My approach to the interpretation of endometrial biopsies and curettings

Either your web browser doesn’t support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. Read article at publisher’s site DOI : Fertil Steril , 3 Cited by: 2 articles PMID: Fertil Steril , 95 4 Free to read.

Hormonal Pathology of the Endometrium

A major proportion of the workload in many histopathology laboratories is accounted for by endometrial biopsies, either curettage specimens or outpatient biopsy specimens. The increasing use of pipelle and other methods of biopsy not necessitating general anaesthesia has resulted in greater numbers of specimens with scant tissue, resulting in problems in assessing adequacy and in interpreting artefactual changes, some of which appear more common with outpatient biopsies. In this review, the criteria for adequacy and common artefacts in endometrial biopsies, as well as the interpretation of endometrial biopsies in general, are discussed, concentrating on areas that cause problems for pathologists.

An adequate clinical history, including knowledge of the age, menstrual history and menopausal status, and information on the use of exogenous hormones and tamoxifen, is necessary for the pathologist to critically evaluate endometrial biopsies.

Histologic dating of the endometrium: Accuracy, reproducibility, and practical value. Oluwole Fadare, Wenxin Zheng · Pathology. Research.

Morphologically, the endometrium is one of the most dynamic target tissues in women. Its cyclic structural changes mirror changes in metabolic functions, and both are regulated by ovarian estradiol and progesterone. Because of this interplay of structure, function, and ovarian hormonal stimuli, the endometrium is considered one of the most sensitive indicators of the hypothalamic-pituitary-ovarian hormonal axis. As a result, morphologic evaluation of the endometrium is used in diagnostic evaluation of infertile patients to determine whether ovulation is occurring Fig.

Schematic representation of steroid hormone-morphologic interactions during the endometrial cycle. Estradiol promotes endometrial proliferation, whereas after ovulation, progesterone converts estradiol-primed endometrium into secretory tissue. Postovulatory estradiol amplifies the progesterone effect, and after withdrawal of both estradiol and progesterone, the endometrial mucosa breaks down and regenerates within the period of menstruation.

Histologic Dating of the Endometrium: Accuracy, Reproducibility, and Practical Value

Study record managers: refer to the Data Element Definitions if submitting registration or results information. After routine time transfer in the frozen embryo transfer cycle, the standard of histological dating were determined according to the pregnancy outcome of the FET cycle. Day 5 blastocysts were transferred with this strategy in natural cycles. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision.

Talk with your doctor and family members or friends about deciding to join a study.

Sixty-three endometrial biopsies were dated histologically by using the standard criteria on two separate occasions by the same observer. Overall, it was found.

Engman is a fellow in reproductive endocrinology and infertility, University of Connecticut School of Medicine, Farmington, Conn. Disagreement about the cause, true incidence, and diagnostic criteria of this condition makes evaluation and management difficult. Here, 2 physicians dissect the data and offer an algorithm of assessment and treatment.

Despite scanty and controversial supporting evidence, evaluation of patients with infertility or recurrent pregnancy loss for possible luteal phase deficiency LPD is firmly established in clinical practice. Although observational and retrospective studies have reported a higher incidence of LPD in women with infertility and recurrent pregnancy losses than in fertile controls, 1 – 4 no prospective study has confirmed these findings.

Furthermore, studies have failed to confirm the superiority of any particular therapy.

How precise is histologic dating of endometrium using the standard dating criteria?

Population carbon dating model ppt Histological dating in infertile couple. Microscopic examination of the evidence still supports abandoning the tissues of pathology – authorstream presentation. Each woman had an endometrial receptivity test allows a natural cycle; nor- mal ovulatory cycle to fertility status3. Interobserver and fallopian tubes from urogenital sinus.

The histologic features of what constitutes “normal” endometrium change with a woman’s age, Noyes RW, Hertig AT, Rock J. Dating the endometrial biopsy.

Diagnosis of Endometrial Biopsies and Curettings pp Cite as. Unable to display preview. Download preview PDF. Skip to main content. This service is more advanced with JavaScript available. Advertisement Hide.

Secretory Phase and Implantation

Nevertheless, there is no consensus regarding the most suitable period of the luteal phase for performing the biopsy. OBJETIVE: This study evaluated the correlation between the histological dating of two endometrial biopsies performed in the same menstrual cycle, on luteal phase days six and ten. Dating was done according to morphometric criteria, in which an endometrium sample is considered out of phase if the minimum maturation delay is one day.

Luteal phase. Female infertility.

In conclusion, the use of classic histologic endometrial dating to estimate the timing of the window of implantation and to adjust progesterone exposure accordingly.

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However, histologic dating of the endometrium as a diagnostic tool of endometrial receptivity has been questioned. Methods: This is a.

Leyendecker, M. Herbertz, G. Kunz, G. METHODS: Normal uteri and uteri with adenomyosis obtained by hysterectomy, excised endometriotic lesions and menstrual blood of women with and without endometriosis were used. RESULTS: With respect to the parameters studied there was a fundamental difference between the cyclical patterns of the basalis and the functionalis of the eutopic endometrium.

The endometrium of endometriotic and adenomyotic lesions mimicked the cyclical pattern of the basalis. The peristromal muscular tissue of endometriotic and adenomyotic lesions displayed the same cyclical pattern of ER and PR expression as the archimyometrium. There was a significantly higher prevalence of fragments of shed basalis in menstrual blood of women with endometriosis than in healthy controls.

Shotgun Histology Proliferative Endometrium


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