The ultrastructure of fibromyomatous myometrium and its relationship to infertility

Abstract

The aim of this study was to determine whether the ultrastructure of the non-neoplastic myometrial portion (host myometrium) of fibromyomatous uteri is normal or abnormal when compared to that of fibromyomata and normal myometria. Myometrial samples from 23 normal and 54 fibromyomatous uteri were examined at the ultrastructural level using standard electron microscopy techniques. Ultrastructural abnormalities of certain cellular organelles were noted in myocytes of fibromyomata but not in those of normal or host myometria. The sarcolemmal dense bands of host myometrial myocytes were of significantly greater length than those of normal myometria, but not significantly different to those of fibromyomata. Consequently, the numbers of caveolae in host myometria and fibromyomata are conceivably decreased in comparison to normal myometria. Host myometria can be, therefore, considered to be structurally abnormal. The specific structural abnormality noted may affect calcium metabolism in these tissues by causing a decrease in the cellular calcium extrusion mechanism and thus raising intracellular calcium concentrations. Such an abnormality may provide an answer, in terms of contraction abnormalities, for the unexplained infertility that occurs in a small percentage of symptomatic myomatous patients.

When Should Uterine Fibroids Be Treated?

“…It has been suggested that uterine fibroids, by altering the normal pattern of uterine contractility, could inhibit proper gamete transport [26]. Tumors protruding into the uterine cavity may produce local inflammation, creating a hostile environment for gamete/embryo survival [27]. Fibroids also may alter blood flow, either mechanically or via biochemical influence, reducing the efficiency of the implantation process [28].…”

Миома Матки И Репродуктивная Функция Женщины: Критическая Оценка Терапевтических Подходов

“…Кроме того, существуют теории об индуци-рованной миомами аномальной сократимости миометрия и маточных труб, приводящей к на-рушению пассажа сперматозоидов и зиготы [13]. Однако в настоящее время ни одна из представ-ленных теорий не является основательно под-твержденной.…”

Reproductive Outcome of Infertile Patients with Fibroids Based on the Patient and Fibroid Characteristics; Optimal and Personalized Management

“…The anatomical location of the fibroids may have a detrimental effect on implantation [3]. Abnormal uterine contractility may adversely affect sperm migration, ovum transport and fertilization [4]. The underlying fibroid may induce inflammatory or vascular changes in the endometrium, resulting in a less receptive implantation site [4].…”

“…Abnormal uterine contractility may adversely affect sperm migration, ovum transport and fertilization [4]. The underlying fibroid may induce inflammatory or vascular changes in the endometrium, resulting in a less receptive implantation site [4]. Recently, it has been suggested that fibroid-derived growth factor impairs endometrial receptivity [5].…”