Endocrine Abstracts

The complex study of the endometrium, in particular, immunohistochemical (IHC), allows to determine the state of steroid receptivity and allows to choose the optimal way of examination in women with autoimmune thyroid diseases and miscarriages.

Aim: To evaluate IHC expression of steroid receptors (ERα, ERβ, PR) in endometrium in women with a history of reproductive loss and autoimmune thyroid diseases

Materials and methods: The study involved 63 women with a history of reproductive failures, divided in 3 groups: I (n=21) - primary hypothyroidism in the compensation stage, II (n=21) - TPO-⁺ positive patients, III (n=21) - without an autoimmune thyroid pathology. The control group (n=21) included women planning pregnancy. The endometrium IHC expression of receptors for estradiol and progesterone in stromal and glandular cells was performed using mouse/ monoclonal antibodies to ERβ, ERα, PR (Leica, Germany). As an evaluation of immunohistochemical reactions was used AllRed Score evaluation method

Results: Was found the expression decrease of ERα in stroma in I and II groups compared with III (P<0.001 and p=0.002, respectively) and the control group (P<0.001). A lower expression level ERα in glands was observed in I and II groups, compared to III (P<0.001 and p=0.03, respectively) and IV (P<0.001). The ERα expression in stroma and glands between groups III and IV were not statistically different (p=0.513 and p=0.07, respectively). In the analysis of progesterone receptors, a significant increase in the expression of ERβ in stroma and glands was found in group III in comparison with IV (P<0.001). In addition, lower rates of ERβ expression in groups I and II were found, but statistical significance was confirmed only in women with primary hypothyroidism (P=0.04). The results of PR expression in stroma and glands indicated their decrease in the I group in relation to the remaining cohorts (PR stroma: P<0.001, PR of the gland: p=0.03).

Conclusions: The estimation of steroid receptors endometrium expression indicated a high degree of damage to the receptor apparatus in women with autoimmune thyroid diseases with imbalance of the secretory function of the endometrium glands. Early diagnosis of the combined immune disorders in this cohort of patients and the proper pre-gravity training will ensure greater effectiveness in the management of subsequent pregnancies.