DMPA Suppresses Cell Proliferation and Enhances Cell
Apoptosis of Eutopic Endometrium in Women with
Endometriosis: A Randomized Controlled Study
Yada Tingthanatikul MD*, Yoko Tawarasumida MD*, Srithean Lertvikool MD*, Anna Wongkularb PhD*,
Areepan Sophonsritsuk MD*, Sawaek Weerakiet MD*, Morakot Sroyraya PhD**, Piyachat Chansela PhD***,
Narin Changklungmoa PhD****, Sineenart Songkoomkrong PhD*****, Jaruwan Poljaroen PhD**, Prasert Sobhon PhD*****
Affiliation :
* Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Mahidol University, Nakhonsawan Campus, Nakhonsawan, Thailand
*** Department of Anatomy, Phramongkutklao College of Medicine, Bangkok, Thailand
**** Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand
***** Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand
Background : Although Depo-medroxyprogesterone acetate (DMPA), an injectable contraceptive progestin, is very effective
for pain relief and prevention of recurrence in women with endometriosis, there is no report on the mechanism of this
medication about cell proliferation and apoptosis.
Objective : To investigate the effects of DMPA on cell proliferation and apoptosis in the eutopic endometrium of women with
endometriosis.
Material and Method: A randomized controlled study was conducted in 28 women with endometriosis. The DMPA-treated
group included 14 women who were scheduled to undergo laparoscopic surgery after 150 mg of DMPA injections. The
control group included 14 women who were scheduled to undergo the surgery without DMPA injection. The endometrial
tissue was obtained from each woman by endometrial aspiration before surgery. The ELISA formats of PCNA and the
quantitative colorimetric analysis of TUNEL were used for estimating cell proliferation and apoptosis of the eutopic
endometrium.
Results : There were no differences in the women characteristics between the two groups. The relative level of cell proliferation
was significantly less in the DMPA than the control groups (1.08±0.57 vs. 1.73±0.50, p = 0.014). Whereas the relative level
of cell apoptosis was greater in the DMPA group than that in the control group (1.12±0.36 vs. 0.82±0.39, p = 0.034).
Conclusion : Three months of 150 mg DMPA treatment could suppress cell proliferation and enhance cell apoptosis of the
eutopic endometrium of women with endometriosis.
Keywords : Apoptosis, Cell proliferation, Depo-medroxyprogesterone, Endometriosis, Eutopic endometrium
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