The magnitude of the variation was not affected by whether the biopsy specimen was obtained in the mid or late luteal phase, the degree of lag between the dating and subsequent menses, or the presence of an LPD. The subsequent probability of changing patient management altered ranged from 22% to 39% depending on the clinical setting. Redating of a specimen by another pathologist would have resulted in a change in the determination of 'in' or 'out' of phase in 22% of cases. To assess the ability of histological dating to discriminate between women of fertile and infertile couples.The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain.Prospective multicenter study, with subjects randomly assigned to biopsy timing.Criterion standard for infertility was 12 months of unprotected, regular intercourse without conception and for fertility at least one live birth within 2 years. Volunteer subjects (847) recruited at 12 clinical sites participating in the National Institutes of Health-funded Reproductive Medicine Network.
Endometrial biopsy specimens (n = 62) were evaluated by five pathologists to assess the effect of interobserver variation on histologic dating of the endometrium. Mean (± standard error) interobserver variation was 0.96 ± 0.08 days, comparable to results reported by other investigators.Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study.Fertile controls were excluded if they had a history of infertility, recurrent pregnancy loss, or recent breastfeeding. After detection of the LH surge, subjects were randomized to biopsy in the mid (days 21-22) or the late (days 26-27) luteal phase.In current practice, the device that is most often used is the Pipelle endometrial aspirator.To ensure a maximum amount of tissue for morphological reading, the specimen should be placed on a piece of lens paper or some other adhesive tissue and then immersed in the fixative.