In the endometrium, proliferative activity occurs even before the complete cessation of menstruation, i.e. The glands at this earlier stage are relatively straight or, at most, slightly coiled and are found within relatively loose endometrial stroma.As the name suggests, there is brisk cell division with prominent mitotic activity in both the glands and the stroma.
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In the mid-secretory phase (days 5-11 post-ovulation or days 19-25 of the cycle), the glands remain dilated, but become more irregular with a papillary or saw-tooth appearence.
The vacuoles move to a supranuclear position and the contents may be seen within the lumina.
In LPD, circulating progesterone levels are decreased and not sufficient to promote full secretory differentiation of the endometrium.
A repeat biopsy taken during the same period of the following cycle will further confirm an abnormally short corpus luteum life span.
1-2 days following ovulation, there is a peak of luteinising hormone and increased progesterone, which brings on the secretory changes.