The Endometrium

A quantitative study of endometrial development in the luteal phase: comparison between women with unexplained infertility and normal fertility

This study compared endometrial development in the luteal phase of women with unexplained infertility (n = 30) with that in women with normal fertility (n = 70) by the use of quantitative histological techniques (morphometric analysis) on endometrial specimens which were precisely timed from the luteinizing hormone surge. When overall endometrial development (histological dating) was considered, the proportion of women with unexplained infertility who had retarded endometrial development (20%) was found to be significantly higher than for women with normal fertility (3%) (P less than 0.01). When individual histological features were considered, women with unexplained infertility were found to have significant deviation from the normal range established from fertile women in only five of the 14 histological features measured. All of these five features related to the glandular but not to the stromal component of the endometrium; four of these five features are related to glandular secretory activity.

The relation between daily salivary progesterone profile and endometrial development in the luteal phase of fertile and infertile women

This study analysed the relation between daily salivary progesterone profiles in the luteal phase and endometrial development as assessed by morphometric studies of endometrial biopsies that were timed by luteinizing hormone surge. Among 34 fertile women studied, a threshold relation was noted between cumulative salivary progesterone concentration and 11 of the 17 morphometric features measured, as well as the results of the histological dating. Above the observed threshold, a significant linear correlation was found between cumulative salivary progesterone and the results of histological dating. Among 55 women, progesterone profile in the first half of the luteal phase, but not the second half, was found to be significantly lower in those with retarded endometrial development than in those with normal development. Overall, 50% of retarded endometrial development was associated with a subnormal progesterone profile, but the other 50% was associated with a normal progesterone profile, in keeping with an abnormal response of the endometrium due to progesterone receptor deficiency. Retarded endometrial development was more likely to be associated with a subnormal progesterone profile in the first half of the luteal phase than in the second half.