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Eutopic Endometrium From Women With Endometriosis Shows Altered Ultrastructure and Glycosylation Compared to That From Healthy Controls—A Pilot Observational Study

Maternal and Fetal Health Research Centre, School of Clinical and Laboratory Science, University of Manchester, Manchester, United Kingdom, carolyn.jones{at}manchester.ac.uk

Ibrahim M. Inuwa, PhD

Department of Human and Clinical Anatomy, Sultan Qaboos University Hospital, Sultanate of Oman

Luciano G. Nardo, MD

Maternal and Fetal Health Research Centre, School of Clinical and Laboratory Science, University of Manchester, Manchester, United Kingdom, Department of Reproductive Medicine, St Mary's Hospital, Manchester, United Kingdom

Pietro Litta, MD

Department of Obstetrics and Gynaecology, University of Padua, Italy

Asgerally T. Fazleabas, PhD

Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois

Endometrial curettings from a cohort of 24 women with endometriosis were compared with matched biopsies from 14 healthy, fertile women and examined for ultrastructural changes and the secretion of glycans bound by the lectin from Dolichos biflorus. Ultrastructural analysis of glandular endometrial tissue from women with stages I to III endometriosis showed heterogeneous responses to the disease, biopsies often showing a mixture of features, combining delays in the maturation sequence with characteristics of later phenotypes particularly in the mid-late secretory phase of the menstrual cycle. Expression of glycans bound by Dolichos biflorus agglutinin was very variable in these cases but generally matched the observed ultrastructure. Biopsies from women with stage IV endometriosis showed immature gland morphology later in the cycle and also failed to express Dolichos biflorus agglutinin—binding glycans, suggesting an association between histological and biochemical function in advanced disease states. These findings may explain in part endometriosis-associated subfertility as blastocyst attachment is intimately associated with appropriate glycosylation and gland morphology.

Key Words: Endometriosis • endometrium • glycosylation • ultrastructure • human.

This version was published on June 1, 2009

Reproductive Sciences, Vol. 16, No. 6, 559-572 (2009)
DOI: 10.1177/1933719109332825


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