Effects of levonorgestrel-releasing intra-uterine system on the expression of vascular endothelial growth factor and adrenomedullin in the endometrium in adenomyosis

Jovelle B. Laoag‐Fernandez, Laoag-Fernandez JB, J B Laoag-Fernandez, T. Maruo, Maruo T, P. Pakarinen, I. M. Spitz, Spitz IM, E Johansson, Johansson E
Human Reproduction · 2003 · vol. 18(4) , pp. 694–699 · doi:10.1093/humrep/deg179 · PMID:12660258 · W2057765159
Non-randomised trial OA: closed CC0 ⤵ 23 in-corpus citations
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Levonorgestrel-releasing intra-uterine system insertion decreased endometrial VEGF and increased endometrial AM expression after three months in women with adenomyosis.

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Abstract

BACKGROUND: The levonorgestrel-releasing intra-uterine system (LNg-IUS) has been used to control menorrhagia, but irregular bleeding during the first 3 months of use was the most notable side effect. Endometrial angiogenesis is believed to be regulated by angiogenic factors. The study aim was to evaluate the effects of LNg-IUS on vascular endothelial growth factor (VEGF) and adrenomedullin (AM) expression in the endometrium. METHODS: VEGF and AM expression were analysed using the avidin-biotin immunoperoxidase method on endometrial curettage specimens from menorrhagic women associated with adenomyosis before and 3 months after LNg-IUS insertion. RESULTS: VEGF expression was abundant both in the endometrial glands and stroma before LNg-IUS insertion, but became scanty 3 months after insertion. No immunostaining for AM was noted in the endometrial glands and stroma before LNg-IUS insertion, whereas AM immunostaining became prominent in the endometrial glands and stroma 3 months after LNg-IUS use. CONCLUSIONS: This is the first study to demonstrate that LNg-IUS insertion results in decreased expression of VEGF and increased expression of AM in the endometrial glands and stroma after 3 months of use. The results obtained suggest that the increase in AM expression in the endometrium may be responsible for the frequent occurrence of irregular bleeding during the initial 3 months of LNg-IUS use.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Contraceptive Agents, Female Endometriosis Endometrium Intrauterine Devices, Medicated Intrauterine Devices, Medicated Levonorgestrel Peptides Vascular Endothelial Growth Factor A Adrenomedullin Adrenomedullin Adult Adult Contraceptive Agents, Female Contraceptive Agents, Female Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium

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References (47)

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