Evaluation of the rabbit as an experimental model for human uterine synechia.

CONTEXT

Pathogenesis of uterine synechia remains unsolved, the causal relationship between synechia and infertility is not clearly established.

AIMS

To evaluate the rabbit as an experimental model for Asherman's syndrome using the endometrial curettage as trigger mechanism then to evaluate its impact on fertility.

SETTINGS AND DESIGN

Experimental study

MATERIALS AND METHODS

13 female rabbits. All submitted traumatic endometrial curettage. Animals of Group 1 (n = 7) were sacrificed at various times following surgery (day 7, 15 and 30), animals of Group 2 (n = 6) were bred and sacrificed during pregnancy. Main outcome were synechia occurring, number of implanted fetus, lumen surface/ global horn perimeter ratio (LS-GHP ratio) and epithelium thickness.

STATISTICAL ANALYSIS

Means were compared using Student 't' test (P < 0.05 was considered significant). Number of implantation sites of two horns were compared with the Wilcoxon test.

RESULTS

No synechia have been observed. Examinations at Day 7, 15 and 30 demonstrate a complete regeneration of endometrium. We observed a significant diminished LS-GHP ratio at day 7 (0.042 ± 0.004 vs 0.074 ± 0.002 mm; P = 0.013) with a higher simple columnar epithelium compared to control (16.6 ± 3.39 vs 10.98 ± 1.7; P = 0.001). We observed a diminished ovum implantation in traumatized horns, even if it was not statistically significant.

CONCLUSION

Even if no intrauterine adhesion were observed, this model represents a pathogenesis condition in the rabbit similar to intrauterine adhesions observed in the human with negative impact on implantation.