Endometrial dating pathology
It is asserted that examination of the endometrium during the secretory phase yields more information about the time of ovulation, degree of progestational change, and normality of the endometrium than any other test used in sterility studies.Attention to qualitative changes in 8 morphological factors is most useful in dating the endometrial biopsy.
Postovulatory phase (secretory phase) endometrial dating has become the standard and is usually reported within a 2-day range, although the accuracy of this dating methodology is the subject of some debate.In addition, the original description fixed the time of ovulation with the onset of the period after the biopsy.The onset of ovulation can be more accurately determined using current modalities, such as determination of the midcycle urinary luteinizing hormone surge or ultrasonic identification of the collapse of a follicle.However, the accuracy of this test has been questioned because abnormal results can be observed in cycles that eventually prove to result in a viable pregnancy.Endometrial dating can be performed both before and after ovulation.Of the 40 patients who had adequate temperature records, 31 (78%) ovulated as predicted allowing a or- 1 day error, indicating that dating is a better gauge of duration of progesterone effect than predictor of onset of menses.
To determine whether biopsy caused early menstruation, the secretory phases of the 25 patients who had recorded temperatures in at least 2 cycles in addition to that in which the biopsy was taken were examined.
The endometrium is functionally divided into two layers: the basalis and the functionalis. The stroma is composed of stromal cells, vessels, and white blood cells thought to be lymphocytes or macrophages.
Cyclic changes occur in both endometrial glands and stroma in response to a changing endocrine environment.
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An appreciation of the relationship between form and function is important for understanding of female reproduction.