Effects of treatment with gonadotropin releasing hormone agonist on the uterine leiomyomata structure

Objective. Our aim was to study the effects of the gonadotropin releasing hormone agonist on the uterine leiomyoma of infertile women. Material and methods. Sixty‐seven nulliparous women (aged 24–39 years) with uterine leiomyomas, underwent ultrasonographic study of leiomioma volume, and were divide...

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Published in:Acta obstetricia et gynecologica Scandinavica 2003-04, Vol.82 (4), p.330-334
Main Authors: Bozzini, Nilo, Rodrigues, Consuelo J., Petti, Domingos A., Bevilacqua, Ruy G., GonÇalves, Sergio P., Pinotti, José Aristodemo
Format: Article
Language:English
Subjects:
Adult
agonist
Antineoplastic Agents, Hormonal - therapeutic use
Biological and medical sciences
Female
Female genital diseases
GnRH
Goserelin - therapeutic use
Gynecology. Andrology. Obstetrics
Hormones. Endocrine system
Humans
Leiomyoma - drug therapy
Leiomyoma - pathology
Leiomyoma - surgery
Medical sciences
myomas
Myometrium - surgery
Parity
Pharmacology. Drug treatments
Receptors, Estrogen - drug effects
Receptors, Progesterone - drug effects
Tumors
Uterine Neoplasms - drug therapy
Uterine Neoplasms - pathology
Uterine Neoplasms - surgery
Uterus - pathology
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Summary:Objective. Our aim was to study the effects of the gonadotropin releasing hormone agonist on the uterine leiomyoma of infertile women. Material and methods. Sixty‐seven nulliparous women (aged 24–39 years) with uterine leiomyomas, underwent ultrasonographic study of leiomioma volume, and were divided in two groups. Thirty‐one had nodes greater than 300 cm3 and were treated with goserelin 3.6 mg every 28 days for 6 months (group I); the other 36 patients did not receive medication (group II or control group). Sixteen patients from group I had ≤ 36% (median) reduction of the leiomyoma volume (subgroup Ia) and the other 15 women had reduction > 36% (subgroup Ib). All women underwent myomectomy. Results. The group with the greater leiomyoma reduction after treatment with goserelin (group Ib) showed a significantly lower percentage of ER+ when compared with group Ia and the control group. Group Ib had a significantly higher percentage of PR+ in relation to the control group, but not to group Ia. The number of blood vessels, AgNOR dots, and cells, and the amount of collagen were not different between the three groups studied. Leiomyomata reduction correlated negatively with the percentage ER+ cells, but positively with the PR+ cells, amount of collagen and number of blood vessels. No correlation was found between the number of AgNOR dots and cellularity. Conclusion. Our data strengthen the hypothesis that the uterine leiomyoma response to steroid hormones results from the presence of specific hormone receptors, and progesterone receptors may also play a role in the development of leiomyoma.
ISSN:0001-6349
1600-0412
DOI:10.1034/j.1600-0412.2003.00049.x