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Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions  Olivier Donnez, M.D., Anne Van Langendonckt,

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Presentation on theme: "Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions  Olivier Donnez, M.D., Anne Van Langendonckt,"— Presentation transcript:

1 Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions  Olivier Donnez, M.D., Anne Van Langendonckt, Ph.D., Sylvie Defrère, Ph.D., Sébastien Colette, Ph.D., Olivier Van Kerk, Jean-Paul Dehoux, D.V.M., Ph.D., Jean Squifflet, M.D., Ph.D., Jacques Donnez, M.D., Ph.D.  Fertility and Sterility  Volume 99, Issue 3, Pages e3 (March 2013) DOI: /j.fertnstert Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

2 Figure 1 (A) Laparoscopic view of a lesion (white arrows) induced after grafting endometrium alone. This brownish lesion is not nodular. (B) Laparoscopic view of a lesion (white arrows) induced after grafting myometrium alone. This lesion resembles poorly vascularized fibrotic tissue. (C) Laparoscopic view of a nodular lesion (white arrow) induced after grafting endometrium and the junctional zone (JZ). Neovascularization from the peritoneum is visible as well as adhesion with the sigmoid and ureter (black arrows). (D) Laparoscopic view of a nodular lesion (white arrow) induced after grafting endometrium and the JZ, revealing adhesions with the omentum (black arrows). Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

3 Figure 2 (A) Nodular lesion (white arrow) observed after grafting endometrium and the junctional zone (JZ). Spontaneous adhesion with the sigmoid is visible (black arrow). (B) Macroscopic section of the previous lesion reveals a solid tumor (white arrows) with a cystic component. Dense adhesion with the sigmoid (mucosa, black arrows) is clearly visible. (C) Macroscopic view of a retrocervical lesion (white arrow) induced after grafting total uterine thickness. This lesion is macroscopically identical to type III endometriotic nodules observed in humans. (D) Macroscopic sagittal section of a lesion induced after grafting total uterine thickness reveals a retrocervical nodular lesion (white arrow) and adhesion with the rectum (mucosa, black arrows). Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

4 Figure 3 (A) Microscopic view of a nodular lesion showing strong adhesion with the sigmoid and infiltrating the muscularis. Glands and stroma (white arrow) are clearly visible through the muscularis. (B) CK22 immunostaining confirming the presence of glandular invasion of the sigmoid muscularis (white arrows). (C) White arrows showing the presence of glands in the submucosal layer of the sigmoid. (D) Endometriotic glands (white arrows) infiltrating the sigmoid mucosa and able to colonize its glandular epithelium (yellow arrows). Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

5 Supplemental Figure 1 Section of the uterus showing total uterine wall thickness. The endometrium and myometrium are easily distinguishable, as is the junctional zone (JZ) (white interrupted lines). Four types of specimens were grafted to the peritoneal cavity: endometrium alone, endometrium plus the JZ, total uterine thickness, and myometrium alone. Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

6 Supplemental Figure 2 Large uterine biopsy was anteriorly performed to avoid adhesion formation in the Douglas pouch. Specimens of tissue were grafted to different abdominal sites using absorbable sutures (3/0 FS2 Vicryl, Johnson & Johnson). Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

7 Supplemental Figure 3 Microscopic view of a lesion induced after grafting endometrium and the junctional zone (JZ), showing the presence of dilated glands (white arrows) surrounded by stroma and smooth muscle hyperplasia. Adhesion with the ureter is also observed (black arrows). Fertility and Sterility  , e3DOI: ( /j.fertnstert ) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions


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