Endometrial dating histology Fetish skype chat online
In contrast, secretory-phase endometrium often demonstrates subtle changes and, in many cases, combinations of morphologic changes, resulting in most instances in errors of 4–5 days.The pathologist can improve this to 2–3 days, however, by acquiring expertise in endometrial dating (all cases of normal endometria are to be dated regardless of reasons for sampling), and by basing the dating on those endometrial morphologic alterations that represent the most advanced phase of the menstrual cycle.The major morphologic criteria useful for dating the endometrium throughout the cycle are presented in Fig. In routine dating, the pathologist should avoid bias by evaluating the histologic section before reading the clinical information.After examining the specimen, the pathologist should attempt to correlate histology with clinical history.In LPD, circulating progesterone levels are decreased and not sufficient to promote full secretory differentiation of the endometrium.
Endometrial biopsies are not to be taken at the onset of bleeding in the following two conditions: if luteal phase defect (LPD) is suspected clinically and is desired to be confirmed histologically, when the biopsy should be taken between POD 7 (21st) and POD 9 (23rd) cycle days to demonstrate a 3–4 day delay in endometrial maturation; or if there are asynchrony of gland/stromal development and dissimilar maturation in different regions of the endometrial specimen.
Timing The best way to prove or disprove that ovulation has taken place is to take an endometrial sample on cycle day 22 or later, preferably at the onset of uterine bleeding.
By obtaining samples at the time of early uterine bleeding, the pathologist will be able to determine whether the bleeding is caused by the breakdown of postovulatory, secretory endometrium; by focal necrosis of the endometrium associated with anovulation; by other pathologic states; or by hormone administration.
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. Schematic representation of steroid hormone-morphologic interactions during the endometrial cycle.