Determination of uterine endometrium antigens by immunohistochemistry in ovulation induction.

Infertility is the inability of the couples to become pregnant in spite of unprotected regular sexual intercourse during a year. 10-15 % of the healthy couples in society have infertility problem.In the treatment of infertility related to ovulation disorder some drugs are used in order to ensure ovulation induction. Clomiphene citrate and gonadotropin are the most common ones. For women, the most common cause of infertility, at the rate of approximately 40%, is ovulation deficiency. It is stated that these agents used in the sources for ovulation induction can affect cellular alterations in the uterus tissue, cell reproduction, the rate of pregnancy and miscarriage and also cause cancer.Our study aims to examine the histological alterations which could be formed in the uterus tissue as a result of ovulation induction with clomiphene citrate and gonadotropin comparatively at the level of immunohistochemical and fine structure.In our study, it was observed that in a group to which clomiphene citrate was applied PCNA immunoreactivity was similar to the control in surface epithelial cells, however it became more widespread in the glandular epithelial cells. It was also determined that in pregnant subjects belonging to the groups to which clomiphene citrate was applied involvement in surface epithelial and decidual cells was highly widespread but not in glandular epithelial cells. It was seen that staining in all groups in which hormone application was made was similar to the groups to which clomiphene citrate was applied. It was specified that in the group in which clomiphene citrate application was made involvement in decidual cells increased differently from the hormone group.While it was being observed that c-fos involvement which is normal and pathological cell reproduction reagent, in the groups to which clomiphene citrate was applied, showed similarity with the hormone group, it was distinguished that reaction in the pregnant group belonging to the groups in which clomiphene citrate application was made was a little bit more moderate.It was distinguished that in the pregnant group belonging to the hormone group LIF immunostaining increased prominently in all structures throughout tissue. It was seen that similarly with the hormone group, in the pregnant group to which clomiphene citrate was applied, in spite of the group to which clomiphene citrate application was made, the involvement in the surface and glandular epithelium and also decidual cells became more widespread and pretty strong.Involvement of Caspase-3, in the group in which hormone application was made, was changing from negative to low despite the control, it was less in the surface and glandular epithelium in the pregnant group to which hormone application was made, in spite of this, it was more intensive in the decidual cells. While it was being observed that in the group to which clomiphene citrate was applied and the pregnant group to which clomiphene citrate was applied, the involvement in the surface and glandular epithelium was moderate, it was determined that the involvement in the pregnant decidual was stronger and more widespread.In the evaluations at the level of fine structure, in the group in which hormone application was made nucleus distribution was normal, neutrophile infiltration in the epithelium and glandular epithelial cells was distinct. It was seen that although surface and glandular epithelial alterations in semithin sections of the pregnant group in which hormone application was made were similar to the group to which hormone was applied, apical face specialization became indistinct. In the groups in which clomiphene citrate application was made, at the level of fine structure, although the surface and glandular epithelium have normal view, neutrophile infiltration which is the symbol of oestrus cycle drew attention. In the semithin sections of the pregnant groups in which clomiphene citrate application was made it was observed that surface and glandular epithelium protected their structure in parallel with the pregnancy.In terms of measured values, endometrial thickness was not significantly different between these groups. In spite of not being statistically significant the highest value was in hormone treated group. Epithelial thickness measurement showed significantly difference between groups. The highest values observed in hormone treated group. Uterine thickness was not significantly different between these groups, but in spite of not being statistically significant the highest value was in hormone treated group.Consequently; in our study in which we evaluated the semithin and fine structures with the immunohistochemical staining which we made by using proliferation and implantation markers for uterus tissue it was thought that hormone application affected the implantation more when compared with the clomiphene citrate application but it destroyed the structure at the level of surface and glandular epithelium and stroma and decidua and perhaps affected the healthy pregnancy process on the other hand clomiphene citrate application did not lead to damage throughout tissue by directing implantation and pregnancy in a more healthy way. We are of the opinion that in the hormone application; disruption of epithelial cell, disappearance of cell surface features and in spite of this, thickening of basal lamina relatively may be an indicator of implantation and rejection.