Fertility control. Effects of the levonorgestrel-releasing intrauterine system on proliferation and apoptosis in the endometrium

Author： Maruo T.

Publisher： Oxford University Press

ISSN： 1460-2350

Source： Human Reproduction, Vol.16, Iss.10, 2001-10, pp. : 2103-2108

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Abstract

BACKGROUND: The levonorgestrel-releasing intrauterine system (LNg-IUS) has been shown to be effective in the management of menorrhagia. In order to evaluate the effects of LNg-IUS on endometrial proliferation and apoptosis, proliferating cell nuclear antigen (PCNA) expression, apoptosis, Fas and Bcl-2 protein expression in the endometrium were determined at the early proliferative phase of the menstrual cycle before and 3 months after LNg-IUS insertion. METHODS: PCNA, Fas and Bcl-2 protein expression were analysed using an avidin–biotin immunoperoxidase method. Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick-end labelling (TUNEL) method. RESULTS: PCNA, immunolocalized both in the nuclei of endometrial glands and stroma was less abundant 3 months after insertion (P < 0.05).="" bcl-2="" protein,="" immunolocalized="" in="" the="" cytoplasm="" of="" endometrial="" glands="" but="" not="" in="" the="" stroma,="" became="" scanty="" 3="" months="" after="" insertion.="" fas="" antigen,="" immunolocalized="" only="" in="" endometrial="" glands="" before="" insertion,="" became="" prominent="" in="" both="" endometrial="" glands="" and="" stroma="" 3="" months="" after="" insertion.="" the="" apoptosis-positive="" rate="" of="" the="" nuclei="" in="" both="" endometrial="" glands="" and="" stroma="" was="" significantly="" higher="" 3="" months="" after="" insertion="" relative="" to="" that="" before="" insertion="">P < 0.05).="" conclusions:="" lng-ius="" resulted="" in="" a="" decrease="" in="" endometrial="" proliferation="" and="" an="" increase="" in="" apoptosis="" in="" endometrial="" glands="" and="" stroma.="" the="" increase="" in="" apoptosis="" associated="" with="" increased="" fas="" antigen="" expression="" and="" decreased="" bcl-2="" protein="" expression="" in="" the="" endometrium="" may="" be="" one="" of="" the="" underlying="" molecular="" mechanisms="" by="" which="" lng-ius="" insertion="" causes="" the="" atrophic="" change="" of="" the="" endometrium.="">