Figure 1

Scanning electron micrographs of three consecutive uterine epithelial biopsies in the same patient in response to different exogenous hormone treatments. Cellular characteristics represent an atrophic epithelium (a-d) and a mature secretory epithelium D21 (e-f). Scale bar = 10 μm (a, c, e) and (b, d, f). (a) Biopsy 1: Cellular inhomogeneity: some cells distended, others flat and without cell borders. Few ciliated cells are evident. Deflated cells with bare apical membranes are also seen (arrowheads). (b) Higher power view of different area of biopsy (a). Non ciliated cells display numerous, densely packed microvilli and cover most of the cell apical membrane. Considerable cell separation is apparent. (c) Biopsy 2: E₂ and P₄ continued for two further days. Some areas still display large pleiomorphic cells with indiscernible cell borders and bare apices while other cells are dome shaped with low, scant microvilli. Overall, there is greater uniformity in cell shape and microvillar height. (d) Higher power view of different area of biopsy (c). Apical membrane defects (arrowheads) and ciliogenesis (arrows) are observed. Cells with bare apices, some deflated, are displayed. (e) Biopsy 3: E₂ and P₄ dose increased. Epithelial cells are small, uniform, clearly defined and well covered with low microvilli. Ciliated cells are more abundant with mature cilia. Secretory droplets and uterodomes (pinopods) are numerous. (f) Higher power view of different area of biopsy (e). Fully developed uterodomes (pinopods) are observed.