Dr. Aygen ÇELİK, Remzi ATILGAN, Berna HALİLOĞLU, Erdin İLTER, Tonguç GÜNDÜZ, Nusret AKPOLAT, Ekrem SAPMAZ

Proksimal tubal oklüzyon işleminin rat over histopatolojisi üzerine etkilerinin incelenmesi: Deneysel çalışma

Amaç: Bipolar koter kullanılarak yapılan unilateral proksimal tubal oklüzyon işleminin birinci ve altıncı aylarda rat over histopatolojisi üzerine etkilerinin incelenmesi. Yöntem: Erişkin 28 Wistar albino rat östrus fazında rastgele 4 gruba ayrıldı. G1 n=7 : Batın açılıp kapatılan ve 1 ay sonra sol ooferektomi yapılan grup. G2 n=7 : Sol proksimal tubal oklüzyon yapılıp 1 ay sonra sol ooferektomi yapılan grup. G3 n=7 : Batın açılıp kapatılan ve 6 ay sonra sol ooferektomi yapılan grup. G4 n=7 : Sol proksimal tubal oklüzyon yapılıp 6 ay sonra sol ooferektomi yapılan grup. Sol over örnekleri formaldehitle tespit edildi. Hematoksilen Eozin ile boyanan preparatlarda over folikül rezervi saptandı. Atretik foliküllerin sayısı, corpus luteum, corpus albicans tespit edildi. Corpus luteum içi anjiogenesiz varlığındaki gerileme ve ovaryan stromada fibrozis varlığı incelendi. Overdeki folikül kisti sayıldı. G1-G2 ile G3-G4 ile karşılaştırıldı. Ordinal veriler için Mann Whitney U testi, nominal veriler için x2 testleri kullanıldı. p0.05, Mann Whitney U test . Corpus luteum içi anjiogenezisdeki gerileme G2 ve G4'de anlamlı olmamakla birlikte azalmıştı. Hiçbir grupta makroskobik veya mikroskobik kist gelişmedi Sonuç: Ratlarda bipolar koter kullanılarak yapılan unilateral proksimal tubal okluzyon işlemi, erken ve geç dönemde over histopatolojisi üzerine herhangi bir zararlı etki yapmamıştır.

Anahtar Kelimeler:

ovaryan histopatoloji, proksimal tubal oklüzyon, rat

Examination of the histopathological effects of proximal tubal occlusion procedure on rat ovaries: An experimental study

Objective: Examination of the effects of unilateral proximal tubal oclusion procedure by bipolar electrical coagulation on rat's ovarian histopathology at the first and six months. Material and Methods: Adult 28 Winstar albino rats at eustrous phase randomly divided into 4 groups. G1 n=7 : Left oopherectomy, one month after laparatomy. G2 n=7 : Left oopherectomy, one month after proximal tubal oclusion. G3 n=7 : Left oopherectomy, six months after laparatomy. G4 n=7 : Left oopherectomy, six months after proximal tubal oclusion. Left ovary specimens fixed with formaldehyde, dyed with Hematoxylen-Eosin and ovarian reserve examined. The number of atretic follicles, corpus luteum and corpus albicans determined. Angiogenesis in corpus luteum and presence of ovarian stromal fibrosis examined. G1and G2 were compared with G3 and G4. Statistical analysis of ordinal results were examined by Mann Whitney U test and nominal results by x2 test f. P0.05, Mann Whitney U test . Angiogenesis regression in corpous luteum were lower in both G2 and G4. No macroscopic or microscopic cyst formation obtained in all groups. Conclusion: Proximal tubal occlusion procedure by bipolar coagulation has no harmful effect on rat oavarian histopathology at both early and late period.

Keywords:

ovarian histhopathology, proximal tubal occlusion, rat,

PDF

___

1. Akman MA, Garca JE, Damewood MD, Watts LD and Katz E. Hydrosalpinx affects the implantation of previously cryopreserved embryos. Hum Reprod 1996; 11: 1013–1014.
2. Camus E, Poncelet C, Goffinet F, Wainer B, Merlet F, Nisand I, et al. Pregnancy rates after IVF in cases of tubal infertility with and without hydrosapinx: metaanalysis of published comparative studies. Hum Reprod. 1999;14:1243-1249.
3. Andersen AN, Yue Z, Meng FJ and Petersen K. Low implantation rate after in-vitro fertilization in patients with hydrosalpinges diagnosed by ultrasonography. Hum Reprod 1994;9: 1935–1938.
4. Strandell A, Lindhard A, Waldenstrom U, Thorburn J, Janson PO, Hamberger L. Hydrosalpinx and IVF outcome: a prospective randomized multicentre trial in Scandinavia on salpingectomy prior to IVF. Hum Reprod 1999;14:2762–2769.
5. Daftary GS, Kayisli U, Seli E, Bukulmez O, Arici A, Taylor HS. Salpingectomy increases peri-implantation endometrial HOXA10 expression in women with hydrosalpinx. Fertil Steril 2007;87:367-372.
6. Zarei A, Al- Ghafri W, Tulandi T. Tubal surgery. Clin Obstet Gynecol. 2009;52:344-350.
7. Shelton KE, Butler L, Toner JP, Oehninger S, Muasher SJ. Salpingectomy improves the pregnancy rate in invitro fertilization patients with hydrosalpinx. Hum Reprod 1996;11: 523-525.
8. Yao M, Tulandi T. Current status of surgical and nonsurgical management of ectopic pregnancy. Fertil Steril 1997;67:421-433.
9. Murray DL, Sagoskin AW, Widra EA, Levy MJ. The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rates and the benefit of surgical correction. Fertil Steril 1998;69: 41-45.
10. Surrey ES, Schoolcraft WB. Laparoscopic management of hydrosalpinges before in vitro fertilizationembryo transfer: salpingectomy versus proximal tubal occlusion. Fertil Steril 2001; 75: 612-617.
11. Sharara FJ, Scott RT, Marut EL, Queenan JT. In-vitro fertilization outcome in women with hydrosalpinx. Hum Reprod 1996;11: 526–530.
12. Van Voorhis BJ, Sparks AET, Syrop CH, Stovall DW. Ultrasound-guided aspiration of hydrosalpinges is associated with improved pregnancy and implantation rates after in-vitro fertilization cycles. Hum Reprod 1998;13:736–739.
13. Aboulghar MA, Mansour RT, Serour GI, Settar MA, Awad MM, Amin Y. Transvaginal ultrasonic guided aspiration of pelvic inflammatory cystic masses before ovulation induction for in vitro fertilization. Fertil Steril 1990;53: 311–314.
14. Sowter MC, Akande VA, Williams JAG, Hull MG. Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx?. Hum Reprod 1997;10: 2147–2150.
15. Bloechle M, Schreiner T , Lise K. Recurrence of hydrosalpinges after transvaginal aspiration of tubal fluid in an IVF cycle with development of a serometra. Hum Reprod 1997;12: 703–705.
16. San Filippo JS, Lincoln SR. Surgical treatment of diseases of the ovary. In: Keye WR, Chang RJ, Rebar RW, Soules MR, eds. Infertility: evaluation and treatment. Philadelphia: WB Saunders, 539–551.
17. Zackrisson U, Mikuni M, Peterson MC, Nilsson B, Janson P and Brannstrom M. Evidence for the involvement of blood flow-related mechanisms in the ovulatory process of the rat. Hum Reprod 2000;15: 264–272.
18. Dar P, Sachs GS, Strassburger D, Bukovsky I, Arieli S. Ovarian function before and after salpingectomy in artificial reproductive technology patients. Hum Reprod. 2000;15:142-144.
19. Chan CC, Ng EH, Li CF, Ho PC. Impaired ovarian blood flow and reduced antral follicle count following laparoscopic salpingectomy for ectopic pregnancy.Hum Reprod. 2003;18: 2175-2180.
20. Souza AZ, Fonseca AM, Izzo VM, Clauzet RM, Salvatore CA. Ovarian histology and function after total abdominal hysterectomy. Obstet Gynecol. 1986;68: 847-849.
21. Anzalone CR, Hong LS, Lu JK, LaPolt PS. Influences of age and ovarian follicular reserve on estrous cycle patterns, ovulation, and hormone secretion in the LongEvans rat. Biol Reprod 2001;64: 1056-1062.
22. Trollmann R, Amann K, Schoof E, Beinder E, Wenzel D, Rascher W,et al. Hypoxia activates the human placental vascular endothelial growth factor system in vitro and in vivo: up-regulation of vascular endothelial growth factor in clinically relevant hypoxic ischemia in birth asphyxia. Am J Obstet Gynecol 2003;188: 517-523.
23. Neeman M, Abramovitch R, Schiffenbauer YS, Tempel C. Regulation of angiogenesis by hypoxic stress: from solid tumours to the ovarian follicle. Int J Exp Pathol. 1997;78: 57-70. Review.
24. Abulafia O, Sherer DM. Angiogenesis of the ovary. Am J Obstet Gynecol. 2000;182: 240-246.
25. Geva E, Jaffe RB. Role of vascular endothelial growth factor in ovarian physiology and pathology. Fertil Steril 2000;74: 429-438.
26. Anderson LL, Bland KP, Melampy RM. Comparative aspectes of uterine luteal relationship. Recent Progr Horm Res 1969; 25: 57.
27. Rolaki A, Drakakis P, Millingos S, Loutradis D, Makriginnakis A. Novel trends in follicular development, atresia and corpus luteum regression: role for apoptosis. Reprod Biomed Online 2005; 11: 93-103.
28. Barber HRK: Anatomy, embriology, and comparative anatomy. Ovarian Carcinoma: Etiology, Diagnosis and treatment. Edited by HRK Barber. New york, Masson, 1978, 13-27.
29. Gordon JD, Mesiano S, Zaloudek CJ, Jaffe RB. Vascular endothelial growth factor localization in human ovary and fallopian tubes: possible role in reproductive function and ovarian cyst formation. J Clin Endocrinol Metab 1996;81: 353-359.
30. Ferrara N, Frantz G, LeCouter J, Dillard-Telm L, Pham T, Draksharapu A, et al. Differential expression of the angiogenic factor genes vascular endothelial growth factor (VEGF) and endocrine gland-derived VEGF in normal and polycystic human ovaries. Am J Pathol 2003;162: 1881-1893.
31. Hejmadi MV, Dajas-Bailador F, Barns SM, Jones B, Wonnacott S. Neuroprotection by nicotine against hypoxia-induced apoptosis in cortical cultures involves activation of multiple nicotinic acetylcholine receptor subtypes. Mol Cell Neurosci. 2003;24: 779-786.
32. Tanaka T, Hanafusa N, Ingelfinger JR, Ohse T, Fujita T, Nangaku M. Hypoxia induces apoptosis in SV40-immortalized rat proximal tubular cells through the mitochondrial pathways, devoid of HIF1-mediated upregulation of Bax. Biochem Biophys Res Commun. 2003;12:222-231.
33. Rosmorduc O, Wendum D, Corpechot C, Galy B, Sebbagh N, Raleigh J, et al. Hepatocellular hypoxia-induced vascular endothelial growth factor expression and angiogenesis in experimental biliary cirrhosis. Am J Pathol. 1999;155: 1065-1073.
34. Corpechot C, Barbu V, Wendum D, Kinnman N, Rey C, Poupon R, et al. Hypoxia induced VEGF and collagen I expressions are associated with angiogenesis and fibrogenesis in experimental cirrhosis. Hepatology 2002;35:1010-1021.
35. Kontoravdis A, Makrakis E, Pantos K, Botsis D, Deligeoroglou E, Creatsas G . Proximal tubal occlusion and salpingectomy result in similar improvement in in vitro fertilization outcome in patients with hydrosalpinx. Fertil Steril 2006;86:1642-1649.