Reappraisal of the ultrastructure of the human endometrial glandular cell

Human endometrium ultrastructure during the implantation window: a new perspective of the epithelium cell types

The human endometrium is a hormonally regulated tissue that cyclically growths and differentiates in order to become a structure adequate for implantation. Molecular studies have shown some contradicting results and thus a reappraisal of the endometrium ultrastructure is warranted. In our study, endometrium biopsies were taken during the implantation window of 10 healthy women of reproductive age and analyzed using electron microscopy. Our results showed that during implantation window, the endometrial epithelium encompassed 4 cell types: microvilli-rich cells, pinopode cells, vesiculated cells, and ciliated cells. These cells showed signs of active communication with their external environment and neighboring cells, such as endocytosis, transcytosis and exocytosis. We highlighted important differences between surface and glandular epitheliums and characterized apocrine and holocrine secretion. It is likely that the features described reflect distinct functions in endometrium physiology that should be taken into account in the evaluation of the endometrium during the implantation window.

Gene expression during successful implantation in a natural cycle

OBJECTIVE

To determine the human endometrial transcriptome during embryonic implantation.

DESIGN

Case report.

SETTING

Tertiary fertility center.

PATIENT(S)

A 24-year-old woman who inadvertently became pregnant during an endometrial biopsy procedure.

INTERVENTION(S)

An endometrial biopsy was performed with a Pipelle device during the midluteal phase (days 19-21) of the cycle; blood samples for hormonal assessments were collected and a transvaginal ultrasound was performed.

MAIN OUTCOME MEASURE(S)

Gene expression analysis of the endometrium during the window of implantation (during the implantation of an embryo) in a natural cycle. Localization of selected genes in endometrial tissue with immunohistochemistry.

RESULT(S)

A total of 394 probe sets were differentially expressed in the pregnant sample when compared with the midsecretory phase nonpregnant endometrial samples. Different gene networks were involved, and selected genes from these signaling pathways were confirmed at the protein level.

CONCLUSION(S)

Endometrial gene expression of a pregnant patient in a natural cycle is significantly different from nonpregnant patients during the midsecretory phase.

Eutopic endometrium from women with endometriosis shows altered ultrastructure and glycosylation compared to that from healthy controls--a pilot observational study

Endometrial curettings from a cohort of 24 women with endometriosis were compared with matched biopsies from 14 healthy, fertile women and examined for ultrastructural changes and the secretion of glycans bound by the lectin from Dolichos biflorus. Ultrastructural analysis of glandular endometrial tissue from women with stages I to III endometriosis showed heterogeneous responses to the disease, biopsies often showing a mixture of features, combining delays in the maturation sequence with characteristics of later phenotypes particularly in the mid-late secretory phase of the menstrual cycle. Expression of glycans bound by Dolichos biflorus agglutinin was very variable in these cases but generally matched the observed ultrastructure. Biopsies from women with stage IV endometriosis showed immature gland morphology later in the cycle and also failed to express Dolichos biflorus agglutinin-binding glycans, suggesting an association between histological and biochemical function in advanced disease states. These findings may explain in part endometriosis-associated subfertility as blastocyst attachment is intimately associated with appropriate glycosylation and gland morphology.

Ultrastructure of ectopic peritoneal lesions from women with endometriosis, including observations on the contribution of coelomic mesothelium

Following a study in a baboon model of endometriosis, we here describe the morphology of ectopic peritoneal lesions in the human to examine the effects of an ectopic site on glandular structure and function. Ectopic biopsies from 17 women with endometriosis were fixed and processed for electron microscopy. Certain biopsies were also probed for intermediate filaments using immunohistochemistry. Ultrastructurally, lesions showed many different glandular morphologies with indications of delayed maturation compared to normal endometrium. Mesothelium covered some lesions and there was evidence of mesothelial invasion into the stroma. Ectopic endometriotic lesions from women with endometriosis showed ultrastructural differences from eutopic endometrium, with indications that mesothelial invasion may contribute to gland development in some lesions.

Reproductive biology and IVF: ovarian stimulation and endometrial receptivity

The influence of ovarian stimulation on endometrium receptivity has been inadequately addressed in medical literature. Hormonal effects of ovarian stimulation on endometrial changes as compared with the natural cycle should be elucidated and correlated with the potential of the embryo to implant. It is important to distinguish between the endometrial effect of induction of ovulation in anovulatory women and those of ovarian (super)ovulation in ovulatory women. Induction of ovulation leads to in vivo conception whereas ovarian stimulation results in in vitro fertilization. The available data in the field indicate that endometrial changes have an impressive negative influence on the potential of embryonic implantation. The aim of this review is to analyse the effects of gonadotropin, GnRH-agonist and GnRH-antagonist administration on endometrial behaviour, to highlight the gaps in current knowledge and to propose areas in which research is needed.

Intranuclear endoplasmic reticulum induced by Nopp140 mimics the nucleolar channel system of human endometrium

Exogenous expression of the characteristic repeat domain of the nucleolar chaperone Nopp140 induces the formation of intranuclear structures, termed R-rings. Here, the R-rings are identified as extensive stacks of membrane cisternae in the otherwise membrane-free nucleus. They consist of bona fide endoplasmic reticulum (ER) containing integral membrane proteins of the smooth and rough ER. Although lacking nuclear pore complexes and lamina, the R-rings derive specifically from the inner nuclear membrane. These findings are consistent with the idea that all transmembrane proteins synthesized in the ER and the outer nuclear membrane can freely diffuse through the pore membrane domain into the inner membrane. Uniquely, the soluble transfected Nopp140 is directly involved in the generation of these membrane stacks as it localizes to the electron dense matrix in which they are embedded. The only well-documented example of intranuclear membrane proliferation is the nucleolar channel system of the postovulation human endometrium. The transient emergence of the nucleolar channel system correlates precisely with the readiness of the endometrium for the implantation of the fertilized egg. The nucleolar channel system exhibits an ultrastructure that is indistinguishable from R-rings, and nuclei of human endometrium harbor Nopp140 and ER marker containing structures. Therefore, the nucleolar channel system appears to be identical to the R-rings, suggesting a role for Nopp140 in human reproduction.

Characteristics of the uterine luminal surface epithelium at preovulatory and preimplantation stages in the marmoset monkey

Light and electron microscopy was used to examine the apical luminal epithelial surface of the uterus at preovulatory and preimplantation stages in the marmoset monkey. Luminal surface charge, detected by cationic ferritin staining, progressively decreased from preovulation to day 11 of pregnancy. The smooth, regular apical plasma membrane at preovulatory stages was in contrast to the convoluted, irregular surface observed during early pregnancy, especially at 1 day before blastocyst implantation. Profiles of microvilli were also altered, becoming thicker and more irregular during early pregnancy. Within the epithelial cell body, cyclic morphologic changes were seen, largely in association with secretory organelles. Giant phagocytic bodies were prominent at all stages examined, although their composition and intensity of staining varied throughout the cycle. Weak to moderate estrogen alpha and progesterone receptor immunostaining of the luminal epithelium was found during preovulatory and early pregnancy stages. This study describes complex cyclic changes in the morphology and biochemical make-up of the uterine luminal epithelial surface in a New World monkey in preparation for blastocyst attachment.

The effects of steroids on the fine structure of the endometrium

This brief review illustrates the lack of ultrastructural studies on human endometrium, particularly on well-dated material from normal, fertile women. The glandular epithelium, with its triad of unusual organelles in the early luteal phase, poses fascinating problems in cell biology and, probably for this reason, has attracted the most work. Many problems in reproductive biology, in uterine pathology and in the study of unexplained infertility are crying out for detailed study of the luminal epithelium, the stroma and the blood vessels. If this review, by highlighting the gaps in our knowledge, stimulates research into these areas, it will have been successful.

Müllerian clear cell carcinofibroma of the uterine corpus

A case of homologous Müllerian clear cell carcinofibroma occurring in the uterine corpus of a 71-year-old woman is described. The classification, histogenesis and possible biological behaviour of this unique tumour are briefly discussed.

Ultrastructural studies on the endometrium of women wearing TCu-200 intrauterine devices by means of transmission and scanning electron microscopy and x-ray dispersive analysis

Endometrial biopsies obtained from 12 young women wearing TCu-200 intrauterine contraceptive devices from six to 12 months were studied by means of transmission and scanning electron microscopes as well as with the use of rubeanic acid stains and x-ray dispersive analysis. Six biopsies were taken at Day 10 and six were taken at Day 20 of the menstrual cycle. The aim was to investigate epithelial and stromal changes possibly related to copper deposition. The main changes were located in the cell organelles at Day 10 of the cycle. The mitochondria disclosed vacuolization of the matrix and myelin figure formation in 70 to 80% of the epithelial cells. There were also increased numbers of lysosomes. There were similar alterations of secretory endometrium in only a few cases. Instead, there was an increased number of mitochondria, and most of them were dividing. Rubeanic acid stains as well as energy-dispersive x-ray analysis failed to reveal significant amounts of copper in the various cell organelles studied. The above observations seem to indicate that there is a definite alteration of the mitochondria of epithelial cells which may result in impairment of respiratory mechanisms and energy production, rendering the endometrial environment inhospitable to the fertilized egg. These changes are thought to be reversible. The absence of copper is explained on the basis of a rapid turnover of the endometrium or to a problem in sampling common to this methodology.