Noyes criteria endometrial dating

PATIENTS: Twenty-five women complaining of infertility had their menstrual cycles monitored by ultrasound and LH plasma levels, to obtain evidence of ovulation.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).Attention to qualitative changes in 8 morphological factors is most useful in dating the endometrial biopsy.During the 1st week of luteal activity, attention should be focused on changes occurring in gland epithelium: gland mitosis, pseudostratification of nuclei, basal vacuolation, and secretion.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.

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.

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.

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.