Noyes criteria endometrial dating

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Dating was done according to morphometric criteria, in which an endometrium sample is considered out of phase if the minimum maturation delay is one day.On day LH 6, blood was drawn for plasma progesterone level determination.During the reproductive years, the cyclical hormonal changes of the menstrual cycle provide a continuously changing morphologic phenotype that is “normal.” In biopsy specimens, the combination of these cyclical changes along with artifacts and limited sampling can make normal patterns difficult to interpret.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.Infertility affects approximately 10-15% of reproductive-aged couples.It is asserted that examination of the endometrium during the secretory phase yields more information about the time of ovulation, degree of progestational change, and normality of the endometrium than any other test used in sterility studies.Reprints: Wenxin Zheng, MD, Department of Pathology, Yale University School of Medicine, 20 York St., EP 2-608, New Haven, CT 06520-8070 (e-mail: [email protected]).

PROCEDURES: Endometrial biopsies were performed on luteal phase days LH 6 and LH 10 (luteal phase day 1 = LH 1 = the day that follows LH peak).These critera were used in 300 sterility biopsies taken from normally menstruating women over a 3-year period.Absence of organic endometrial disease and availability of accurate menstrual history were the only selection criteria. 42 of the 300 patients (14%) menstruated on the day predicted, 36 (12%) menstruated later, and 222 (74%) menstruated earlier.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. TY - JOURT1 - Histologic dating of the endometrium T2 - Advances in Anatomic Pathology AU - Fadare, Oluwole AU - Zheng, Wenxin PY - 2005/3Y1 - 2005/3N2 - 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.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.During the 2nd week , stromal changes (including edema), predecidual reaction, stromal mitosis, and leukocytic infiltration are the key criteria.Tissue from the fundus of the uterus gives the most reliable information.When a or- 1 day error was allowed, 112 patients (38%) were found to menstruate at the time predicted.When these same slides were reviewed by a single observer and the date for the most advanced area of the biopsy was used, 179 patients (60%) menstruated within 1 day of prediction.Female factors that affect fertility include the following categories: Infertility is a problem that involves both partners.Diagnostic testing is unnecessary if the couple has not attempted to conceive for at least 1 year, unless the woman is age 35 years or older, or if they have a history of a male factor infertility, endometriosis, a tubal factor, diethylstilbestrol (DES) exposure, pelvic inflammatory disease, or pelvic surgery.

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