Human Reproduction, Vol. 11, No. 7, pp. 1438-1444, 1996
© 1996 European Society of Human Reproduction and Embryology
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Contraception: Endometrial lymphomyeloid cells in abnormal uterine bleeding due to levonorgestrel (Norplant)
1McMaster University, Faculty of Health Sciences, Department of Medicine Hamilton, Ontano, Canada 2National Research Institute for Family Planning 12 Da Hui Si, Beijing 100081, People's Republic of China 3Monash University, Department of Obstetrics & Gynaecology Melbourne, Australia 4Nuffield Department of Obstetrics & Gynaecology, Oxford University Oxford, UK and 5Study Group on Human Reproduction, University of Indonesia Jakarta, Indonesia
Correspondence: 6To whom correspondence should be addressed at: Departments of Medicine, Pathology, Obstetrics & Gynecology, 3V39, McMaster University, 1200 Main Street, West, Hamilton, Ontario, Canada L8N 3Z5
Endometrial lymphomyeloid cell subsets were evaluated in samples from normal women and from women with abnormal uterine bleeding due to subcutaneous levonorgestrel implants (Norplant) or an intrauterine device (IUD). The frequency of CD3+, CD68+, CD43+ and endometrial granulated lymphold cells was evaluated by inimunohistochemical or phloxine-tartrazine staining of formalinfixed paraffin-embedded samples. In normal women, cyclic variation in lymphomyeloid subsets was seen. In women using Norplant for contraception, the frequency of CD3+, CD68+ and CD43+ cells was dramatically decreased, compatible with endometrial atrophy. When Norplant users with abnormal bleeding were compared to women without bleeding, however, the number of CD68+ cells was significantly increased and the number of CD3+ and CD43+ cells was preserved, contrary to the hypothesis that this group would show a greater degree of atrophy and hence, tissue fragillty. A similar pattern was seen in a preliminary study of women with bleeding associated with use of copper-only IUD contraception, and in samples taken from late secretory and menstrual phase biopsies from normal cycling women. Whether these changes in endometrial lymphomyeloid cells represent a result of bleeding arising from a common mechanism or rather cause the uterine bleeding is discussed.
Key words: abnormal uterine bleeding/endometnal lymphomyeloid cells/intrauterine device/Norplant
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