Hormonally mediated disturbance of angiogenesis in the human endometrium after exposure to intrauterine levonorgestrel

McGavigan, C.J., Dockery, P., Metaxa-Mariatou, V., Campbell, D., Stewart, C.R., Cameron, I.T. and Campbell, S. (2003) Hormonally mediated disturbance of angiogenesis in the human endometrium after exposure to intrauterine levonorgestrel. Human Reproduction, 18, pp. 77-84. (doi: 10.1093/humrep/deg023)

Abstract

BACKGROUND: The levonorgestrel intrauterine system (LNG‐IUS) is a contraceptive device that is used for treatment of menorrhagia. The system induces inter‐menstrual bleeding within the first few months after insertion. We hypothesized that this bleeding might be associated with a change in vascular development. METHODS: A randomized, controlled study was undertaken on 48 women. RESULTS: Hysterectomy specimens were obtained and immunocytochemistry was carried out with antibodies to CD31, α‐smooth muscle actin and myosin. Stereological measurement of blood vessels was also undertaken. Most vessels appeared normal, including the arterioles. Large thin‐walled vessels were present in the superficial endometrium of the treated group but were almost completely absent in the controls. The distribution of cytoskeletal markers revealed well‐formed basal arterioles with more widespread expression in the superficial stroma than was found in untreated tissue. The volume fraction of blood vessels (P = 0.0001), the number of vessel cross‐sections per unit area (P = 0.0003) and the cross‐sectional diameters of the largest vascular lumens (P = 0.0001) were significantly increased following treatment with LNG‐IUS. However, there was no difference in the median values of vessel diameter or the vascular surface density. CONCLUSION: These findings suggest that the LNG has a localized effect on some vessels within the superficial endometrium.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stewart, Dr Colin
• Authors: McGavigan, C.J., Dockery, P., Metaxa-Mariatou, V., Campbell, D., Stewart, C.R., Cameron, I.T., and Campbell, S.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Human Reproduction
• Publisher: Oxford University Press
• ISSN: 0268-1161
• ISSN (Online): 1460-2350