25% of women who are examined for infertility are diagnosed with endometrial hyperplasia. It consists in the overgrowth of the uterine mucosa. This disease is dangerous because it can eventually become cancer.
One of its varieties is glandular cystic endometrial hyperplasia. This form of the disease leads to cancer is less likely than atypical and better treatable. However, this is the next stage in the development of the disease after glandular hyperplasia. A focal form is also distinguished, in which a glandular-fibrous, fibrous or glandular endometrial polyp is formed, the treatment of which is usually surgical. Quite often it is formed not one.
If hyperplasia is suspected, curettage is carried out for diagnostic and therapeutic purposes. Firstly, during the manipulation, the overgrown endometrium, including polyps, is removed. Secondly, the obtained material is sent to histology, with the help of which the type of hyperplasia is determined.
Today, curettage is increasingly performed under the control of hysteroscopy. Its use minimizes the likelihood of complications and significantly increases the efficiency of manipulation, since it is carried out under the control of the eye.
Most women who have experienced this disease are interested in how the glandular cystic endometrial hyperplasia affects pregnancy. Experts say that conception with this disease is not excluded, but problematic and undesirable.
The fact is, the cause of hyperplasia is an increased amount of estrogen and / or a lack of progesterone. This occurs when hormones are imbalanced as a result of various diseases and / or a prolonged absence of ovulation.
Estrogens, which are secreted by the ripening follicle, stimulate the growth of the uterine mucosa. After ovulation, a yellow body forms in its place, which synthesizes progesterone. This hormone has the opposite effect on the endometrium and prepares it for implantation of the embryo.
With prolonged absence of ovulation, progesterone is not secreted. Against this background, glandular cystic endometrial hyperplasia occurs. However, it is often the result of a high level of estrogen in the body.
This occurs with inadequate hormone therapy, ovarian tumors, obesity and a number of other diseases. As a result of studies, it was found that adipose tissue is able to secrete estrogens, especially if there is a lot of it.
Against the background of hormonal disorders, and especially the absence of ovulation, pregnancy becomes extremely problematic. In addition, implantation of an embryo into an altered endometrium also occurs with difficulty.
It was found that pregnancy accelerates the transition of a benign neoplasm into a malignant tumor. Therefore, pregnancy with hyperplasia is extremely undesirable.
However, after treatment, women with this disease give birth to healthy babies. Therefore, glandular cystic endometrial hyperplasia, the treatment of which consists of curettage and hormone therapy, is not an obstacle to maternity.
The patient should take drugs selected individually by her gynecologist-endocrinologist for six months. The results of therapy are monitored by ultrasound, biopsy, curettage.
Among hormonal drugs, gestagens, COCs, and drugs that cause artificial menopause are used. Their choice and regimen depends on concomitant diseases, age of the patient, desire to become pregnant, weight and a number of other factors.
Sometimes in nulliparous patients, the doctor may try to do without curettage. However, in the absence of the result of hormone therapy, it will still have to be done.
Thus, glandular cystic endometrial hyperplasia is dangerous in that it can lead to cancer and infertility. After successful treatment, the prognosis is favorable.