| Objectives: (l)To investigate endometrial pinopodes during the normal menstrual cycle, reassess endometrial morphological criteria identifying the best morphological indicators in normal women. (2) To study the effort of controlled ovarian hyperstimulation on endometrial morphology simultaneously. (3) To investigate the effort of controlled ovarian hyperstimulation on endometrial estrogen and progesterone receptors and estradiol and progesterone levels.Methods:(l)8 women with regular menstrual periods and proven fertility .24 donors undergoing ovarian stimulation .The age distribution of these women was similar to that of the donor group. The dates in group 1 was assigned by detection of the LH surge using a commercially available urine kit, The histological dating according to morphological criteria (Noyes et al, 1950),The day of LH peak day was designated day 13,The day of oocyte retrieval was designated day 14 in ovarian stimulation cycles .The endometrial samples were obtained sequentially from 24 donors. Samples were taken every 48-72h, on days 14-24. Sampling of uterine fundus was performed using pipelle. The endometrium tissue was divided into two parts, one part was fixed in 2.5% (w/v) glutaraldehyde solution hi a sodium cacodylate buffer (0.1 mol/ pH 7.3). The specimens were dehydrated in an acetone series, dried in a critical point drier using carbon dioxide, mounted on the specimen holder, coated with gold, and examined under a SEM. Another part was fixed in 10% neutral formallin solution for 24h and embedded in paraffin, The material was prepared to be used forimmunohistochemistry and stained with hematoxylin-eosin. Observation was done "blindly" for clinical and laboratory data, and endometrial dating was performed with use of Noyes et al criteria. The sections were used for the detection of nuclear ERs and PRs used the monoclonal antibodies ER-GM704702 x PR-GM3 56902 respectively: All immunohistochemical studies were performed based on the avidin-biotin-peroxidase complex system, Endometrial expression of both receptors was graded on The Quantitative Method of Immunohistochemistry -PU. Blood samples were draw on days 12 (the day of HCG administration) and days 13 of COH cycles, for the measurement of serum E2 and progesterone levels. Statistical analysis was performed with x2 test.Results :(1)The surface morphology of secretory epithelial cells showed a characteristic pattern in natural cycles , Around day 17 of a normalized cycle the microvilli reach their maximum development .being long ,thick and upright. By day 18, bulging increases and the tips of microvilli appear swollen, On day 19 bulging is pronounced, the microvilli decrease in number and length and fuse. Smooth and slender membrane projection form, arising from the entire cell apex (developing pinopodes) .On days 20, microvilli are virtually absent and the membranes protrude and fold maximally, with shapes resembling mushrooms or flowers (fully developed pinopodes).On day 21 bulging decreases slightly and small tips of microvilli reappear on the membranes , which are now wrinkled and cells size start to increase (regressing pinopodes).By day 22 pinopodes and cell bulging have largely regressed. Days 23 and 24 are characterized by a further increase in cell size, decrease in bulging and cells become dome-shaped and covered with short and stubby microvilli. The sequence of changes was observed in all cycles studied .However ,the cycle days when these changes occurred varied greatly between women, In natural cycles fully developed pinopodes appeared with a range of 3 days, 21.13 ?.78,median 21. On gland opening area, the pmopodes are abundant. (2)In COH cycles the fully develoed pinopodes appeared within a range of 5 days ,maturation was advanced with pinopodesformed by day 19, (19.25 ±1.1 ,median 19).Immunohistochemical studies for steroid receptors showed that the luminal surface and glands stained similarly for both the ERs and the PRs, In COH cycles, the decline in epithelial ERs staining was observed as early as day...
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