Endometrial dating noyes
Women collected daily, first morning voided urine for measurement of estradiol and progesterone metabolite excretion, estrone conjugates (E1c), and pregnanediol glucuronide (Pdg), respectively, throughout the cycle of study. Between 7–9 days after home detection of a LH surge (Sure Step), participants underwent an endometrial biopsy using a small bore (Pipelle) catheter. E1c varied over a 2-fold range in these normal women, from 1196–2040 ng/cycle.Tissue was prepared for histological and biochemical analyses. Pdg excretion was much more variable, ranging from 22–119μ g/cycle.To examine the relationship between endometrial histological maturation and reproductive hormones, we studied 11 fertile women, aged 18–37 yr. P.), all of whom were blinded to the participant’s identity or timing of biopsy within her cycle.All participants had had at least 1 previous pregnancy and cycled regularly, every 25–35 days. Final dating was agreed upon based upon the method of Noyes E1c and Pdg were integrated throughout the cycle using the trapezoidal rule, and correlations were sought between deviation from expected histology (based upon urinary hormones and LH surge) and integrated hormone values.Data analysis, clustering and pathway analysis were performed with GCOS, Gene Spring 7.3 and Ingenuity, respectively.RESULTS According to Noyes’ criteria, all endometria taken on the day of oocyte retrieval showed an advanced maturation, ranging from d2 to d4.This interaction involves the embryo, with its inherent molecular programme of cell growth and differentiation, and the temporal differentiation of endometrial cells to attain uterine receptivity.Implantation itself is governed by an array of endocrine, paracrine and autocrine modulators, of embryonic and maternal origin.
The glands critreia this day 17 endometrium contain prominent subnuclear glyco- gen vacuoles underlying a single row of nuclei in the endometrial glands. These regularly tortuous glands in this day 20 endometrium contain secretions that are largely intracellular apical, and datig intraluminal.
ENDOMETRIAL HISTOLOGY varies across the normal menstrual cycle and is due to stimulation by estradiol and progesterone.
Estradiol stimulation results in proliferation of the basalis and functionalis, whereas progesterone promotes glandular development and secretion and is believed to initiate the changes necessary for implantation.
No relationship could be found between histological lagging of endometrial maturation and lower excretion of E1c.
A moderate correlation was observed (Spearman’s r = 0.6; 2 days), one excreted 24 μg Pdg/cycle, the next to lowest value.