A study of endometrial morphology in women who failed to conceive in a donor insemination programme

Objective To examine the morphology of endometrium in women who failed to conceive after nine or more cycles of donor insemination treatment. Design Prospective study. Setting Jessop Hospital for Women, Sheffield. Subjects Two groups: twenty‐six infertile women and a control group of eight fertile women. Intervention Endometrial biopsy specimens were obtained in the mid‐luteal phase, timed precisely by the luteinising hormone surge. Main outcome measure Morphological study of endometrial biopsy specimens by the use of traditional dating criteria and established morphometric techniques. Results Twelve biopsy specimens (42%) were found to be retarded. In addition, morphometric analysis revealed significant differences in the glandular component of the endometrium between the infertile and fertile groups. Conclusion Endometrial defect leading to implantation failure may be an important underlying cause of failure to conceive after repeated attempts at donor insemination. The endometrium should be investigated in this group of women, and further attempts at donor insemination treatment should be offered only in conjunction with attempts to restore the normality of the endometrium.