Effects Of Mirena On Eutopic Endometrium Of Endometriosis Patients: A Clinical And Basic Study

BACKGROUNDEndometriosis is a common disease thought to affect 10%~15% women of reproductive age. The condition located in pelvic cavity often leads to a variety of symptoms that range from pain to infertility. In spite of surgical and medical treatments, recurrence as an important clinical problem remains frustrating. The mechanism of EM is not well understood, but the most often cited and accepted theory is the Implantation Hypotheses. The imbalance between phenomenon of retrograde menstruation and the relative low morbidity may be due to the characteristic features of eutopic endometrium. As more and more evidences suggest that eutopic endometrium of patients shares alterations with the ectopic tissue, we propose that the origin of disease is in uterus, and prospected the condition can be prevented or controlled by managing eutopic endometrium directly.The common used drugs in the treatment of EM, such as GnRHa or gestrinone, aimed on the "estrogen dependent disease", are to induce a sufficiently hypo-estrogenism and/or hyper-progestrogenism or hyper-androgenism. They are expensive and provide only short-term symptomatic relief, with up to 50% of women having a recurrence of disease within a year of treatment discontinuation. Because all of these drugs are not cytoreductive, they are hoped to be used for a prolonged period. After more than 20 years on the sidelines, progestogens are gradually regaining popularity and are the currently the only safe and economic option.Mirena(?) (the levonorgestrel-releasing intrauterine system, LNG-IUS) permits the slow and controlled release over 24h of 20μg LNG in the uterine cavity. In addition to providing effective contraception, Mirena induces hypomenorrhea and amenorrhea. Pioneering work on use of it for EM suggested that Mirena greatly reduced menstrual pain and risk of recurrence. One of the interesting questions for future is the prophylactic effect of LNG-IUS on EM. There is still no basic evidence on Mirena's potential to control eutopic endomerium of EM patients.OBJECTIVESTo investigate if the local effects of Mirena can change the pathogenic feature of eutopic endomtrium of EM patients.To investigate the functional effects on eutopic endometium of oral MPA and injective GnRHa.