Dating of secretory endometrium

Histopathology Uterus, endometrium--Proliferative endometriu

A study on uterine endometrial dating in endometrial cytology. Endometrium , Cytology , Histology , Dating.

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January 20, Released: November 08, accepted: April 22, [Advance Publication] Released: Information related to the author. Previous article Next article.

Error in histologic dating of secretory endometrium: variance component analysis.

The aims of the present study using hysteroscopic assessment of the mid-secretory phase endometrium were: All patients who had undergone hysteroscopic examination of the endometrium at our University Hospital, Okinawa, Japan, between January and December , and became pregnant, were considered for the study. Patients with chemical or subclinical abortion, i. The vast majority of patients underwent outpatient hysteroscopy as part of the overall evaluation of infertility or repeated early abortion.

At diagnosis of pregnancy, the mean age of the patients was These pregnant patients were analysed retrospectively with special reference to a possible relationship between endoscopic findings and pregnancy outcome. Nine patients, whose pregnancies ended in ectopic pregnancy or in miscarriage suspected to be due to significant factors, e.

Three patients were lost to follow-up after conception. Thus, women were included in this analysis. Hysteroscopy was scheduled in a menstrual cycle not manipulated with any hormonal agents. Patients were well informed regarding the procedure and were asked to prevent conception in the cycle.

Lidocaine is not thought to have vaso-constrictive or dilative effects. No apparent change was observed in vasculature between pre- and post-PCB in those patients receiving PCB in the middle of hysteroscopy. Patients received cleansing and disinfection of their vulva and vagina in the dorsal lithotomy position.

E. Pathology by systems

A rigid hysteroscope which had a 4. After introducing the hysteroscope through the internal uterine os, the uterine cavity was scanned thoroughly.

After completion of the examination, endometrial biopsy was performed in 32 patients who agreed to the procedure. Hysteroscopic findings were observed and diagnosed by more than three gynaecologists, including the authors H. The specimens biopsied in 32 patients were submitted to conventional light microscopic examination to compare the observed hysteroscopic findings with histology of the endometrium. Post-ovulatory day of the cycle was specified by one of the authors K. Serum progesterone and oestradiol, taken on the day of hysteroscopy, were measured in 83 patients by enzyme immunoassay kits DPC Estradiol and Progesterone assay kits; Diagnostic Products Corporation.


The normal values for progesterone and oestradiol in the luteal phase days 3—15 after ovulation were 0. In this study, early pregnancy loss early spontaneous abortion was categorized into blighted ovum or intrauterine embryonic death, based on the findings of serial transvaginal ultrasonography. Blighted ovum was designated in cases where embryonic echoes were never visualized in the gestational sac, and embryonic death in cases where embryo heart action, which had been once identified, disappeared within 11 weeks of gestation menstrual age. Of patients, 62 The clinical characteristics of these two groups are shown in Table I.

There were no differences either in the frequency of patients with infertility factors or the distribution pattern of infertility factors between the two groups, and the overwhelming majority of patients had infertility factors. As shown in Table II , of the pregnancies occurring after hysteroscopic examination, 68 It was noted that 32 of these 68 pregnancies occurred in patients who had undergone hysterosalpingography or selective salpingography alone, several months prior to conception.

There were no significant differences between the two groups for any of these assisted interventions. Of the pregnancies, persisted successfully to live birth term and 16 preterm , but 42 ended in early pregnancy loss 20 in embryo deaths and 22 in blighted ova Table II.

Error in histologic dating of secretory endometrium: variance component analysis.

No patients were encountered who suffered from late abortion at 12—21 weeks gestation. Endometrial specimens from 32 patients were examined to specify the post-ovulatory day of the cycle according to histological criteria for dating the endometrium Table III.


Serum samples from 83 patients were submitted to progesterone and oestradiol assays Table IV. There were no significant differences for serum progesterone and oestradiol concentrations and progesterone: The glands exhibit a regular tortuosity and are clearly oriented from the base to the surface of the endometrium; subnuclear glycogen vacuoles are clearly visible. The glands of this day 17 endometrium contain prominent subnuclear glyco- gen vacuoles underlying a single row of nuclei in the endometrial glands.

Day 17 endometrium, with reduced Ki67 staining.

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These regularly tortuous glands in this day 20 endometrium contain secretions that are largely intracellular apical, and partially intraluminal. In this day 23 - 24 endometrium, the glands are beginning to show regressive changes; spiral arterioles are present and are most prominent in the lower left portion of the illustration; they are beginning to be surrounded by cuffs of predecidua; predecidual stromal change is not yet apparent in the superficial compacta. The glands of this day 25 endo- metrium are markedly regressed, and the superficial compacta has a diffusely predecidualized stroma.

This high power photomicrograph of a day 25 endometrium shows a spiral arteriole cut in multiple profiles and surrounded by predecidual stroma; note the admixture in the stroma of large decidualized cells and smaller endometrial granulocytes.