Search

Endometrial polyp is the lesion frequently found by hysteroscopy. The presence of endometrial polyp is associated with abnormal uterine bleeding and is probably associated with infertility. Until today, clinical guidelines for endometrial polyp remain elusive. The aim of this preliminary study was to estimate whether the shape of endometrial polyps affects the response to the treatment with an oral contraceptive (OC). We performed a retrospective case series study on 50 women diagnosed as endometrial polyps by hysteroscopy and managed by the administration of OC. Hysteroscopy was performed in the follicular phase of the menstrual cycle before medical treatment. Endometrial polyps were classified as pedunculated polyps ( n == 25) or sessile polyps ( n == 25). After diagnosis, OC was administered for 2--5 months (median 3 months) intermittently: To quantify the regression rate of lesions, the area index of endometrial polyps was assessed. In the study group, when comparing the efficacy of treatment with OC, there was a statistically significant difference in the regression rate between sessile polyps and pedunculated polyps (76%% vs. 44%%, p == 0.042). We conclude that sessile polyps are more sensitive to OC treatment than pedunculated polyps, implying usefulness of the hysteroscopic classification of the shape of polyps in the management of endometrial polyps. [ABSTRACT FROM AUTHOR]

Preoperative diagnosis of chronic ectopic pregnancy is often difficult because of the high incidence of negative results on pregnancy tests as a consequence of the very small amount of live villi, subtle symptoms, and the poor specificity of ultrasonographic patterns. A 45-year-old woman was referred to our department for evaluation of a mass 8 cm in diameter with solid parts in the right adnexal area. Transvaginal ultrasonography showed a mass consisting of a cystic part with an irregular thick capsule distinct from the right ovary. In the center of the cystic part, a fetus-like image, 20 mm in length was seen. Preoperative diagnosis was confirmed by the laparoscopy, which revealed a swollen right tube containing a fetus with highly necrotic changes. This case was unique because chronic ectopic pregnancy was detected at an early stage before absorption of the conceptus occurred, which coincidentally is an appropriate time for morphological diagnosis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Matrix metalloproteinases (MMPs) and the plasminogen activator (PA)/plasmin system are two major groups of proteases involved in the matrix degradation required for embryo implantation. We previously showed that the content of cholesterol sulfate (CS) in rabbit endometrium increases characteristically during the implantation period. Furthermore, CS has been reported to inhibit serine proteases. In this study, we investigated whether CS can regulate the activity of proteases in cultured human endometrial stromal cells. [ABSTRACT FROM PUBLISHER]

Aim: Hysterosalpingography (HSG) is one of the most commonly used methods in order to evaluate the condition of fallopian tubes in infertility clinics. In the present paper, we retrospectively compared the findings of HSG and laparoscopy to elucidate the relationship between tubal dysfunction and background factors, such as Chlamydia trachomatis infection, endometriosis and previous surgery. Methods: We retrospectively reviewed clinical records of 314 patients who were examined by both HSG and laparoscopy between 1996 and 2001 in the Department of Obstetrics and Gynecology, University of Tokyo. Results: When HSG findings were evaluated in reference to those of laparoscopy, sensitivity and specificity for tubal patency were 0.63 and 0.79, respectively, whereas those for peri-tubal adhesion were 0.65 and 0.61, respectively. We compared the percentage of existence of background factors between the patients who were diagnosed as normal by both HSG and laparoscopy (Group L[+]) and those whose fallopian tubes were observed as patent by HSG, but were not patent by chromopertubation under laparoscopy (Group L[–]). The percentage of patients with positive chlamydial antibodies in Group L(–) (42.9%, 15/35) was significantly higher than that of patients with positive chlamydial antibodies in Group L(+) (22.8%, 44/193, P < 0.05). Conclusions: These finding suggested that even if HSG showed normally patent tubes in a patient with positive Chlamydia trachomatis antibodies, the possibility of tubal occulusion still remains high and further examination by laparoscopy is recommended. (Reprod Med Biol 2007; 6: 39–43) [ABSTRACT FROM AUTHOR]

Background: Although Brenner tumors with endocrine activities have been reported, the source or mechanisms for hormone production is poorly known at present. Case Report: A 66-year-old Japanese woman presented with atypical vaginal bleeding. A left ovarian tumor was detected on ultrasonography and CT scanning. Her serum estradiol level was elevated (73.5 pg/ml). We performed total hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. The ovarian tumor was diagnosed as a benign Brenner tumor associated with simple hyperplasia of the endometrium. Postoperatively, the serum estradiol level decreased. Immunoreactivity of cytochrome P-450 aromatase was detected in stromal cells. Conclusion: Stromal contribution to the secretion of estrogen was shown in this case. Considering the known source of estrogen production being tumor cells in certain cases of Brenner tumor, there seem to be two types of estrogen-producing Brenner tumors depending on the source of estrogen, i.e. tumor cells or stromal cells.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The presence of hepatocyte growth factor (HGF) in follicular fluid (FF) relative to concentrations of sex steroid hormones and human chorionic gonadotrophin (HCG) was investigated. A total of 69 FF samples were obtained during oocyte retrieval for in-vitro fertilization (IVF) from 11 patients with no apparent endocrine disorders. The concentrations of HGF, oestradiol, progesterone, HCG and testosterone in FF samples were measured by enzyme-linked immunosorbent assay. Transcription of HGF and its receptor, c-met, was detected by reverse transcription-polymerase chain reaction (RT-PCR). Human FF samples contained ~90-fold higher amounts of HGF (24.2 ± 1.2 ng/ml), compared with those of serum (0.28 ± 0.04 ng/ml). Concentrations of HGF in FF were positively correlated with those of progesterone (r = 0.649, P < 0.0001) and HCG (r = 0.264, P = 0.026) concentrations in FF. However, HGF concentrations were not significantly correlated with oestradiol and testosterone. HGF in FF was detected by Western blotting, as a single 90 kDa band, corresponding to a single chain form. Additionally, mRNA for both HGF and its receptor were detected in a crude granulosa cell preparation from the pre-ovulatory follicles. These findings suggest that HGF is produced locally in human ovarian follicles and may have a physiological role as an autocrine/paracrine factor. [ABSTRACT FROM AUTHOR]