Endometrium

About: Endometrium is a research topic. Over the lifetime, 12366 publications have been published within this topic receiving 360693 citations.

Dating the endometrial biopsy.

Abstract: It is asserted that examination of the endometrium during the secretory phase yields more information about the time of ovulation degree of progestational change and normality of the endometrium than any other test used in sterility studies. Attention to qualitative changes in 8 morphological factors is most useful in dating the endometrial biopsy. During the 1st week of luteal activity attention should be focused on changes occurring in gland epithelium: gland mitosis pseudostratification of nuclei basal vacuolation and secretion. During the 2nd week stromal changes (including edema) predecidual reaction stromal mitosis and leukocytic infiltration are the key criteria. Tissue from the fundus of the uterus gives the most reliable information. These critera were used in 300 sterility biopsies taken from normally menstruating women over a 3-year period. Absence of organic endometrial disease and availability of accurate menstrual history were the only selection criteria. 12 observers dated the biopsies. 42 of the 300 patients (14%) menstruated on the day predicted 36 (12%) menstruated later and 222 (74%) menstruated earlier. When a +or- 1 day error was allowed 112 patients (38%) were found to menstruate at the time predicted. When these same slides were reviewed by a single observer and the date for the most advanced area of the biopsy was used 179 patients (60%) menstruated within 1 day of prediction. To test the validity of the dating criteria change in basal body temperature was used to correlate endometrial dating with ovulation rather than onset of menstruation. Of the 40 patients who had adequate temperature records 31 (78%) ovulated as predicted allowing a +or- 1 day error indicating that dating is a better gauge of duration of progesterone effect than predictor of onset of menses. To determine whether biopsy caused early menstruation the secretory phases of the 25 patients who had recorded temperatures in at least 2 cycles in addition to that in which the biopsy was taken were examined. The secretory phase was definitely shorter in the biopsied than control cycle suggesting that biopsy does accelerate the onset of flow. However further analysis showed that biopsy does not interfere with length of flow or succeeding menstrual rhythm.

Physiological action of progesterone in target tissues.

Abstract: I. Introduction II. Synthesis and Secretion of Progesterone III. The Progesterone Receptor A. PR expression and regulation IV. Progesterone Regulation of Gene Expression in the Uterus, Ovary, and Chick Oviduct A. Progesterone effects on proliferation and decidualization in the uterus during the menstrual cycle B. Progesterone regulation of insulin-like growth factor (IGF) pathways in the endometrium C. Control of ovulation D. Implantation, uterine proliferation, and early pregnancy E. Myometrial contractility F. Chick oviduct V. Progesterone Action in the Breast A. Effect of progesterone on proliferation of the normal breast B. Progesterone regulation of genes associated with cell cycle progression C. Progesterone regulation of growth factors and growth factor receptors in the breast D. Markers of progestin action in the breast E. Progesterone effects on lactation VI. Progesterone Effects in the Brain VII. Progesterone Effects on Bone VIII. Antiestrogen Action of Progesterone A. Inhibition of ER expressio...

Dating the endometrial biopsy.

Abstract: It is asserted that examination of the endometrium during the secretory phase yields more information about the time of ovulation degree of progestational change and normality of the endometrium than any other test used in sterility studies. Attention to qualitative changes in 8 morphological factors is most useful in dating the endometrial biopsy. During the 1st week of luteal activity attention should be focused on changes occurring in gland epithelium: gland mitosis pseudostratification of nuclei basal vacuolation and secretion. During the 2nd week stromal changes (including edema) predecidual reaction stromal mitosis and leukocytic infiltration are the key criteria. Tissue from the fundus of the uterus gives the most reliable information. These critera were used in 300 sterility biopsies taken from normally menstruating women over a 3-year period. Absence of organic endometrial disease and availability of accurate menstrual history were the only selection criteria. 12 observers dated the biopsies. 42 of the 300 patients (14%) menstruated on the day predicted 36 (12%) menstruated later and 222 (74%) menstruated earlier. When a +or- 1 day error was allowed 112 patients (38%) were found to menstruate at the time predicted. When these same slides were reviewed by a single observer and the date for the most advanced area of the biopsy was used 179 patients (60%) menstruated within 1 day of prediction. To test the validity of the dating criteria change in basal body temperature was used to correlate endometrial dating with ovulation rather than onset of menstruation. Of the 40 patients who had adequate temperature records 31 (78%) ovulated as predicted allowing a +or- 1 day error indicating that dating is a better gauge of duration of progesterone effect than predictor of onset of menses. To determine whether biopsy caused early menstruation the secretory phases of the 25 patients who had recorded temperatures in at least 2 cycles in addition to that in which the biopsy was taken were examined. The secretory phase was definitely shorter in the biopsied than control cycle suggesting that biopsy does accelerate the onset of flow. However further analysis showed that biopsy does not interfere with length of flow or succeeding menstrual rhythm.

Endometrial receptivity markers, the journey to successful embryo implantation.

Abstract: Human embryo implantation is a three-stage process (apposition, adhesion and invasion) involving synchronized crosstalk between a receptive endometrium and a functional blastocyst. This ovarian steroid-dependent phenomenon can only take place during the window of implantation, a self-limited period of endometrial receptivity spanning between days 20 and 24 of the menstrual cycle. Implantation involves a complex sequence of signalling events, consisting in the acquisition of adhesion ligands together with the loss of inhibitory components, which are crucial to the establishment of pregnancy. Histological evaluation, now considered to add little clinically significant information, should be replaced by functional assessment of endometrial receptivity. A large number of molecular mediators have been identified to date, including adhesion molecules, cytokines, growth factors, lipids and others. Thus, endometrial biopsy samples can be used to identify molecules associated with uterine receptivity to obtain a better insight into human implantation. In addition, development of functional in vitro systems to study embryo-uterine interactions will lead to better definition of the interactions existing between the molecules involved in this process. The purpose of this review was not only to describe the different players of the implantation process but also to try to portray the relationship between these factors and their timing in the process of uterine receptivity.

Global Gene Profiling in Human Endometrium during the Window of Implantation

Abstract: Implantation in humans is a complex process that is temporally and spatially restricted. Over the past decade, using a one-by-one approach, several genes and gene products that may participate in this process have been identified in secretory phase endometrium. Herein, we have investigated global gene expression during the window of implantation (peak E2 and progesterone levels) in well characterized human endometrial biopsies timed to the LH surge, compared with the late proliferative phase (peak E2 level) of the menstrual cycle. Tissues were processed for poly(A+) RNA and hybridization of chemically fragmented, biotinylated cRNAs on high density oligonucleotide microarrays, screening for 12,686 genes and expressed sequence tags. After data normalization, mean values were obtained for gene readouts and fold ratios were derived comparing genes up- and down-regulated in the window of implantation vs. the late proliferative phase. Nonparametric testing revealed 156 significantly (P < 0.05) up-regulated gene...