The earliest morphological evidence of ovulation is:
Subnuclear (basal) vacuolation : Ist HPE evidence of ovulation ( evidence of progesterone secretion ) Endometrial biopsy Invasive test EBX: HPE (Formalin) and AFB for TB( Normal saline ) Done usually 2-4 days before expected date of menses(D24 - D26) Not done Post menses Secretory endometrium( Progesterone acts) on EBxtells cycle is ovulatory Proliferative endometrium: anovulatory Early secretory Subnuclear vacuolation (Ist HPE evidence of progesterone secretion) Seen on D16 of cycle Nuclei of glands gone up Stromal edema Late secretory Toous/ coiled glands All secretions in lumen of gland Cork screw glands( on D20 of cycle) Max stromal edema seen around D22of cycle) HPE of Proliferative endometrium Pseudostratification Long tubular glands
Pseudo stratification
Basal vacuolation
Decrease in glycogen content
Predecidual reaction
Tests of Ovulation