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The cylindrical epithelium of the glands is multi-row (in 2-4 rows), signs of its polymorphism are noted. In the case of a significant severity of the process, structural restructuring is determined. The glandular epithelium has a high degree of casino activity (denia), including both pathological and intensive proliferation (growth). The area of the cell cytoplasm and nuclei is increased. The first contains a large amount of RNA (ribonucleic acid), in the pale nuclei with an increased area - a high concentration of DNA (deoxyribonucleic acid). Large nucleoli and evenly or, with significant atypia, unevenly located chromatin and chromatin clumps are also clearly visible.
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There are various theories of the effect of adenomatous endometrial polyps on pregnancy: on the possibility of sperm migration and fertilization processes, implantation of a fertilized egg and the gestation period. There are suggestions about a simple mechanical destructive effect of polyps, a decrease in the degree of receptivity of the uterine mucosa as a result of increased activity of cytokines, a change in the properties of membrane proteins involved in adhesion (adhesion) of cell surfaces, etc.
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Compatibility of pathology and pregnancy.
The question of the primacy of processes is also not sufficiently clarified: do polyps develop in women with infertility, or deposit bonus codes is a consequence of neoplasms. But so far, the most convincing theory seems to be a mechanical obstacle to the meeting and fusion of the egg with the spermatozoon, especially with significant sizes (more than 10 mm in length) of adenomatous formations located in the bottom and close to the mouth of the fallopian tubes. In addition, even if fertilization and implantation have occurred, these tumors can cause abnormal waves of uterine muscle contractions, which can lead to miscarriages.
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Arrows indicate polyps in the uterine cavity. Approximately 11-15% of women of reproductive age with this disease and in 40% of postmenopausal women, clinical manifestations may be absent, especially with small polyps. The main manifestations are not specific. These include:
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Uterine bleeding, exceeding the norm of menstrual bleeding in duration and volume of blood (menometrorrhagia). They can be single or recurrent. Acyclic and contact bleeding. Infertility. Anemization and deterioration of general well-being in the form of weakness and malaise with heavy and/or recurrent bleeding. Drawing, aching pain in the lower abdomen. With a significant size of casino, they can acquire a pronounced cramping character. Perhaps the occurrence of whitish discharge (leucorrhea) with the development of necrotic, dystophic and inflammatory processes in the polyp.
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