The endometrial deficient secretory phase.

Abstract

The deficient secretory phase is a functional abnormality of the endometrium that has hitherto been poorly recognized. Endometrial curettings form 34 cases were examined in detail by histology. We also performed morphometric analyses of epithelial cell nuclei and assessed the oestrogen and progesterone receptor status of these cases compared with controls. Clinicopathological correlations were examined. The cases showing the deficient secretory phase were characterized histologically by the presence of elongated, hyperchromatic glandular cell nuclei, diminished or no secretory activity in the second half of the menstrual cycle and poorly developed stroma. Morphometry confirmed that the nuclei were different in shape from those seen at any time during the normal menstrual cycle and from basal endometrium. Nuclear expression of oestrogen and progesterone receptors in formalin-fixed and paraffin-embedded sections was reduced. It is apparent from this study that the endometrial appearances described represent a definable condition that may be linked to menstrual irregularities and, in some circumstances, infertility; it should be more widely recognized.