Receptive status of the endometrium in patients of reproductive age with serous and mucinous ovarian cystadenoma before and after unilateral adnexectomy

Abstract

BACKGROUND: Currently, the incidence of benign ovarian tumors has increased, and numerous studies have reported its negative effect on womens reproductive health. In modern literature, approximately 30% of patients with ovarian neoplasms have reproductive problems. In the presence of ovarian diseases, changes in the endometrium alter its receptivity, thereby reducing the chances of successful conception and gestation and gaining increasing attention. Patients seeking to preserve their reproductive function prefer organ-preserving surgical interventions; however, in clinical practice, adnexectomy is often necessary because of damaged ovarian tissue. AIM: To analyze the morphofunctional state of the endometrium and its receptivity in patients with serous and mucinous ovarian cystadenomas before and after surgical treatment. MATERIALS AND METHODS: The prospective study included patients of reproductive age with benign epithelial tumors (serous/mucinous cystadenomas) who had not received hormonal drugs for 6 months before surgical treatment. Group 1 included 32 patients with serous cystadenoma, and group 2 included 30 patients with mucinous cystadenoma. Before and 612 months after unilateral salpingo-oophorectomy, a pipelle biopsy of the endometrium was performed during the implantation window. The qualitative and quantitative parameters of pinopodes were examined, and the expression levels of estrogen (ER) and progesterone (PR) receptors in the glands and stroma of the endometrium were evaluated. RESULTS: Preoperatively, the number of pinopodes decreased in patients with serous cystadenoma, and the expression level of ER in the stroma and those of PR in the stroma and glands was reduced. Postoperatively, the number of mature pinopodes increased, and the expression levels of ER in the stroma and PR in the stroma and glands was increasing. Preoperatively, in patients with mucinous cystadenomas, the expression levels of ER in the stroma and glands and PR in the stroma and glands decreased, and the number of pinopodes reduced. Postoperatively, compared with patients with serous cystadenomas in the glandular component of the endometrium, those with mucinous cystadenoma had lower expression levels of both ER and PR, lower PR expression level in the stromal component, and increased number of pinopodes. CONCLUSIONS: The results of this study showed that benign ovarian tumors are accompanied by impaired morphofunctional state and receptivity of the endometrium, and timely surgical intervention positively affects these indicators and increases the reproductive potential of women.