Adhesion of human endometrial fragments to peritoneum in vitro

Patrick G. Groothuis, Carolien A.M. Koks, Anton F.P.M. de Goeij, Gerard A.J. Dunselman, Jan Willem Arends, J.L.H. Evers
In: Fertility and Sterility · 1999 · vol. 71(6) , pp. 1119–1124 · doi:10.1016/s0015-0282(99)00122-3 · PMID:10360921 · W2171471341
article OA: bronze CC0 ⤵ 54 in-corpus citations
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This study investigated the adhesion of human endometrial fragments to peritoneal tissue under in vitro conditions to understand mechanisms of endometriosis development.

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Abstract

ObjectiveTo evaluate the adhesion of endometrial fragments obtained during the proliferative phase of the menstrual cycle to fresh human peritoneum obtained during abdominal surgery.DesignA prospective, descriptive, morphologic and cell biologic study.SettingTertiary care university medical center.Patient(s)Six female volunteers.Intervention(s)After endometrial biopsies performed during diagnostic laparoscopy, endometrial fragments were generated by enzymatic digestion and mechanical separation. Peritoneum was obtained during abdominal operations for benign indications.Main outcome measure(s)Adhesion of endometrial fragments was studied by histologic examination and scanning and transmission electron microscopy.Result(s)After incubation, the mesothelium was intact in some areas, whereas in other areas mesothelial cells were damaged or absent. Adhesion of endometrial fragments was observed only at locations where the basement membrane was exposed. In areas largely denuded of mesothelial cells, endometrial fragments spread over the basement membrane to form monolayers.Conclusion(s)Human peritoneum is suitable for studying the adhesion of endometrial fragments. Intact mesothelium prevents the adhesion of endometrial fragments, suggesting that trauma to the mesothelial lining is a prerequisite for endometrial cell adhesion.

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