Human Reproduction, Vol. 17, No. 10, 2523-2528,
October 2002
© 2002 European Society of Human Reproduction and Embryology
In-vitro adhesion of endometrium to autologous peritoneal membranes: effect of the cycle phase and the stage of endometriosis*
1 Leuven University Fertility Center and 2 Department of Pathology, UZ Gasthuisberg, KU Leuven, Belgium
BACKGROUND: Endometrium can adhere to autologous peritoneum. This study was undertaken to determine the effect of the menstrual cycle phase and the presence and stage of endometriosis on in-vitro adhesion of endometrium onto autologous peritoneum. METHODS: This was performed in an academic medical research centre. Sixty-seven subfertile women with a visually normal pelvis (n = 18) and with biopsy-proven endometriosis (n = 49) were included. Endometrial and peritoneal biopsies were obtained at laparoscopy during menstrual, follicular and luteal phase. Endometrium was cultured in vitro with autologous peritoneum, followed by fixation, paraffin embedding, serial sectioning, hematoxylin–eosin and immunohistochemical staining. Endometrial–peritoneal adhesion was evaluated using light microscopy. RESULTS: Endometrial–peritoneal adhesion was observed in 
80% of the adhesion assays and was not affected by the phase of the cycle, or by the presence and stage of endometriosis. The continuity of the mesothelial layer was disrupted at the attachment sites. Epithelialization was observed along the edges to integrate the endometrial implant. After adhesion, histological changes were observed within and below the implant. CONCLUSIONS: Endometrium obtained during menstrual, follicular or luteal phase appears to have a similar potential to implant in vitro on autologous peritoneum, and this adhesion process is not affected by the stage of endometriosis.
Key words: adhesion/endometriosis/endometrium/peritoneum/tissue culture
* Presented in part at the 7th Biennial World Congress of Endometriosis, London, May 14–17, 2000.
3 To whom correspondence should be addressed at: Leuven University Fertility Center, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. E-mail: sophie.debrock{at}uz.kuleuven.ac.be
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