Endometrial histology, microvascular density and caliber, and matrix metalloproteinase-3 in users of the Nestorone-releasing contraceptive implant with and without endometrial breakthrough bleeding.

Abstract

OBJECTIVE:

This descriptive study evaluated endometrial histology, microvascular density and caliber, and quantification of matrix metalloproteinase (MMP-3) expression in long-term users of the Nestorone (NES)-releasing implant who presented or not endometrial breakthrough bleeding (BTB).

METHODS:

Endometrial biopsies were obtained from 32 healthy women with unpredictable BTB. The quantitative analysis was performed only in 20 samples.

RESULTS:

The mean duration of use of the implant among the 14 women with BTB was 19.6+/-1.0 months, and the other six women had used the implant for 17.7+/-2.3 months (mean+/-S.E.M.). Histological analysis of the endometrial tissue showed a predominance of progestogenic pattern followed by atrophic and proliferative endometrium in both groups. Mucosal breakdown and glandular pseudostratification were observed in half of the cases. Endometrial vascular density was 73.1+/-10.0 and 57.5+/-24.1 vessels/mm(2), and maximum vessel diameter was 923.3+/-86.0 and 1038.0+/-404 microm (mean+/-S.E.M.) in the group with and without BTB, respectively, without significance, and the rate of cells expressing MMP-3x1000 counted stromal cells was 155.8+/-24.8 and 127.0+/-19.0 (mean+/-S.E.M.) in both groups, respectively, without significance.

CONCLUSIONS:

This study provides information about some endometrial aspects of women using NES in contraceptive implants. In addition, the endometrium was similar during long-term use of NES-releasing contraceptive implants in women with and without endometrial bleeding.

• Authors: Marilia Oliveira-Ribeiro, Carlos A Petta, Liliana A L De Angelo Andrade, Margarete M Hidalgo, Alessandra Pellogia, Luis Bahamondes
• Journal: Contraception (Contraception) Vol. 73 Issue 6 Pg. 634-40 (Jun 2006) ISSN: 0010-7824 [Print] United States
• PMID: 16730498 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Contraceptive Agents, Female
• Drug Implants
• Norprogesterones
• ST 1435
• Matrix Metalloproteinase 3

Topics

• Adult
• Biopsy
• Contraceptive Agents, Female (adverse effects)
• Drug Implants (adverse effects)
• Endometrium (blood supply, drug effects, enzymology, pathology)
• Female
• Humans
• Matrix Metalloproteinase 3 (analysis)
• Metrorrhagia (chemically induced)
• Microcirculation (drug effects)
• Norprogesterones (administration & dosage, adverse effects)