The presence of pinopodes in the human endometrium does not delineate the implantation window.

OBJECTIVE: To assess pinopode formation in human endometrium during the luteal phase of the menstrual cycle and in the first trimester of pregnancy. DESIGN: Prospective clinical study. SETTING: Outpatient infertility clinics and outpatient family planning clinic. PATIENT(S): Thirty-two regularly cycling infertile women, 15 regularly cycling fertile women, 9 women receiving elective termination of pregnancy, and 1 woman receiving GnRH agonist and hormone therapy addback. INTERVENTION(S): Endometrial tissue was collected by suction pipelle and examined by scanning electron microscopy for pinopode formation. MAIN OUTCOME MEASURE(S): Endometrial tissue was scored (0, 1, 2, 3, or 4) depending on the percentage of the surface covered in pinopodes (from 0% to >20% of 100 fields). RESULT(S): Pinopodes were present throughout the luteal phase of the menstrual cycle, up to the 11th week of pregnancy, and in the endometrium of the woman on GnRH agonist and hormone therapy. CONCLUSION(S): Pinopodes can be detected in the progesterone-exposed endometrium for an extended period of time, in contradistinction to the perception that they are markers for the implantation window in the human endometrium.

Laparoscopic ultrasound-guided radiofrequency ablation of uterine fibroids.

Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation. Symptom improvement, including a decrease in menstrual bleeding and pain, was achieved in 2 patients at 3 months. At 7 months, 1 of these 2 patients experienced symptom worsening which correlated with recurrent fibroid on MRI. The third, initially technically successfully treated patient did not experience any symptom relief after the procedure and was ultimately diagnosed with adenomyosis. Our preliminary results suggest that RFA is a technically feasible treatment for symptomatic uterine fibroids in appropriately selected patients.