Endometrial differentiation in the peri-implantation phase of women with recurrent miscarriage: a morphological and immunohistochemical study.
OBJECTIVE
To study endometrial differentiation in the peri-implantation phase of women with recurrent miscarriage and to compare the results with endometrium of normal fertile women.


METHODS
A prospective study of endometrial specimens precisely timed from the LH surge, using traditional histologic dating (Noyes' criteria), quantitative histologic measurement (morphometric analysis), and immunohistochemical techniques.


RESULTS
Fifteen of 25 (60%) subjects in the recurrent miscarriage group had retarded endometrial development in the peri-implantation period as monitored by morphometry. The recurrent miscarriage group showed reduced levels of four mucin-related secretory epitopes, and greater reductions were associated with morphological retardation. Normal differentiation was observed in all of the 14 subjects in the control group.


CONCLUSIONS
Women with idiopathic recurrent pregnancy loss may be divided into two distinct subgroups on the basis of their endometrial response in the peri-implantation period. Precisely timed endometrial biopsy should be incorporated in the investigation of recurrent miscarriage.
Serle
E
E
Department of Obstetrics and Gynaecology, Jessop Hospital for Women, United Kingdom.
Aplin
J D
JD
Li
T C
TC
Warren
M A
MA
Graham
R A
RA
Seif
M W
MW
Cooke
I D
ID
D000026:Abortion, Habitual / Q000473:pathology*; D000328:Adult; D000911:Antibodies, Monoclonal; D002454:Cell Differentiation; D010064:Embryo Implantation; D004717:Endometrium / Q000378:metabolism / Q000473:pathology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D008183:Luteal Phase / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D009077:Mucins / Q000032:analysis / Q000378:metabolism; D011247:Pregnancy; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies
D000911:Antibodies, Monoclonal; D009077:Mucins; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone