Cytological and hystological study of endometrium in women using I.U.D.

With special reference to the mechanism of contraception by I.U.D.

Abstract

An attempt was made to elucidate how the intrauterine device (I.U.D.) disturbs the implantation by means of morphological and cytological changes of endometrium caused by attachment of the I.U.D.
Cytological examinations were made on 125 women who wore I.U.D. by touch smear of removed I.U.D. during mid-luteal phase. Endometrial biopsies were done in 80 of 125 cases.
Cytological examination was studied with histology of corresponding endometrium. The endometrium was fixed and stained by Hematoxylin-Eosin and Watanabe's silver staining, and the touch smear was stained by Papanicolaou's staining. 70% of 80 cases showed abnormal findings of endometrium histologically.
In the silver staining, remarkable increase of the reticulum fibers of endometrial stroma was found in 85% of 80 cases.In the cytological study, 87 cases revealed class I, 38 cases were class II and there was no cases over class III. There is no relationship between cytological findings and wearing period of I.U.D. Histiocytic giant cells were found in 50% of cases and increase of stroma cell was noticed in 91%.
Which shows that reactive change of endometrium against I.U.D. is remarkable and increase of stromal cells consisting mainly by spindle type fibroblast was closely related to the histological findings, which showed hyperplasia of endometrial stroma.
These results imply that stromal changes seem one of the mechanism of the contraception of I.U.D.