Johannisson, E., Landgren, B. M., Rohr, H. P., & Diczfalusy, E. (1987). Endometrial morphology and peripheral hormone levels in women with regular menstrual cycles. Fertility and Sterility, 48(3), 401-408. https://doi.org/10.1016/s0015-0282(16)59406-0
Johannisson E, Landgren BM, Rohr HP, Diczfalusy E. Endometrial morphology and peripheral hormone levels in women with regular menstrual cycles. Fertil Steril. 1987;48(3):401-408. doi:10.1016/s0015-0282(16)59406-0
Johannisson, Elisabeth, et al. "Endometrial morphology and peripheral hormone levels in women with regular menstrual cycles." Fertility and Sterility, vol. 48, no. 3, 1987, pp. 401-408.
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Uterine lining changes follow the LH surge in regular cycles
A 1987 study of 90 women with regular cycles and normal luteal hormone profiles found that the uterine lining changes in a regular pattern around the LH surge. From about 3 days before to 8 days after the surge, the pattern held regardless of phase length. Each woman gave one biopsy, and researchers measured 11 features.
Study at a glance: Uterine lining changes follow the LH surge in 90 women with regular cycles. Source: Johannisson E et al., 1987, PMID 3622793.
Key Findings
Ninety of the 95 women recruited had a hormone profile compatible with a normal cycle and were used to map the lining changes.
In these 90 women, lining changes were most statistically significant from days LH -3/-2 to LH +7/+8, whether the first or second phase of the cycle was short or long.
In the 90 women, the phase through the surge had a geometric mean of 14.8 days (range 9 to 23). The phase after had 13.3 days (range 9 to 20).
Nineteen women had 31 to 35 day cycles and a 17.8 day first phase. Within the biopsy window, their lining did not differ significantly from women with 25 to 30 day cycles.
Mitoses in gland cells fell from days LH -3/-2 to LH +5/+6 (P < 0.05). Mitoses in stroma cells rose between days LH -1/0 and LH +1/+2 (P < 0.02).
Interpretation
This study biopsied each of 90 healthy women once. Each biopsy fell on a set day near the LH surge. The goal was to map how the uterine lining changes across the cycle. The authors propose dating the lining from the LH surge. They suggest a mechanism that links follicle growth to lining growth. The findings support larger studies on how this timing link affects fertility.
RRM Context
The paper ties lining development to the LH surge, a marker of ovulation, which sits at the center of restorative reproductive medicine. Its authors call the ideal 28-day cycle rare. They link the timing mechanism to some unexplained infertility, which RRM reads as undiagnosed.
Our editorial summary of this paper, not the article's abstract.
Abstract
Endometrial biopsies from 90 women with regular menstrual cycles and a hormonal profile compatible with normal luteal function were morphometrically assessed using 11 different indices and the results were plotted in 48-hour periods around the day of the luteinizing hormone (LH) surge (LH +/- 0). The endometrial dating reached its highest significance from days LH -3/-2 to days LH +7/+8, when the changes occurred with a high degree of regularity regardless of the length of the preovulatory and postovulatory phases. It is proposed therefore that the dating of the endometrium should be related to the LH surge rather than to the "ideal" 28-day cycle. The results also seem to suggest the existence of a regulatory mechanism for the synchronization of follicular maturation and midcycle endometrial development. Further study of the factors involved in this mechanism may result in a better understanding of certain forms of unexplained infertility.
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