Adhesion of human endometrial fragments to peritoneum in vitro

Objective: To evaluate the adhesion of endometrial fragments obtained durin g the proliferative phase of the menstrual cycle to fresh human peritoneum obtained during abdominal surgery. Design: A prospective, descriptive, morphologic and cell biologic study. Setting: Tertiary care university medical center. Patient(s): Six female volunteers. Intervention(s): After endometrial biopsies performed during diagnostic lap aroscopy, endometrial fragments were generated by enzymatic digestion and m echanical separation. Peritoneum was obtained during abdominal operations f or benign indications. Main Outcome Measure(s): Adhesion of endometrial fragments was studied by h istologic examination and scanning and transmission electron microscopy. Result(s): After incubation, the mesothelium was intact in some areas, wher eas in other areas mesothelial cells were damaged or absent. Adhesion of en dometrial fragments was observed only at locations where the basement membr ane was exposed. In areas largely denuded of mesothelial cells, endometrial fragments spread over the basement membrane to form monolayers. Conclusion(s): Human peritoneum is suitable for studying the adhesion of en dometrial fragments. Intact mesothelium prevents the adhesion of endometria l fragments, suggesting that trauma to the mesothelial lining is a prerequi site for endometrial cell adhesion. (Fertil Steril(R) 1999;71:1119-24. (C) 1999 by American Society for Reproductive Medicine.).