scholarly journals Sonographic Folliculometry and Endometrial Echocomplex as an Evidence of Ovulation in Infertility Cases

2017 ◽  
Vol 9 (4) ◽  
pp. 331-335
Author(s):  
Mridu Sinha ◽  
Sphurti Katiyar ◽  
Shashi B Arya ◽  
Jai K Goel
Keyword(s):  
Endometrial Thickness ◽  
Endometrial Biopsy ◽  
Transvaginal Sonography ◽  
Histopathological Study ◽  
Diagnostic Modality ◽  
Hormonal Imbalance ◽  
Proliferative Endometrium ◽  
Vaginal Probe ◽  
Luteal Phase Defect ◽  
Secretory Endometrium

ABSTRACT Objectives To study the diagnostic accuracy of folliculometry and endometrial echo complex as an evidence of ovulation in infertility. Materials and methods This clinical study was conducted on 100 infertile women. The women were subjected to follicular monitoring by transvaginal sonography (TVS) from cycle day 8 or 10 of menstruation with 7.5 MHz vaginal probe of Siemens ultrasound machine. Evidence of follicular growth, ovulation, and morphology of endometrial echo complex with its thickness was noted. Endometrial biopsy was performed premenstrually as a day care procedure after excluding pregnancy. Results Out of 100 women, 81 cases were with evidence of ovulation on TVS and 68 were confirmed on histopathology. All the studied patients were also evaluated for endometrial thickness on the day of ovulation, echo complex of endometrium suggestive of ovulation was seen in 64 cases, out of these 59 cases were confirmed on histopathology. On histopathological study of 100 cases, we found 69 cases with secretory endometrium, 18 with proliferative endometrium, 10 patients with endometritis, one each with luteal phase defect, irregular shedding of endometrium, and hormonal imbalance. Conclusion We found folliculometry predicted ovulation 86% accurately with a specificity of 58.60% and sensitivity of 98.55%. Similarly, appearance of endometrium predicted ovulation 85% accurately with a specificity of 83.80% and sensitivity of 85.50%. Thus, TVS has undeniable advantages in terms of cost, time, acceptability, risk, convenience, and could easily diagnose signs of ovulation in cases of infertility. The TVS has quintessential role as the first diagnostic modality in patients presenting with infertility. How to cite this article Katiyar S, Arya SB, Goel JK, Sinha M. Sonographic Folliculometry and Endometrial Echocomplex as an Evidence of Ovulation in Infertility Cases. J South Asian Feder Obst Gynae 2017;9(4):331-335.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Endometrial assessment in cases of primary infertility in women: a prospective study

2020 ◽  
Vol 9 (2) ◽  
pp. 580
Author(s):  
Soumya R. Patil ◽  
Rajesh Patil
Keyword(s):  
Prospective Study ◽  
Endometrial Biopsy ◽  
Endometrial Tissue ◽  
Morphological Pattern ◽  
Adult Age ◽  
Hormonal Imbalance ◽  
Healthy Female ◽  
A Prospective Study ◽  
Secretory Endometrium ◽  
Morphological Patterns

Background: Worldwide Infertility rate prevails around 8-12% of all couples; approximately 80 million are infertile. In India 10-15% of couples are infertile. Investigating for infertility is to intervene into the modifiable/treatable causes. Therefore, the present study has been undertaken to investigate the morphological patterns of endometrial tissue in women with primary infertility.Methods: The study included 60 cases with complaints of infertility (primary). The premenstrual D and C was done to obtain endometrial biopsy. The present prospective study was a descriptive study and the values are mentioned in percentages.Results: In present study a total of 60 cases were studied. Out of which 36 cases (60%) belonged to the young adult age group. The predominant morphological pattern was that of secretory endometrium seen in 22 cases (36.66%) as opposed to proliferative, endometritic or tubercular pattern. The predominant menstrual pattern recorded was regular; seen in 41 cases (68.33%) as opposed to irregular or mennorhagic patterns.Conclusions: The endometrial biopsy has a great role in screening the cases of infertility as it helps to assess the information about ovulation, ripening of the endometrial tissue and other abnormal endometrial reaction, hormonal imbalance. This is the only method to label the diagnosis of endometrial tuberculosis in an apparently healthy female.

scholarly journals A PROSPECTIVE STUDY ON TRANSVAGINAL DOPPLER SONOGRAPHY OF ENDOMETRIUM IN WOMEN WITH POSTMENOPAUSAL BLEEDING.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Richa Choudhary ◽  
Dr. Rishikant Sinha
Keyword(s):  
Doppler Sonography ◽  
Endometrial Thickness ◽  
Resistive Index ◽  
Transvaginal Sonography ◽  
P Value ◽  
Postmenopausal Bleeding ◽  
Early Screening ◽  
Reproductive Life ◽  
Vaginal Probe ◽  
A Prospective Study

Objectives: This present study was to evaluate the clinical profile and Transvaginal Doppler Sonography findings of endomterium in women with postmenopausal bleeding. Methods: Detail history, clinical examinations and relevant investigations were performed to all cases of PMB. BMI was calculated. Transvaginal sonography of the uterus and Doppler analysis of the blood flow were performed using vaginal probe at 5-7.5 megahertz. Endometrial thicknesses as well as other pathologies in the cavity were noted. Resistive index was calculated. Results: Data was analyzed by using SPSS version 26 software. One sample statistical methods was used. Mean ± standard deviation was observed. P-value was taken equal to less than 0.05 for significant differences. Conclusions: Highest prevalence of PMB was seen in women with age greater than 50 years. Most of the cases had BMI 20-25 kg/m2. Most of the benign and malignant cases had parity status P3-P4 and P1-P2 respectively. Endometrial thickness of malignant PMB cases was significantly greater than benign PMB cases. Resistive index of malignant PMB women was significantly lower than benign PMB women. Hence, promotion of healthy lifestyles and contraceptives in early reproductive life and awareness for the need of early screening should be recommended to reduce the prevalence of PMB. And early diagnosis and management of post menopausal bleeding are needed for prevention from malignancy. Key words: Postmenopausal Bleeding, Benign, Malignancy, Transvaginal Doppler Sonography.

scholarly journals Endometrial study by Ultrasonography and its correlation with Histopathology in Abnormal uterine bleeding

2018 ◽  
Vol 9 (2) ◽  
pp. 31-35
Author(s):  
Pravin Shrestha ◽  
Smita Shrestha ◽  
Vibha Mahato
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Proliferative Endometrium ◽  
Group 2 ◽  
Histopathological Workup

Background: Abnormal Uterine Bleeding is defined as any deviation from a normal menstrual pattern. It is one of the common presentation in extremes of ages. However endometrial hyperplasia and carcinoma are commoner in perimenopausal and postmenopausal women warranting investigations like ultrasonography and endometrial biopsy.Aims and Objective: The aim of the study was to note the endometrial thickness by transabdominal ultrasonography and observe the histopathological pattern in women presenting with abnormal Uterine Bleeding.Material and Methods: Premenopausal women more than 45 years of age and the postmenopausal patients, without any pelvic pathology were included in the study. Endometrial thickness was measured by transabdominal sonography and endometrial biopsy was done. Tissue obtained was sent for histopathological examination.Results: A total of 105 patients were studied. Majority (92%) of patients were premenopausal. Proliferative Endometrium (32%) was the most common finding in premenopausal and atrophic endometrium (37.5%) in postmenopausal group. Malignancy was higher in a postmenopausal group (12.5%) as compared to the premenopausal group (2%). Malignancy was not seen when endometrial thickness was less than 11mm in the premenopausal age group. Endometrial hyperplasia was also more common when the thickness was more than 11mm.In postmenopausal group12.5% of patients, had complex hyperplasia.25% had simple hyperplasia and malignancy was seen in 12.5% of patients. When endometrial thickness was less than 5 mm, hyperplasia and malignancy was not seen.Conclusion: Measurement of Endometrial thickness and histopathological workup in patients above 45 years presenting with abnormal uterine bleeding will be helpful in detecting endometrial hyperplasia and carcinoma.Asian Journal of Medical Sciences Vol.9(2) 2018 31-35

scholarly journals Study of endometrial histopathology in women with abnormal uterine bleeding

2017 ◽  
Vol 6 (3) ◽  
pp. 824
Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karnaboopathy Ranganathan
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
A Prospective Study ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.

scholarly journals Endometrial Evaluation by Histopathology in Abnormal Uterine Bleeding in Perimenopausal and Postmenopausal Patients

2014 ◽  
Vol 1 (2) ◽  
pp. 75 ◽  
Author(s):  
Kairavi Desai ◽  
Kiran Patole ◽  
Manasi Kathaley
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Vacuum Aspiration ◽  
Important Symptom ◽  
Proliferative Endometrium ◽  
Laboratory Investigations ◽  
Histopathological Results

<p><strong>Introduction:</strong> Abnormal Uterine Bleeding (AUB) is an important symptom of both benign and serious gynaecological diseases. Abnormal perimenopausal or postmenopausal bleeding is associated with endometrial carcinoma in approximately 10% of cases. The present study is designed to study the histopathological results of the endometrial biopsy in women with abnormal perimenopausal and postmenopausal uterine bleeding.</p><p><strong>Aims and Objectives:</strong> To study, the various histopathological patterns of endometrium, in patients with abnormal uterine bleeding, those are in perimenopausal and postmenopausal age group.<br /><br /> <strong>Materials and Methods:</strong> In all 100 patients were selected for the study after satisfying the specific inclusion and exclusion criteria. They underwent detailed history taking including the pattern of bleeding associated with general, systemic, and pelvic examination. They were subjected to routine laboratory investigations and pelvic ultrasound examination. Endometrial biopsy was done irrespective of endometrial thickness. Endometrial biopsy was done in OPD without anaesthesia. Biopsy was performed using a manual vacuum aspiration syringe, and the material collected was sent for histopathological examination. Endometrium was also obtained from patients undergoing diagnostic or therapeutic dilatation and curettage. Analysis of Histopathology report was done and results were obtained. Results: Most predominant findings of histopathological examination were the … •Proliferative Endometrium in 29% •Simple hyperplasia without atypia 28% •Secretory 20% •Followed by other patterns</p><p><strong>Conclusion:</strong> Study of endometrial histopathology in perimenopausal and postmenopausal women with abnormal uterine bleeding is helpful to diagnose hyperplasia and carcinoma of endometrium.</p>

scholarly journals VALUE OF ENDOMETRIAL THICKNESS MEASUREMENT FOR DIAGNOSING ENDOMETRIAL HYPERPLASIA IN PERIMENOPAUSAL WOMEN

2020 ◽  
pp. 1-3
Author(s):  
Bishnu Prasad Das ◽  
Chintumoni Gogoi
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Strong Association ◽  
Abnormal Uterine Bleeding ◽  
Thickness Measurement ◽  
Endometrial Biopsy ◽  
Transvaginal Sonography ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Invasive Method

Objective- to determine the sonographic findings associated with endometrial hyperplasia (EH+) in perimenopausal women with abnormal uterine bleeding (AUB). Methods- a retrospective study, in which 150 subjects, perimenopausal women with AUB, underwent transvaginal sonography (TVS) and endometrial biopsy. The TVS findings were evaluated with regard to EH+. Result- Biopsy proven EH+ was seen in 18.67% of subjects. EH+ was not found in any patient with TVS showing endometrial thickness < 8 mm. Conclusion- There is a strong association between TVS endometrial thickness and endometrial biopsy findings. The risk of development of endometrial cancer is 29% in patients with complex atypical hyperplasia and 2% in patients with hyperplasia without atypia. Thus TVS should be in the first investigation in the management of AUB. Invasive method like dilatation and curettage (D&C) to be considered in cases with endometrial thickness > or = 8 mm.

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

SECRETORY CARCINOMA OF ENDOMETRIUM: A MORPHOLOGICAL MIMICKER POSING DIAGNOSTIC DILEMMA - A RARE CASE

2021 ◽  
pp. 32-33
Author(s):  
Dharani V C ◽  
Manjunath H K ◽  
Bhargavi Mohan ◽  
Varaprasad B M ◽  
Thej M J
Keyword(s):  
Endometrial Thickness ◽  
Good Prognosis ◽  
Endometrial Biopsy ◽  
Pathological Examination ◽  
Secretory Carcinoma ◽  
Diagnostic Dilemma ◽  
Immunohistochemical Markers ◽  
Obese Female ◽  
Well Differentiated ◽  
Post Menopausal

BACKGROUND: Secretory carcinoma of the endometrium, a rare subtype of endometrioid carcinoma morphologically resembles the early secretory phase of endometrium and is almost always well differentiated and carries excellent prognosis. Very few cases of secretory carcinoma have been reported in the literature till date. Case presentation:A 58 yr old obese female presented with post-menopausal bleeding. Ultrasound revealed increased endometrial thickness and endometrial biopsy showed hyperplasia without atypia in secretory transformation. Pathological examination of the hysterectomy specimen revealed features of secretory carcinoma of the endometrium as an incidental nding. CONCLUSION: Secretory carcinoma, a rare subtype of well differentiated endometrial carcinoma carries very good prognosis and morphologically mimics various pathological conditions of endometrium. Hence, this needs to be carefully evaluated morphologically in addition with immunohistochemical markers to arrive at an accurate diagnosis.

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