating hormone, luteinizing hormone) and sex steroid hormones (estradiol, prolactin) was studied, for 21 days of a cycle estimated the content of progesterone. Level of an expression of receptors of progesterone and estrogen estimated in endometrium and at endometrial polyps, also in І a cycle phase.
The conducted research revealed reliable decrease in level of progesterone at women with endometrial polyps against the background of lack of significant changes in the receptor device. At patients with micropolyps the tendency to a hypoprogesteronemia was also observed, but changes in an expression of steroid receptors it was not also revealed.
The authors conclusion is the low concentration of progesterone initiate non-hormonal pathophysiological mechanisms of development of endometrial polyps which should be considered at purpose of antirecurrent therapy.
Thus, in case of progesteron deficit perverse mechanisms literally overlap in an attempt to start the process of tumor. Inflammation is an important component of the physiological menstrual cycle, during prolonged hypoprogesteronemia it becomes pathological. It is directly involved in the formation of such a microenvironment for endometrium in which the mechanisms of fibrosis fully realize their potential, cell proliferation and angiogenesis, creating a strong foundation for the subsequent formation and growth of endometrial polyps. To date, it is proved that an imbalance in estrogen-progesterone system actually increases the risk of developing endometrial polyps, but not always through steroid receptors.
- Indraccolo, U., Di Iorio, R., Matteo, M., et al. “The pathogenesis of endometrial polyps: a systematic semi-quantitative review.” European Journal of Gynaecological Oncology XXXIV.1 (2013): 5–22.
- Cicinelli, E., Resta, L., Nicoletti, R., et al. “Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis.” Human Reproduction 20.5 (2005): 1386–9.
- Aplin, J., Fazleabas, A., Glasser, S., Giudice, L. The Endometrium. UK. Informa healthcare (2008): 882 p.
- Roy, S., Bagchi, D., Raychaudhuri, S. Chronic inflammation. Molecular Pathophysiology, Nutritional and Therapeutic Interventions. Boca Raton. CRC Press Taylor & Francis Group (2013): 460 p.
- Berezhnaya, N.M. “Role of immune system cells in the tumor microenvironment. Cells and cytokines – inflammation of the participants.” Oncology 11.1 (2009): 6–17.
- Al-Jefout, M., Black, K., Schulke, L., et al. “Novel finding of high density of activated mast cells in endometrial polyps.” Fertil Steril 92.3 (2009): 1104.
- Radzinsky, V.E. Ordiyants, I.M., Dobretsova, T.A. “Endometrium in the fire. Acute and chronic inflammation of the endometrium, from new perspectives to new strategies.” StatusPraesens 2 (2016): 126–31.
- Kuvacheva, N.V., Morgun, A.V., Hilazheva, E.D., et al. “Inflammasome develop: new mechanisms of regulation of cell-cell interactions and secretory activity of the cells.” Siberian Medical Review 5 (2013): 3–10.
- Harada, T. Endometriosis: Pathogenesis and Treatment. Japan. Springer (2014): 475 p.
- Adamyan, L.V., Aznaurova, J.B. “Molecular aspects of pathogenesis of endometriosis.” Reproduction Problems 2 (2015): 66–77.
- Fujiwaki, R., Iida, K., Kanasaki, H., et al. “Cyclooxygenase-2 expression in endometrial cancer: correlation with microvessel count and expression of vascular endothelial growth factor and thymidine phosphorylase.” Human pathology 33.2 (2002): 213–9.
- Erdemoglu, E., Guney, M., Karahan, N., Mungan, T. “Expression of cyclooxygenase-2, matrix metalloproteinase-2 and matrix metalloproteinase-9 in premenopausal and postmenopausal endometrial polyps.” Maturitas 59 (2008): 268–74.
- Makletsova, S.A., Ipastova, I.I. “Progesterone role in implantation and early pregnancy: from the history of modern solutions to the issue.” StatusPraesens 14.3 (2013): 111– 6.
How to Cite
Copyright (c) 2016 T. F. Tatarchuk, D. G. Herman
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.