Histologic and Ultrastructural Changes in Human Endometriotic Implants Treated with the Antiprogesterone Steroid Ethylnorgestrienone (Gestrinone) During 2 Months
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Treatment of endometriosis with ethylnorgestrienone for 2 months induced inactivity and involutionary changes in most implants, suggesting a progesterone withdrawal effect without altering disease extent.
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Abstract
In 20 infertile patients, the laparoscopic, histologic, and ultrastructural characteristics of endometriotic implants were studied before and after a 2-month course of therapy using 1.25 mg of the antiprogesterone steroid ethylnorgestrienone daily. Before treatment, well-differentiated endometriotic foci were seen only in implants with a rich microvascular supply. It is postulated that the degree of microvascular development may determine the differentiation of ectopic endometrium. After therapy, well-differentiated endometriotic tissues were recovered in only one patient. In all other patients, the foci remained undifferentiated, while in 11 patients striking epithelial involutionary changes were seen, such as nuclear pyknosis, extrusion of nuclear remnants, enhanced lysosomal autophagy, abortive secretion, and focal epithelial erosion. These histologic and ultrastructural changes reflect a progesterone withdrawal effect in endometriotic implants. It is thus concluded that ethylnorgestrienone induces inactivity in most endometriotic implants, while marked involution is observed in many foci. However, this subcellular involution does not result in a change of the extent of the disease according to the American Fertility Society classification system. Preliminary data concerning the pregnancy rate reveal that five patients conceived during a mean follow-up period of 6 months.
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Cited by (29)
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- THE ROLE OF MACROAUTOPHAGY IN THE PATHOGENESIS OF ENDOMETRIOSIS 2024
- Autophagy in endometriosis. 2017
- Autophagy in endometriosis: Friend or foe? 2017
- Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis 2014
- Progesterone Resistance and Targeting the Progesterone Receptors: A Therapeutic Approach to Endometriosis 2012
- Surgical management of endometriosis-associated pain 2003
- Endometriosis 2003
- Epidemiology of Endometriosis 2003
- Treatment of Endometriosis 2001
- Endometriosis, Endometrioma, and the Problem of Adhesions 2000
- Endometriosis and Pelvic Pain 1998
- Biases in the endometriosis literature 1998
- Rationale for Surgical Treatment of Endometriosis 1995
- Recurrent Endometriosis 1995
- Diseases of the Peritoneum 1994
- Aberrant integrin expression in the endometrium of women with endometriosis. 1994
- Estrogen and progesterone receptors in endometriotic tissue and endometrium: comparison according to localization and recurrence. 1993
- The staging of peritoneal endometriosis by the type of active lesion in addition to the revised American Fertility Society classification 1993
- 5 Appearances of endometriosis 1993
- Estrogen and progesterone receptors in endometriotic tissue and endometrium: comparison according to localization and recurrence 1993
- Gestogens and anti-gestogens as treatment of endometriosis 1991
- Steroid receptors in endometriosis 1991
- Is There a Rationale for GnRH Analogue Therapy in Endometriosis? 1990
- Is There a Rationale for GnRH Analogue Therapy in Endometriosis? 1990
- THE RATIONALE FOR ENDOCRINE THERAPY 1989
- Histologic study of ovarian endometriosis after hormonal therapy 1988
- The morphologic effect of short-term medical therapy of endometriosis 1987
- Histology and ultrastructure of human endometriotic tissues treated with dydrogesterone (Duphaston) 1987
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