Die Archimetra als neues morphologisch-funktionelles Konzept des Uterus sowie als Ort der Primärerkrankung bei Endometriose

Leyendecker, G.; Kunz, G.; Noe, M.; Beil, D.; Huppert, Peter; Mall, Gerhard

doi:10.1007/s004440050126

Cited by 10 publications

(10 citation statements)

References 108 publications

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“… ( Left ) A schematic representation of the endometrial‐subendometrial unit (“archimetra”) within the human uterus based on immunocytochemical results18 and the morphological and ontogenetic data,16,17 respectively. The endometrial‐subendometrial unit is composed of the glandular ( green ) and the stromal part of the endometrium and the stratum subvasculare of the myometrium with predominantly circular muscular fibers (yellow).…”

Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

“…Unlike the two outer layers of the myometrium that develop late during ontogeny14 and therefore are termed “neomyometrium,”17 the anlage of the archimyometrium can already be identified during the first trimester of gestation (hence its denomination) 14. Circular mesenchymal layers surround the fused paramesonephric ducts and develop into muscular fibers during midgestation.…”

Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

“…[14][15][16] The archimyometrium is the muscular component of the archimetra, of which the others are the epithelial and stromal endometrium. 3,14,16,17 It extends from the lower part of the cervix through the uterine corpus into the cornua, where it continues as the muscular layer of the fallopian tubes. 14,15 In high-resolution sonography and 14 showing the architecture of the subendometrial myometrium (archimyometrium) in a human fetal uterus.…”

Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

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Uterine Peristaltic Activity and the Development of Endometriosis

Leyendecker

Kunz

Herbertz

et al. 2004

Annals of the New York Academy of Sciences

146

103

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Peristaltic activity of the nonpregnant uterus serves fundamental functions in the early process of reproduction, such as directed transport of spermatozoa into the tube ipsilateral to the dominant follicle, high fundal implantation of the embryo, and, possibly, retrograde menstruation. Hyperperistalsis of the uterus is significantly associated with the development of endometriosis and adenomyosis. In women with hyperperistalsis, fragments of basal endometrium are detached during menstruation and transported into the peritoneal cavity. Fragments of basal endometrium have, because of their equipment with estrogen and progesterone receptors and because of their ability to produce estrogen, an increased potential of implantation and proliferation, resulting in pelvic endometriosis. In addition, hyperperistalsis induces the proliferation of basal endometrium into myometrial dehiscencies. This results in endometriosis-associated adenomyosis with a prevalence of approximately 90%. Adenomyosis results in impaired directed sperm transport and thus constitutes an important cause of sterility in women with endometriosis. Our own date and that from the literature strongly suggest that the principal mechanism of endometriosis/adenomyosis is the paracrine interference of endometrial estrogen with the cyclical endocrine control of archimyometrial peristalsis exerted by the ovary, thus resulting in hyperperistalsis.

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Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

Section: The Morphological Basis Of Uterine Peristalsismentioning

confidence: 99%

See 1 more Smart Citation

Uterine Peristaltic Activity and the Development of Endometriosis

Leyendecker

Kunz

Herbertz

et al. 2004

Annals of the New York Academy of Sciences

146

103

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“…Voraussetzung für die Entwicklung dieser Theorie war ein vertieftes und teilweise auch neues Verständnis der Struktur des Uterus, seiner zyklischen Funktionen sowie seiner Phylo-und Embryogenese [33,39]. Dieses daraus resultierende Konzept der Archimetra wurde bereits ausführ-lich in dieser Zeitschrift diskutiert [23]. Die Archimetra ist der innere Teil des Uterus, bestehend aus dem Endometrium und dem Stratum subvasculare des Myometriums (Archimyometrium).…”

Section: Immunhistochemische Charakteristika Der Basalis Sowie Ektopeunclassified

Dislozierung basalen Endometriums

Leyendecker

Mall

Noe

et al. 2003

Reproduktionsmedizin

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“…Eine Erkrankung des entwicklungsgeschichtlich ältesten Teils des uterinen Myometriums bei Patientinnen mit Endometriose stört durch eine uterine Hyper-und Dysperistaltik diesen Transportprozess empfindlich, der bei einer ausgedehnten Adenomyosis vollständig zum Erliegen kommt [8,9] . 3).…”

Section: Introductionunclassified

Gestörte uterine Transportfunktion in der Hysterosalpingoszintigraphie (HSSG) als prädiktiver Funktionstest für die Durchführung einer IVF-Therapie

Kissler

Wildt²,

Kohl³

et al. 2002

Zentralbl Gynakol

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Hysterosalpingoscintigraphy (HSSG) is a simple method to evaluate the transport function of uterus and fallopian tubes. There is a quick uptake of radionuclides into the uterus and a transport to the side bearing the dominant follicle in 70 % of the patients in the late follicular phase of the cycle. Uptake and transport of the immotile radionuclides imitate the directed sperm transport through the female genital tract at the time of ovulation. 214 of 796 infertility patients with proven patency of fallopian tubes (27 %) showed only an uptake of the particles without a transport towards the fallopian tubes (negative HSSG). In these patients no spontaneous pregnancy occurred and pregnancy rate remained low by the means of timed intercourse or insemination. Indeed, the pregnancy rate (8.4 %) was significantly lower compared with the patients who became pregnant by timed intercourse, insemination or spontaneously and had a positive HSSG before (15 %; p=0.001). However, the pregnancy rate that could only be achieved by methods of ART was significantly higher in the group of patients with negative HSSG (57 % vs. 25 %, p=0.05). Our data suggest that HSSG is a new method to evaluate the integrity of the inner genital tract's transport function, especially in patients suffering from idiopathic infertility. Impaired transport function (negative HSSG) should be considered as an indication for IVF-treatment.

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Die Archimetra als neues morphologisch-funktionelles Konzept des Uterus sowie als Ort der Primärerkrankung bei Endometriose

Cited by 10 publications

References 108 publications

Uterine Peristaltic Activity and the Development of Endometriosis

Uterine Peristaltic Activity and the Development of Endometriosis

Dislozierung basalen Endometriums

Gestörte uterine Transportfunktion in der Hysterosalpingoszintigraphie (HSSG) als prädiktiver Funktionstest für die Durchführung einer IVF-Therapie

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