Raga, F. Bonilla-Musoles, E. Klein, F. The aim of the present prospective study was to obtain quantitative data on endometrial volume by three-dimensional 3D ultrasound at the time of embryo transfer in an in-vitro fertilization programme and to assess its value in predicting endometrial receptivity. It is concluded that endometrial volume by 3D transvaginal ultrasound may become a new objective parameter by which to predict endometrial receptivity. Endometrial differentiation, embryo development, and embryo-endometrial interactions leading to implantation require continuous and synchronous dialogue between these two compartments. Since the introduction of transvaginal sonography, a number of studies have attempted to define a relationship between endometrial thickness, echogenicity and endometrial receptivity.
Thomas Strowitzki, A. Germeyer, R. Popovici, M. Intensive research work has been performed to better understand the regulation of the endometrium and its clinical implications to improve implantation. Although many proteins and molecules may influence endometrial development, their co-ordinated contribution to the implantation process is still poorly understood and a translation into clinical use has not sufficiently been performed. Clinical evaluation of the endometrium by ultrasound and other techniques, like endometrial biopsy and analysis of uterine secretions, has been intensively studied and therapeutic options to improve endometrial function have been suggested and tested.
Evaluation of hyperplasias in the post treatment setting in an endometrial biopsy or curettage and avoid diagnostic are inappropriate for endometrial dating.
A more recent article on endometrial biopsy is available. See patient information handout on endometrial biopsy. Related Content. Endometrial biopsy is an office procedure that serves as a helpful tool in diagnosing various uterine abnormalities. The technique is fairly easy to learn and may be performed without assistance. The biopsy is obtained through the use of an endometrial suction catheter that is inserted through the cervix into the uterine cavity.
Twirling the catheter while moving it in and out of the uterine cavity enhances uptake of uterine tissue, which is aspirated into the catheter and removed.
My approach to the interpretation of endometrial biopsies and curettings
Study Design : Prospective, non-randomized clinical study. Materials and Methods : This was a prospective observational study. Women with tubal factor, male factor and unexplained infertility were included in the study. Results : The mean age was 35 years and mean duration of infertility was 8 years. Seventy five The mean endometrial thickness was 8.
ABSTRACT: Endometrial hyperplasia is of clinical significance because it is often a for endometrial intraepithelial neoplasia provides definitive assessment of a To date, neither the dose nor the schedule for progestin agents has been well.
The endometrium is typically biopsied because of abnormal bleeding. Endometrial hyperplasia and endometrial carcinoma are dealt with in separate articles. An overview of gynecologic pathology is in the gynecologic pathology article. Other indications: . An increased gland density is seen focally, at the edge of one tissue fragment, in association with tearing of the stroma compression artifact. The big table of metaplasias – adapted from Nicolae et al. Endometrial cancer is the most common gynecologic malignancy in the USA.
From Libre Pathology. Main article: Proliferative phase endometrium. Main article: Secretory phase endometrium.
Endometrial Intraepithelial Neoplasia
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.
with postmenopausal bleeding will be found to have endometrial cancer, all patients must the explanation of the bleeding without further assessment To date, trials comparing open versus laparoscopic surgery have shown, as would be.
Providing cutting-edge scholarly communications to worldwide, enabling them to utilize available resources effectively. We aim to bring about a change in modern scholarly communications through the effective use of editorial and publishing polices. Monique Monard. E-mail : bhuvaneswari. Courtney Marsh. Katelyn Schumacher. Warren Nothnick. The female reproductive system prepares the female body for conception and pregnancy through two distinct cycles, the ovarian cycle and the endometrial cycle. The human endometrium, under the influence of complex biological signals, undergoes cyclic changes in preparation for implantation and the initiation of pregnancy.
Endometrial biopsy is useful in the work-up of abnormal uterine bleeding, cancer screening, endometrial dating and infertility evaluation.
Steven G. Arch Pathol Lab Med 1 March ; 3 : — It is well known that a number of problematic diagnostic scenarios occur relative to these specimens. Recognition of diagnostic pitfalls and practical approaches to their resolution help improve quality. Although most diagnostic pathologists encounter numerous endometrial specimens in their daily practice, many perplexing problems are still encountered when dealing with these specimens.
The intent of this review is to emphasize practical aspects of endometrial specimen handling and report generation, with selected comments on common diagnostic pitfalls, particularly those noted as such in the literature and in my own experience as a consultant and as the Pathology Referee for the Gynecologic Oncology Group. For other recent reviews on the pathology of the endometrium, particularly regarding diagnostic problems related to endometrial carcinoma, the reader is referred to recently published monographs, chapters, and review articles, including but not limited to the ones referenced here.
The approach to any endometrial sampling specimen, whether from an outpatient biopsy or a formal curettage, should be dictated by the clinical indication for submission of the specimen. Regardless of the indication, the approach to examination of the specimen is similar, although the information expressed in the final surgical pathology report will differ.
15 years of transcriptomic analysis on endometrial receptivity: what have we learnt?
Metrics details. Over the course of the last four decades, IVF has allowed an increasing number of infertile couples the chance to conceive. Considering the extensive research and advances in ART, too many IVF attempts still do not result in a successful pregnancy [ 1 , 2 ].
The standard method of endometrial dating is the histological evaluation of an endometrial biopsy specimen (Noyes et al., ). Indeed, this technique has.
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.
Topics such as endometritis, endometrial polyps, changes that are induced by hormones and tamoxifen within the endometrium, endometrial metaplasias and hyperplasias, atypical polypoid adenomyoma, adenofibroma, adenosarcoma, histological types of endometrial carcinoma and grading of endometrial carcinomas are discussed with regard to endometrial biopsy specimens rather than hysterectomy specimens. The value of ancillary techniques, especially immunohistochemistry, is discussed where appropriate.
In many histopathology laboratories, endometrial specimens account for a major proportion of the workload. Most specimens are taken because of abnormal uterine bleeding or other related symptoms, and the pathologist is expected to exclude an endometrial cancer or a precancerous lesion. In some cases, a benign cause for abnormal uterine bleeding is identified, such as endometritis or endometrial polyp.
In this review, I will outline my approach to the interpretation of endometrial biopsy specimens, especially concentrating on areas which, in my experience, create difficulties for pathologists. Endometrial biopsy specimens are now rarely taken to date the endometrium and to assess whether ovulation has occurred, as serum measurements of various hormones give equivalent or more information.
Histologic dating of the endometrium: Accuracy, reproducibility, and practical value
This article discusses briefly endogenous hormonal effects cyclic changes, luteal phase defect, unopposed estrogen effect and describes the histologic patterns encountered in the most commonly used hormone therapies: oral contraceptives, ovulation stimulation, hormone replacement therapy, and antitumoral hormone therapy.
Here, 2 physicians dissect the data and offer an algorithm of assessment and Histologic dating of an endometrial sample is the gold standard for evaluation of.
Study record managers: refer to the Data Element Definitions if submitting registration or results information. This study will evaluate the utility of the endometrial biopsy as a tool for the routine evaluation of the luteal phase of women presenting for infertility evaluation. The study will establish whether the mid-luteal or late-luteal phase is the most appropriate time to perform an endometrial biopsy.
The study will be conducted through the multi-center Reproductive Medicine Network. Women with a history of infertility will be age matched to fertile women controls. Women will be randomized either to the mid-luteal phase 7 to 8 days post-ovulation endometrial biopsy group or to the late-luteal phase 12 to 13 days post-ovulation endometrial biopsy group. Endometrial specimens will be evaluated histologically by a “blinded” pathologist. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.