자궁내막증은 정상적으로 여성 생식기의 자궁내강에 있는 내막 조직이 자궁내강 바깥에 존재하는 것으로 정의되는 질환으로 아직까지 그 정확한 발생기전은 증명된 바 없다. 본 연구는 생리중 역류된 자궁내막이 복강내에 이식되어 자궁내막증이 발생한다는 가설을 실험적으로 증명하기 위한 것으로 복강내에 이식된 자궁내막 조직에 미치는 조직학적 평가와 이식편의 부피를 관찰하고 GnRH agonist와 양측 난소절제술이 이식편에 미치는 영향을 대조군과 비교 분석하였다. 본 연구에서 복강 내에 이식된 자궁내막 조직이 괴사되 지 않고 조직학적으로도 자궁내막의 조직이 잘 보존되었 다는 것은 Sampson의 가설을 실험적으로 입증한 증거라 고 할 수 있다. 또한 estradiol의 혈중 농도가 GnRH agonist 를 투여한 군과 양측 난소절제술을 시행한 군에서 대조군 에 비해 유의하게 낮게 관찰되면서 동시에 이식편의 부피 가 현저하게 감소하였다는 결과는 자궁내막증의 진행에 estrogen이 관여한다는 사실을 간접적으로 입증한 것으로 estrogen의 분비를 억제하는 GnRH agonist가 자궁내막증의 치료에 중요한 역할을 할 수 있다고 생각된다.

Endometriosis is the presence of functioning endometrial glands and stroma outside the uterine cavity. However, the exact mechanism of endometriosis involved remains unclear. To prove Sampson`s hypothesis of retrograde menstruation as a cause of endometriosis, we evaluated endometriosis artificially induced in the rabbits. Sampson`s hypothesis of retrograde menstruation as a cause of endometriosis was proved by evaluating the result of intrapelvic implantation of endometrium. Endometrium obtained from one uterine horn after stimulation with estradiol injection was surgically implantated into the peritoneum, and the viabilities of the implants were studied histologically. Thirty rabbits were used for this study and were randomly assigned to three groups. Group 1 served as a control, group 2 was those with intramuscular injection with GnRH agonist and group 3 was those that were operated for bilateral ovariectomy. Laparotomies were performed after 25 days in all rabbits to assess the histologic evaluation and the volume of endometrial implants. And blood sampling was done from descending aorta, 17β-estradiol were estimated. The results were summarized as followings: 1. The concentration of 17β-estradiol was checked 91±19 pg/ml in control, 34±7 pg/ml after injection with GnRH agonist, 25±6 pg/ml in bilateral ovariectomy. Administration of GnRH agonists and bilateral ovariectomy significantly decreased the serum estradiol level. 2. The volume of endometrial implants after injection with GnRH agonists (5.9±1.4 mm3) and after ovariectomy (1.4±0.1 mm3) were significantly less than those of control group (30.0±6.2 mm3)(p＜0.01). 3. In the histologic evaluation of endometrial implants, the number of endometrial gland and stroma was increased in control, but was significantly decreased in other groups (p＜0.05). This study showed that intrapelvic implantation with endometrium can cause endometriosis, and Sampson hypothesis was experimentally proved thouse indirectly. And estradiol level was significantly suppressed in GnRH agonists and ovariectomized group. It can be stated that GnRH agonists may be one of the potential modalities of treatment in the patients with endometriosis.