Secretory endometrium

by Adnan Karavelic MD FRCPC
June 8, 2022

What is secretory endometrium?

Secretory endometrium describes the changes seen in the endometrium during the second half of the menstrual cycle. It is a normal finding in women of reproductive age. The secretory endometrium produces substances necessary to support the implantation of an egg should conception occur.

Secretory endometrium

What causes secretory endometrium?

The endometrium is a layer of tissue on the inside of the uterus. During the menstrual cycle, the endometrium grows under the influence of two major hormones – estrogen and progesterone. In the first part of the menstrual cycle, between menses and ovulation (ovulation is when a mature egg is released from the ovary, pushed down the fallopian tube, and is made available to be fertilized), the endometrium grows under the influence of estrogen.

After ovulation, the endometrium grows under the influence of progesterone. During this phase, the endometrial glands become long and twisted, and the secretion starts. Pathologists call this phase the secretory endometrium.

How is the diagnosis of secretory endometrium made?

The diagnosis of secretory endometrium is usually made after a small sample of tissue is removed from the endometrium during a procedure called an endometrial biopsy or uterine curetting.

Common reasons for these procedures include:

  • Abnormal (dysfunctional) uterine bleeding.
  • Postmenopausal bleeding.
  • Screening for endocervical or endometrial cancer.
  • Endometrial dating.
  • Follow up of previously diagnosed endometrial hyperplasia.
  • Endometrial or endocervical polyps.
  • Infertility.
Post ovulation day (POD)

The microscopic changes that take place in the endometrium allow your pathologist to determine how many days it has been since ovulation occurred. This information is called the post-ovulation day and it is especially important for women trying to become pregnant. You may see the post-ovulation date described in your report.

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