To test the validity of the dating criteria, change in basal body temperature was used to correlate endometrial dating with ovulation rather than onset of menstruation.Of the 40 patients who had adequate temperature records, 31 (78%) ovulated as predicted allowing a or- 1 day error, indicating that dating is a better gauge of duration of progesterone effect than predictor of onset of menses.Using variance component analysis, estimates of intrauterine, intraevaluator, and interevaluator variability were determined.Inconsistencies between evaluators accounted for 65% of the observed variability, whereas 27% was because of inconsistencies in duplicate readings by the same evaluator.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.COMMENT: A re-biopsy should be considered within the clinical context.
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.
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.
ENDOMETRIUM, ASPIRATION: - CONSISTENT WITH MENSTRUAL ENDOMETRIUM (FRAGMENTED ENDOMETRIUM WITH SIMPLE GLANDS WITH APOPTOTIC CELLS, ABUNDANT NEUTROPHILS, CONDENSED ENDOMETRIAL STROMA (FOCAL) AND BLOOD).
ENDOMETRIUM, ASPIRATION: - ENDOMETRIAL GLANDS WITH APOPTOTIC CELLS, INFILTRATING NEUTROPHILS, AND GLANDULAR PROLIFERATIVE ACTIVITY. - SCANT STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS. COMMENT: The findings are most in keeping with late menstrual endometrium.
ENDOMETRIUM, BIOPSY: - VERY SCANT STRIPPED EPITHELIUM PROBABLY FROM THE LOWER UTERINE SEGMENT. - SCANT STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS.