Early-stage endometriosis: adhesion and growth of human menstrual endometrium in nude mice.
OBJECTIVE
To evaluate the implantation of menstrual endometrium and the early stages of evolution of endometriotic lesions.


METHODS
Experimental prospective study.


METHODS
An academic research environment.


METHODS
Ten nude mice.


METHODS
A minilaparotomy was performed to place fresh human menstrual endometrial samples in the peritoneal cavity. Removal of the transplants was performed successively on days 1, 3, and 5 by laparotomy.


METHODS
Adhesion of endometrial fragments and early stages of endometrial lesions was morphologically and immunohistochemically studied.


RESULTS
As early as day 1, stromal cells were found to be attached to the mesothelium. A progressive reorganization of epithelial and stromal cells into endometrial glands was observed. On day 5, cystic endometriotic lesions were characterized by more extensive proliferative activity in glandular cells and a higher VEGF score in stromal cells than that observed in previously removed transplants.


CONCLUSIONS
Menstrual human endometrium is able to implant on intact mesothelium and to reorganize itself into structured glands and stroma under the influence of unknown factors. We suggest that stromal and glandular cells have two distinct roles: stromal cells are involved in the attachment process and glandular cells in the growth of the endometriotic lesion.
Nisolle
M
M
Infertility Department Research, Service de Gynécologie, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium. michelle.nisolle@gyne.ucl.ac.be
Casanas-Roux
F
F
Donnez
J
J
D000328:Adult; D000818:Animals; D004715:Endometriosis / Q000209:etiology* / Q000473:pathology; D004717:Endometrium / Q000276:immunology / Q000473:pathology* / Q000637:transplantation*; D016228:Endothelial Growth Factors / Q000378:metabolism; D005260:Female; D006801:Humans; D008222:Lymphokines / Q000378:metabolism; D008598:Menstruation; D051379:Mice; D008819:Mice, Nude; D011446:Prospective Studies; D016378:Tissue Transplantation; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors