Editing Endometrium (section)

==Diseases related with endometrium==
[[File:Endometrial histopathologies and cytopathologies.jpg|thumb|300px|Histopathologic and cytopathologic images.<br />(A) proliferative endometrium (Left: HE × 400) and proliferative endometrial cells (Right: HE × 100)<br />(B) secretory endometrium (Left: HE × 10) and secretory endometrial cells (Right: HE × 10)<br />(C) atrophic endometrium (Left: HE × 10) and atrophic endometrial cells (Right: HE × 10)<br />(D) mixed endometrium (Left: HE × 10) and mixed endometrial cells (Right: HE × 10)<br />(E): endometrial atypical hyperplasia (Left: HE × 10) and endometrial atypical cells (Right: HE × 200)<br />(F) endometrial carcinoma (Left: HE × 400) and endometrial cancer cells (Right: HE × 400).]]

[[Chorionic tissue]] can result in marked endometrial changes, known as an [[Arias-Stella reaction]], that have an appearance similar to [[cancer]].<ref name=pmid11756756>{{Cite journal  | last1 = Arias-Stella | first1 = J. | title = The Arias-Stella reaction: facts and fancies four decades after. | journal = Adv Anat Pathol | volume = 9 | issue = 1 | pages = 12–23 |date=Jan 2002 | doi =  10.1097/00125480-200201000-00003| pmid = 11756756 | s2cid = 26249687 }}</ref>  Historically, this change was diagnosed as [[endometrial cancer]] and it is important only in so far as it should not be misdiagnosed as cancer.

* [[Adenomyosis]] is the growth of the endometrium into the muscle layer of the uterus (the [[myometrium]]).
* [[Endometriosis]] is the growth of tissue similar to the endometrium, outside the uterus.<ref name=Lagana2019>{{Cite journal|last1=Laganà|first1=AS|last2=Garzon|first2=S|last3=Götte|first3=M|title=The Pathogenesis of Endometriosis: Molecular and Cell Biology Insights|journal=International Journal of Molecular Sciences|volume=20|issue=22|page=5615|date=10 Nov 2019|doi=10.3390/ijms20225615|pmid =31717614|pmc=6888544 |doi-access=free }}</ref>
* [[Endometrial hyperplasia]]
* [[Endometrial cancer]] is the most common [[cancer]] of the human female genital tract.
* [[Asherman's syndrome]], also known as intrauterine [[adhesions]], occurs when the basal layer of the endometrium is damaged by instrumentation (e.g., [[Dilation and curettage|D&C]]) or infection (e.g., endometrial [[tuberculosis]]) resulting in endometrial sclerosis and adhesion formation partially or completely obliterating the uterine cavity.

Thin endometrium may be defined as an endometrial thickness of less than 8&nbsp;mm. It usually occurs after [[menopause]]. Treatments that can improve endometrial thickness include [[Vitamin E]], [[L-arginine]] and [[sildenafil citrate]].<ref>{{cite journal |vauthors=Takasaki A, Tamura H, Miwa I, Taketani T, Shimamura K, Sugino N |title=Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium |journal=Fertil. Steril. |volume=93 |issue=6 |pages=1851–8 |date=April 2010 |pmid=19200982 |doi=10.1016/j.fertnstert.2008.12.062 |doi-access=free }}</ref>

[[Gene expression profiling]] using [[cDNA microarray]] can be used for the diagnosis of endometrial disorders.<ref>{{Cite journal| volume = 94| journal = Fertility and Sterility| title = Genome-based expression profiling as a single standardized microarray platform for the diagnosis of endometrial disorder: an array of 126-gene model | first6 = C.| issue = 1| pages = 114–119| doi = 10.1016/j.fertnstert.2009.01.130| pmid = 19328470| year = 2010| last6 = Lee | first5 = C. | first2 = I.| last2 = Chen | first1 = L.| last3 = Chen | first3 = M.| last5 = Wang | first4 = H.| last4 = Yan| last1 = Tseng| doi-access = free}}</ref>
The [[European Menopause and Andropause Society]] (EMAS) released Guidelines with detailed information to assess the endometrium.<ref>{{cite journal |vauthors=Dreisler E, Poulsen LG, Antonsen SL, Ceausu I, Depypere H, Erel CT, Lambrinoudaki I, Pérez-López FR, Simoncini T, Tremollieres F, Rees M, Ulrich LG |title=EMAS clinical guide: Assessment of the endometrium in peri and postmenopausal women |journal=Maturita |volume=75 |issue= 2|pages= 181–90|year=2013 |pmid=23619009 |doi= 10.1016/j.maturitas.2013.03.011}}</ref>

===Embryo transfer===
{{Anchor|Triple-line}}

An endometrial thickness (EMT) of less than 7&nbsp;mm decreases the pregnancy rate in [[in vitro fertilization]] by an [[odds ratio]] of approximately 0.4 compared to an EMT of over 7&nbsp;mm. However, such low thickness rarely occurs, and any routine use of this parameter is regarded as not justified. The optimal endometrial thickness is 10mm. Nevertheless, in human a perfect synchrony is not necessary; if the endometrium is not ready to receive the embryo an ectopic pregnancy may occur. This consist of the implantation of the blast outside the uterus, which can be extremely dangerous.<ref name="KasiusSmit2014">{{cite journal|last1=Kasius|first1=A.|last2=Smit|first2=J. G.|last3=Torrance|first3=H. L.|last4=Eijkemans|first4=M. J. C.|last5=Mol|first5=B. W.|last6=Opmeer|first6=B. C.|last7=Broekmans|first7=F. J. M.|title=Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis|journal=Human Reproduction Update|volume=20|issue=4|year=2014|pages=530–541|issn=1355-4786|doi=10.1093/humupd/dmu011|pmid=24664156|doi-access=free}}</ref>
[[File:Triple-line endometrium.jpg|thumb|''Triple-line'' endometrium measuring 7mm.]]
Observation of the endometrium by [[transvaginal ultrasonography]] is used when administering [[fertility medication]], such as in [[in vitro fertilization]]. At the time of [[embryo transfer]], it is favorable to have an endometrium of a thickness of between 7 and 14 [[millimeter|mm]] with a ''triple-line'' configuration,<ref name="ZhaoZhang2012">{{cite journal|last1=Zhao|first1=Jing|last2=Zhang|first2=Qiong|last3=Li|first3=Yanping|title=The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles|journal=Reproductive Biology and Endocrinology|volume=10|issue=1|year=2012|pages=100|issn=1477-7827|doi=10.1186/1477-7827-10-100|pmid=23190428|pmc=3551825 |doi-access=free }}</ref> which means that the endometrium contains a [[hyperechoic]] (usually displayed as light) line in the middle surrounded by two more [[hypoechoic]] (darker) lines. A ''triple-line'' endometrium reflects the separation of the basal layer and the functional layer, and is also observed in the periovulatory period secondary to rising [[estradiol]] levels, and disappears after ovulation.<ref name="BaerwaldPierson2004">{{cite journal|last1=Baerwald|first1=A. R.|last2=Pierson|first2=R. A.|title=Endometrial development in association with ovarian follicular waves during the menstrual cycle|journal=Ultrasound in Obstetrics and Gynecology|volume=24|issue=4|year=2004|pages=453–460|issn=0960-7692|doi=10.1002/uog.1123|pmid=15343603|pmc=2891966}}</ref>

Endometrial thickness is also associated with live births in IVF. The live birth rate in a normal endometrium is halved when the thickness is <5mm.<ref>1. Gallos, I. D. et al. Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers. Reprod. Biomed. Online 37, 542–548 (2018).</ref>