Investigating the histological shape and structure is clinically meaningful to determine the hormonal changes, the ovulation cycle, and find out the endometrial bleeding as well as infertility. Investigating the upper half of the two-thirds of the endometrium is quite useful in determining the normal menstrual cycle. Ovarian steroids are not responded by the basal third of the endometrium throughout the menstrual cycle. There is proliferative phase of stroma and glands in which there is a rapid growth. There is mitotic activity of endometrial stroma cells, which have scant cytoplasm and the cells are compacted spindle cells.
When ovulation occurs, the growth of endometrium gradually slows mitotic activity within few days and ceasing the mitotic activity. Beneath the nuclei of the glandular epithelium is the post ovulatory endometrium which is distinguished by the presence of basal secretory vacuoles. During the third week of menstrual cycle, this secretary activity is quite prominent in which the basal vacuoles push past the nuclei of the glandular epithelium. The secretions are poured in the gland lumens during the fourth week. The glands are dilated by maximum excretion during 18 and 24 days. There is serrated shape of glands during the fourth week. This appearance is due to glands shrinkage and accentuation by secretory exhaustion.
- Following the 21 to 22 day, there is development of prominent spiral arterioles during the stromal changes in late secretory phase while dating the endometrium.
- Following the 23 to 24 day, edema between the stromal cells occurs and increases in ground substance considerably. There is accumulation of cytoplasmic eosinophilia with stromal cell hypertrophy, and resurgence of stromal mitosis.
- Following the 24 to 28 day, predecidual changes occurs throughout the functionalis, accompanying by occasional lymphocytes and scattered neutrophils. This is followed by escape of blood into stroma and disintegration of functionalis, which symbols the starting of menstrual shedding.
The confirmation of ovulation is by prominent basal vacuolation of glandular epithelial cells. There is exhibition of mitotic activity of stromal and glandular cells during the proliferative phase. For sure, the ovulation cannot be determined in the late stages o f endometrial shedding or during the proliferative phase.
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