MORPHOLOGICAL FEATURES OF ENDOMETRIUM IN WOMEN OF REPRODUCTIVE AGE: ANALYSIS OF MORPHOMETRIC INDICATORS

Abstract

Endometrium is the main structure in the process of implantation, which undergoes permanent morpho-functional changes, and its adequate state and pregravidar transformation are necessary conditions for normal passing of pregnancy, especially in its first trimester. The research of the features of the morphological structure of normal endometrium using modern morphometric methods is necessary for understanding the essence of the pathological processes of the fuctional layer of the uterus, the progress of which may hinder pregnancy.

Material and Methods. For morphometric researching histological preparations of the functional layer of the uterus of 20 women of reproductive age with normal endometrium in the proliferation and secretion phase were used. Serial, progressive sections of paraffin blocks, thickness 2–4 micron were carried out, and were painted according to the standard method of hematoxylinum and eosin. Measurement and analysis of the diameter of the glands of the endometrium, the thickness of the wall of the glands, the ratio of the cross-sectional area of ​​the glands to the area of the endometrium was carried out.

Results. On the basis of morphometric research of histological preparations of the functional layer of the uterus in women of reproductive age, with a normal menstrual cycle, whose average age was (32+10) years, it was found that the results of the morphological research can be used for the purpose of analytical study of both physiological and pathological transformability of human endometrium.

In the endometrium of the proliferation phase, the diameter of the glands arranged from 28.29 to 70.29 μm with an IQR of 21.94. The thickness of the wall is equable and its value was (15.02±3.61) μm. The ratio of the cross-sectional area of the glands to the area of the parenchyma section was equable throughout the samples and ranged from 7 % to 13 % with an average value of 10 %.

In the morphometric study, the polymorphism of the glandular endometrial structures of the secretory type is confirmed by certain indices: the diameter of the glands is 71.81 (47.71; 83.95) μm and ranges from 33.39 μm to 125.02 μm with an IQR of 36.24. The increase in diameter compared with the parameters of the proliferation phase is statistically significant (p <0.05 with an exact value of the Man-Whitney U=72 criterion). At the same time, the thickness of the walls of the glands decreased somewhat and was (13.13±3.37), which was statistically significantly lower than the thickness index in the proliferation phase. The glands had more chaotic layout in comparison with the samples of the proliferation phase – the ratio of the cross-sectional area of the glands to the area of the parenchyma section ranged from 17 % to 52 % with an average of 32 % (the difference is statistically significant, p <0.05 at the value of c² = 97).

Conclusions. The morphological structure of the endometrium of women of reproductive age is characterized not only by histological but also by morphometric differences. Thus, the data obtained by us indicate a reliable difference between the main morphometric indices of the glands of the uterine mucus in the proliferative and secretory phases of the menstrual cycle in norm.

Prospects for further research. The morphological structure of the endometrium in conditions of norm and pathology requires new approaches with the use of modern available methods neccesary to understand the nature of the pathological processes of the fuctional layer of the uterus, especially in women of reproductive age, who are addressing the infertility caused by the uterine factor.