Ultrastructural changes in the endometrium of women using progesterone-releasing intrauterine devices for more than 5 years
González Angulo, A.; Aznar Ramos, R.
Archivos de Investigacion Medica 19(3): 319-328
1988
ISSN/ISBN: 0066-6769 PMID: 3242440 Document Number: 307690
A scanning and transmission electron microscopy study was undertaken in endometrial biopsies obtained from 10 young healthy women who had been using progesterone releasing intrauterine devices (Progestasert). The device had been used continuously for more than five years, and had a daily release of a 65 .mu.g of progesterone. The purpose of the work was to characterize the changes in the surface and glandular epithelium as well as in the stroma in a model where there is a mechanical action by the IUD and a continuous local hormonal effect resulting from the release of progesterone. All biopsies studied with the scanning electron microscope showed a marked decrease of the number of ciliated cells; the few cells present had less cilia and these were short or blunted: this in areas of contact with the IUD and also remote from it. Sparcity and shortening of microvilli of the secretory cells was always observed and in areas, there were hypertrophic denudated secretory cells covered by scarce deformed microvilli. With transmission electron microscopy the surface epithelium was thinned and had a decrease in the number of microvilli of secretory cell and a paucity of cilia in the non-secretory cells. In few cases there was a definitive cell destruction with rupture of membranes and cytoplasmic degradative changes. Glandular alterations included dilatation of the smooth endoplasmic reticulum. Stromal cells were markedly enlarged with plentifulness of cytoplasmic organelles such as endoplasmic reticulum, mitochondria and glucogen. These observations indicate that most likely the suppressed appearance of the epithelium nad the modifications of the stroma cells were the result of a constant hormonal effect. Other changes such as severe degeneration and rupture on the surface epithelium were in all likelihood the effect of the mechanical action of the devices.