Dating endometrium


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Endometrial cancer is the most common gynecologic malignancy in the USA. Endometrium with changes due to exogenous hormones. Endometrium with squamous morules.

Uterine Cycle - The Phases of Endometrial Change

Endometrium with psammoma bodies. Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach 2nd ed.


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  8. J Clin Pathol 59 8: J Clin Pathol 64 2: Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum 1st ed. Obstet Gynecol Surv 51 5: The best way to prove or disprove that ovulation has taken place is to take an endometrial sample on cycle day 22 or later, preferably at the onset of uterine bleeding. By obtaining samples at the time of early uterine bleeding, the pathologist will be able to determine whether the bleeding is caused by the breakdown of post-ovulatory, secretory endometrium; by focal necrosis of the endometrium associated with anovulation; by other pathologic states; or by hormone administration.

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    Also, during the period of bleeding, both the external os and the isthmus lower uterine segment are widened, facilitating penetration of the biopsy forceps into the endometrial cavity. The final argument in favor of taking samples at the onset of bleeding is that endometrium of the first 2 days of menstruation is relatively easy to recognize histologically.

    In contrast, secretory-phase endometrium often demonstrates subtle changes and, in many cases, combinations of morphologic changes, resulting in most instances in errors of 4—5 days. The pathologist can improve this to 2—3 days, however, by acquiring expertise in endometrial dating all cases of normal endometria are to be dated regardless of reasons for sampling , and by basing the dating on those endometrial morphologic alterations that represent the most advanced phase of the menstrual cycle.

    Endometrial biopsies are not to be taken at the onset of bleeding in the following two conditions: These changes are presumably due to the poor development of the corpus luteum.

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