In the nongestational endometrium, predecidual cells are engaged in phagocytosis and digestion of extracellular collagen matrix. Major morphologic criteria for dating the endometrium during the menstrual cycle. Use our care to fertility status. According to most investigators, measurements of serum progesterone levels rather than histological dating of the endometrium provide for the best assessment of LPD see discussion later in this chapter. Noyes et al. Experimental endometrial regeneration in the rabbit has shown that proliferation kinetics and morphologic alterations of the regenerative but estrogen-deprived atrophic endometrium associated with ovariectomy are similar to those in animals with intact ovaries.
An essential component of epithelial regeneration is provided by stromal cells which aggregate in cellular 'balls' beneath the regenerative surface epithelium Fig. This is characterized by protrusions and eventual detachment of the apical portion of cells containing glycoproteins. Morphologically, the endometrium is one of the most dynamic target tissues in women. These features are consistent with ameboid contraction-expansion-mediated motility. An inflammatory reaction composed of leukocytes is generally absent in association with apoptotic bodies. The glands of this day 17 endometrium contain prominent subnuclear glyco- gen vacuoles underlying a single row of nuclei in the endometrial glands. Predecidualization not pseudodecidualization is accompanied by an increase in nuclear DNA synthesis, mitotic activity, and the formation of a pericellular laminin substance.
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As a result, morphologic evaluation of the endometrium is used in diagnostic evaluation of infertile patients to determine whether ovulation is occurring Fig.
Endometrial dating and determination of the window of implantation in healthy fertile women.
Such a condition, also called irregular shedding, is presumably associated with a persistent corpus luteum from a recent or remote intrauterine or ectopic pregnancy and with relatively increased blood progesterone levels. During cycle days 1 and 2, synthesis of nuclear deoxyribonucleic acid DNA is near zero level in the secretory functional layer of the endometrium. Postovulatory day 11 cycle day It destroys the glandular and stromal cells as well as the vascular endothelium. These cellular activities may contribute to menstrual breakdown of the endometrium.
Despite earlier suggestions, they are not necessarily sufficiently temporarily distinct and discriminated enough to allow a high degree of reproducibility in accurately dating the endometrium by histology. These complex cellular and molecular events take place in the functionalis layer of the endometrium following withdrawal of both E2 and P. In the nongestational endometrium, predecidual cells are engaged in phagocytosis and digestion of extracellular collagen matrix. Functions of macrophages in human decidual tissue in early pregnancy. Fadare O, Zheng W: