Immunohistochemical characteristics of intramural leiomyomata that enlarge during controlled ovarian hyperstimulation for in vitro fertilization.
OBJECTIVE
This study aimed to determine the immunohistochemical characteristics of intramural leiomyomata that enlarged during controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF).


METHODS
For this retrospective case-control clinical study and immunohistochemical analysis, 5 patients with enlarged intramural leiomyomata during COH for IVF, who had undergone myomectomy immediately after a failed IVF cycle, were recruited retrospectively. Fifteen consecutive patients who had had myomectomy for intramural leiomyomata <5 cm, but had never undergone any infertility treatment, served as the control group. Histological examinations and immunohistochemical staining with proliferating cell nuclear antigen (PCNA), transforming growth factor-beta (TGF-beta) and fibronectin were performed on all specimens taken from the study and control groups. The main outcome measures were defined as histological and immunohistochemical scores.


RESULTS
Hematoxylin and eosin as well as PCNA staining showed increased mitotic index, cellularity and proliferation index in these growing leiomyomata (study group). There were neither increased mitoses nor cellularity in the leiomyomata of the control group, while PCNA, TGF-beta and fibronectin scores in the study group were significantly higher than those in the control group (p < 0.001).


CONCLUSIONS
This study is the first to report increased TGF-beta, PCNA, cellularity and mitosis in leiomyomata enlarging during COH for IVF. Further studies with larger sample size are needed to determine the role of TGF-beta, PCNA and fibronectin in the growth of leiomyomata during COH.
Zeyneloglu
Hulusi B
HB
Department of Obstetrics and Gynecology, Baskent University, Ankara, Turkey. hnzeynelog@e-kolay.net
Esinler
Ibrahim
I
Ozdemir
Binnaz H
BH
Haydardedeoglu
Bulent
B
Oktem
Mesut
M
Batioglu
Sertac
S
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005307:Fertilization in Vitro; D005353:Fibronectins / Q000378:metabolism; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D015870:Gene Expression; D006728:Hormones / Q000494:pharmacology*; D006801:Humans; D007150:Immunohistochemistry; D007247:Infertility, Female / Q000628:therapy; D007889:Leiomyoma / Q000378:metabolism* / Q000601:surgery; D008938:Mitosis / Q000187:drug effects; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012189:Retrospective Studies; D016212:Transforming Growth Factor beta / Q000378:metabolism; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000601:surgery
D005353:Fibronectins; D006728:Hormones; D018809:Proliferating Cell Nuclear Antigen; D016212:Transforming Growth Factor beta; D005640:Follicle Stimulating Hormone