Thus, studies that clearly delineate which histologic parameters serve as the greatest source of disagreement for pathologists provide a valuable framework for further refinement of the criteria for From the *Department of Pathology and †Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
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Typical fragmentation, stromal collapse and bloody necrotic background of a menstrual specimen.
Balls of endometrial stroma that, taken out of context, are occasionally mistaken for endo- metrial carcinoma or sarcoma.
The glands of this day 25 endo- metrium are markedly regressed, and the superficial compacta has a diffusely predecidualized stroma.
This high power photomicrograph of a day 25 endometrium shows a spiral arteriole cut in multiple profiles and surrounded by predecidual stroma; note the admixture in the stroma of large decidualized cells and smaller endometrial granulocytes.
The following day was taken as the first of the luteal phase (LH 1).
Mean endometrial thickness on day LH 0 was 10.3 mm (range 7 to 13 mm; standard deviation 1.4 mm).In the first of these, the catheter was introduced with its subterminal orifice directed to the right uterine wall and in the second, to the left.Histological analyses were done in the portion of the tissue nearest to the embolus.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.In this day 23 - 24 endometrium, the glands are beginning to show regressive changes; spiral arterioles are present and are most prominent in the lower left portion of the illustration; they are to be surrounded by cuffs of predecidua; predecidual stromal change is not yet apparent in the superficial compacta.Mc Nemar's test showed no statistical difference between these data (p33.36%). Endometrial maturation, whose role in human reproduction was first recognized by Jones, Twenty five regularly cycling healthy women, complaining of infertility for at least one year, voluntarily agreed to participate in the study group and gave their informed written consent.CONCLUSIONS: The correlation found between the endometrial datings suggests that biopsies performed on either of these two days are suitable for evaluation of endometrial maturation. All procedures were also approved by the Medical Ethics Committee of the Universidade Federal de São Paulo.The specimen was fixed in formaldehyde 10% and sections of 4 mµ thickness were stained with hematoxilin-eosin.Endometrial maturity was evaluated through morphometric analysis, taking into account four semi-quantitative parameters (amount of luminal secretion in the gland, pseudo-stratification of the glandular epithelium, stromal differentiation and edema), estimated on a scale from 0 to 3, and two quantitative parameters (number of supra- and subnuclear vacuoles in the glandular epithelium and the volume fraction of the gland occupied by the epithelium). According to the morphometric criteria, the endometrium was considered as immature (out of phase) if histological analysis showed a maturation delay of one or more days.Day 10 - 12 endometrium crriteria glands that are endomegrial tortuous and crowded; intraglandular nuclear pseudo- stratification mitotic activity are more prominent see inset and the stroma is edematous and mitotically active.The glands exhibit a regular tortuosity and are clearly oriented from the base to the surface of the endometrium; subnuclear glycogen vacuoles are clearly visible.