Secretory endometrium dating
Typically, a weak pseudodecidual response will occur (Fig. The microscopic appearance of the endometrium exposed to oral contraceptives varies, depending on the dose of progestin.
Typically, stroma having a weak progestin effect surrounds simple, straight, widely spaced, and inactive-appearing endometrial glands.
The endometrium usually atrophies, but variable hyperplasia and, rarely, adenocarcinoma can occur due to the weak estrogen agonist effect.
Chronic endometritis is sometimes demonstrated in endometrial biopsies for infertility or recurrent pregnancy loss.
With oral contraceptives, the progestin effect dominates because progestins decrease estrogen receptors. The appearance of the stroma depends on the dose of progestin.Recently a detailed analysis on endometrial dating demonstrated that the histologic criteria used are not as temporally distinct as originally thought, and thus do not provide an accurate method to detect a luteal phase defect.In one study, approximately 20% of fertile couples had a delay of more than 2 days.In addition, the original description fixed the time of ovulation with the onset of the period after the biopsy.