Major effects of Gn RH-I in the reproductive tissues are regulation of cell proliferation, activation of apoptosis and remodulation during the process of embryo implantation.
In this retrospective study, endometrial samples were obtained from 30 women with normal menstrual cycles.
- ASSESSMENT LIMITED AS NO DEFINITE ENDOMETRIAL STROMA IS PRESENT.
ENDOMETRIUM, ASPIRATION: - ONE MINUTE STRIP OF POSSIBLE NONPROLIFERATIVE ENDOMETRIAL EPITHELIUM, INSUFFICIENT FOR ADEQUATE DIAGNOSTIC ASSESSMENT. ENDOMETRIUM, BIOPSY: - ENDOCERVICAL MUCOSA AND STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS.
However, the intra- and interobserver variability inherent in dating the product of the endometrial biopsy-the endometrium-has led to the current situation, in which, in approximately 20% of cases, variability attributed to the pathologist alone is determinant of whether a given biopsy in "in phase" or out of phase (ie, an assigned postovulatory date that is at least 2 days behind the chronologic date).
Meanwhile, continued use of the criteria of Noyes et al for endometrial dating is recommended until more precise modalities for assessing the adequacy of endometrial maturation are available. AB - The continued use of the endometrial biopsy for the diagnosis of luteal phase defects (LPDs) and in the general evaluation of the infertile couple is based largely on tradition, the absence of a clearly superior diagnostic modality, the absence of studies that have either validated or repudiated its efficacy with certainty, its ability to assess the endometrial response irrespective of endogenous progesterone levels, its ability to monitor the endometrial response to hormonal therapy in fertility treatments, and, finally, its ability to exclude other intrinsic endometrial anomalies that may be detrimental to the implantation of the conceptus, such as chronic endometritis or neoplasia.Indications Abnormal uterine bleeding: postmenopausal bleeding, malignancy/hyperplasia Monitoring adjuvant hormonal treatment (tamoxifen) Endometrial dating Presence of endometrial cell in PAP smear in women 40 years of age Abnormal Pap smear with atypical cells favoring endometrial origin (AGUS) Follow-up of previously diagnosed endometrial hyperplasia Cancer screening (e.g.HNPCC/Lynch syndrome, Cowden syndrome) Inappropriately thick endometrial stripe found on USG 3 Sampling of the Endometrium Office biopsy procedures (Pipelle, Vabra aspirator, Karman cannula) agree with a D&C performed in 95% of the time Office biopsy has a 16% false negative rate when the lesion is a polyp or cancer Patients with persistent PMB after a negative office biopsy should have D&C ( /- hysteroscopy) D&C is the gold standard sampling method preoperative D&C will agree with diagnosis at hysterectomy 94% of the time 5 Adequacy criteria Clinical history e.g.With use of LH peak, 24 of 26 samples were in phase, and 2 were 3 days behind.Pinopodes appeared on days 20–21 and persisted through day 28 in small groups or larger areas.
Search for endometrium dating:
The endometrium is typically biopsied because of abnormal bleeding.