Tc. Li et al., THE CORRELATION OF PLACENTAL PROTEIN-14 CONCENTRATIONS IN UTERINE FLUSHING AND ENDOMETRIAL MORPHOLOGY IN THE PERIIMPLANTATION PERIOD, Human reproduction, 8(11), 1993, pp. 1923-1927
The relationship between the concentrations of placental protein 14 (P
P14) in uterine flushing and the endometrial morphology in the mid-lut
eal phase was assessed in a prospectively designed study involving the
precise timing of all samples by the luteinizing hormone (LH) surge.
A total of 29 regularly cycling women with unexplained infertility or
recurrent miscarriage were studied. To flush the uterine cavity, 10 ml
of physiological saline solution was used immediately prior to sampli
ng of an endometrial specimen for morphological study, in the mid-lute
al phase. PP14 concentrations were measured by radioimmunoassay in ute
rine flushings and plasma samples; the endometrium was assessed by the
use of histological dating criteria and morphometric techniques. PP14
levels in uterine flushings were correlated with endometrial dating a
nd volume fraction measurement of the glands. They were consistently b
elow the sensitivity of the assay with histological dating of < day LH
+ 5, or when the glandular lumen occupied < 20% of the gland. In cont
rast, PP14 concentrations in plasma were not related to histological d
ating or morphometric analyses, and did not differ in patients with no
rmal endometrial development (20.8 ng/ml) and in those with retarded e
ndometrial development (22.5 ng/ml). The presence of detectable concen
trations of PP14 in uterine flushing was significantly associated with
normal histological dating. Uterine flushing may therefore provide a
reliable, non-invasive alternative to endometrial biopsy in the evalua
tion of endometrial function in the peri-implantation period.