In many species of mammals, blastocyst implantation stimulates a decidual reaction in which fibrocytic elements within the stroma of the endometrium differentiate into epitheloid decidual cells. In women, decidualization begins under the influence of steroid hormones during the last week of the normal menstrual cycle, even in the absence of conception. This process provides a reliable histological criterion for dating late secretory endometrium.Explants of normal late secretory endometrium synthesize and release immunoreactive prolactin. Since the amount of hormone producedin vitrodepends upon the cycle day as determined by histological criteria, the production of prolactin appears to be related to the extent to which the decidual reaction has spread throughout the stroma. The authors hypothesized, therefore, that the production of prolactin in luteal phase defect would correlate with decidual changes rather than with ideal menstrual dates. In the present study, this hypothesis was tested by measuring the production of prolactin by 17 samples of endometrium which were “out of phase‘’ by histological dating. The amount of prolactin produced by these tissues was compared to that produced by explants of normal late secretory endometrium. Samples of endometrium obtained from 78 patients were included in the study.Samples of endometrium from 61 patients were found to be histologically “in phase‘’ as judged by the onset of menstruation. Luteal phase defect endometria (n= 17) were compared with normal endometria of similar histological appearance with respect to the production of prolactin during a 24-hour incubation period. Nine of the “out of phase‘’ endometria were dated as day 23, since a single layer of decidualized cells was evident around many of the spiral arterioles. The production of prolactin by these tissues was not different from that by normal day 23 tissues.
展开▼
