EJMS

Abstract

Background:Depo-medroxyproges-trone acetate (DMPA) and norethestrone enanthate (NET-EN) were considered the long acting injectable contraceptives widely used in Egypt. It had been suggested that they exhibited widespread side effects on the uterus and different body organs. Aim of work: to investigate the histological and immuno-histochemical changes of induced depo-medroxy-progestrone acetate (DMPA) and norethestrone enanthate (NET-EN) on the uterus of adult albino rats. Material and methods: this study was carried on 40 adult female albino rats divided into 4 groups: Group I (control group), Group II (sham control group) subdivided into 2 subgroups :1- receiving 5ml saline IM every 15 days and 2-receiving 5ml sunflower oil IM every 15 days for 3.5 months, Group III (short term injected group) subdivided into (short term injected DMPA group) injected IM with 3.5 mg DMPA every 15 days for 1.5 months and (short term injected NET-EN ) injected with 4mg NET-EN every 15 days for 1.5 months and Group IV(long term injected group): subdivided into :(long term injected group) subdivided into (long term DMPA injected group) injected IM with 3.5 mg DMPA every 15 days for 3.5 months and (long term injected NET-EN group) injected with IM 4 mg NET-EN every 15 days for 3.5 months. The animals were scarified 15 days after the last injection and the uteri of all groups were excised and prepared for histological, immuno-histochemical study. Results: histological examination of the uterus of group III (short term injected group) revealed inflammatory monocellular infiltration, exudates and degenerated endometrial glands and accumulation of haemosidrin granules in the endometrial tissue. Group IV(Long term injected group) showed that in DMPA injected group the endometrium exhibited hyperplasia of the endometrial epithelium, dilation and increased number of endometrial glands, inflammatory cellular infiltration, vacuolization, congested blood vessels and accumulated haemosidrin. The long term injection of NET-EN showed similar changes with marked dysplastic changes of endometrial epithelium, granuloma formation. The immunohistochemical study revealed variable degrees of reduction in alkaline phosphatase enzyme activity and increase in acid phosphatase enzyme activities in the endometrial epithelium in the experimental groups. Conclusion: DMPA and NET-EN induced injection has marked harmful effects in the endometrium of adult albino rat which is directly proportional with the duration of injection which may be precancerous.