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Human Reproduction, Vol. 11, No. suppl_2, pp. 35-44, 1996
© 1996 European Society of Human Reproduction and Embryology

Endometrial vasculature in Norplant® users: preliminary results from a hysteroscopic study

Martha Hickey, Ian Fraser2, Dennis Dwarte1 and Sian Graham

1 Electron Microscopy, University of Sydney NSW 2001, Australia Departments of Obstetrics and Gynaecology NSW 2001, Australia

Correspondence: 2To whom correspondence should be addressed

Long-acting progestogenic contraceptives are frequently associated with disturbances of menstrual bleeding patterns. In particular, irregular, frequent and prolonged bleeding are commonly seen. The mechanism of this irregular bleeding is unknown, but changes in the endometrial vasculature are thought to be of importance. In endometrial biopsies from Norplant® users, an increase in endometrial mlcrovascular density has been observed after 3–12 months. Morphological changes in endometrial capillaries following progestogen exposure have, suggested an increase in vascular fragility. Little is known about the structure and function of the endometrial vasculature in vivo following exposure to exogenous contraceptive steroids. This study has developed techniques for the assessment of vascular fragility by imposing a mechanical stress on the endometrium and observing subsequent bleeding under direct vision. The techniques were used in a preliminary examination between 1 and 9 months after Norplant insertion, and the study identified a number of morphological and functional characteristics of Norplant-exposed endometrium.

Key words: endometrium/hysteroscopy/Norplant/progestogens/vascular


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