Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging

Georg Kunz, G Kunz, D Beil, Peter Huppert, P Huppert, G Leyendecker
Human Reproduction · 2000 · vol. 15(1) , pp. 76–82 · doi:10.1093/humrep/15.1.76 · PMID:10611192 · W1992014827
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Endometriosis and infertility are associated with a significantly enlarged subendometrial myometrium, visualized by vaginal sonography and MRI, suggesting a uterine basis for the disease.

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Abstract

In women with endometriosis, the peristaltic activity of the uterus is significantly enhanced and may even become dysperistaltic at midcycle. Since uterine peristalsis is confined to the endometrium and the subendometrial myometrium with its predominantly circular arrangement of muscular fibres it was assumed that this dysfunction might be associated with structural abnormalities that could be visualized by high resolution ultrasonography and magnetic resonance imaging (MRI). Therefore, the uteri of women with and without endometriosis were subjected to endovaginal sonography (EVS) and to MRI. In EVS, women with laparoscopically proven endometriosis and infertility exhibited an infiltrative expansion of the archimetra in that the halo surrounding the uterine endometrium and representing the subendometrial myometrium was significantly enlarged compared with controls. The expansion was more pronounced in older than in younger women. There was, however, no relationship between the width of the expansion and the severity of the endometriotic disease. Similar data were obtained by MRI in that the 'junctional zone' in women with endometriosis and infertility was expanded in comparison with controls. The results of this study provide further support to the notion that endometriosis is primarily a uterine disease.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Magnetic Resonance Imaging Ultrasonography Uterus Adult Endometriosis Endometriosis Estradiol Estradiol Female Humans Infertility, Female Infertility, Female Myometrium Myometrium Ovarian Follicle Ovarian Follicle Progesterone Progesterone

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References (45)

Cited by (50)

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