Endometrial Dating Histology

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.

Gynecological Surgery volume 1 , pages — Cite this article. Metrics details. The paper briefly reviews the main pathologies of the endometrium that can be detected by hysteroscopy. Emphasis is put on dysfunctional endometrial bleeding and the recently discovered molecular mechanisms that trigger its occurrence, on the difference between hyperplasia and intra-epithelial neoplasia of the endometrium and on the DNA alterations commonly found in endometrial adenocarcinomas. This review of uterine pathology is intended for gynecologic endoscopists and is accordingly focused on lesions of the endometrium and of the inner portion of the myometrium. Hysteroscopy is usually performed to investigate either infertility or abnormal uterine bleeding. In abnormal bleeding, the uterus may contain endometrial hyperplasia, atrophy, neoplasia, polyp, adenomyosis, submucosal leiomyoma, uterine sarcoma or no lesion, leading then to the diagnosis of dysfunctional uterine bleeding [ 1 ].

Metrics details. Displacement of the window of implantation WOI has been proposed as an important factor contributing to repeated implantation failure RIF. However, the use of histologic endometrial dating as a diagnostic tool of endometrial receptivity has been questioned.

The uterus is lined by a thick mucosa, the endo metrium , surrounded by a thick wall of smooth muscle, the myo metrium. The endometrium consists of a simple columnar epithelium , forming numerous tubular glands, supported by a thick vascular stroma. Both glands and stroma undergo extensive changes during the menstrual cycle. The endometrium is functionally subdivided into two layers.