POSSIBILITIES OF STUDYING THE STROMAL AND VASCULAR COMPONENTS OF THE ENDOMETRIUM IN WOMEN WITH INFERTILITY AND A HISTORY OF POST-COVID SYNDROME
DOI:
https://doi.org/10.11603/24116-4944.2024.2.15096Keywords:
infertility, SARS-CoV-2 virus, endometrium, post-covid syndrome, coronavirus disease-2019, morphological examination, reproductive healthAbstract
The aim of the study – to optimize vascular and stromal components investigations of endometrial biopsies in women with infertility and a history of long-term COVID-19.
Materials and Methods. A study was conducted between 2022 and 2024, and it included 80 women of reproductive age with COVID-19 and 40 women without a history of COVID-19. For both groups, the requirements for inclusion in the samples were: an established infertility diagnosis. The study methods included ultrasound examination of the pelvic organs and subsequent biopsy of changed endometrial tissue taken during office hysteroscopy in the secretory phase with a detailed study of the samples, particularly emphasizing the study of stromal and vascular components.
Results and Discussion. Histological endometrial samples of both groups were homogeneous in the middle stage of the secretory phase, according to hyperplasia of the uterine mucosa without atypia (p=0.382). The lumen of the glands varied from narrowed to dilated in cross-sectional view on the analyzed slides. The vascular component had poorly developed spiral arteries and sometimes dilated venules. The groups were homogeneous, according to dyschronosis of the menstrual cycle (p=0.188). Stromal edema was insignificant; there was heterogeneity of the stromal tissue, and decidualization disorders were noted in 23 (57.5 %) women in the control group and 62 (77.5 %) patients in the study group (p=0.033). Gland atrophy and weak secretory activity were noted in 17 (42.5 %) women from the control group and in 33 (41.3 %) women with a severe history of post-covid syndrome (PCOS, p=0.022). The groups differed among themselves regarding the detected plasma cells in the field of view (p=0.029).
Conclusions. In women with infertility and a history of prolonged COVID-19, analysis of the stromal and vascular components of the uterine mucosa during the middle stage of the secretory phase frequently reveals poorly developed and fibrotic stroma, the presence of plasma cells, and reduced secretory activity of the glands.
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