Structure, Function, and Evaluation of the Female Reproductive Tract
The female reproductive tract, including the fallopian tubes-or oviduct-the uterine corpus (endometrium and myometrium), and cervix facilitate fertilization, embryo implantation, provide fetal support, and act to deliver a healthy child. The primary focus of this chapter is the endometrium, an essential part of the uterus. The endometrium primarily consists of epithelium and stroma cells, a specialized vasculature, and a dynamic population of immune cells. Together, the endometrial cells respond to cyclic production of ovarian hormones to proliferate, differentiate, and allow embryo implantation or alternatively shed with menstruation. From an evolutionary standpoint, the most important function of the endometrium is to govern normal embryo implantation and provide an immunoprotected site for subsequent development of the placenta and fetus. As with other hormone-responsive, proliferative tissues, such as that in the breast or prostate, the endometrium is prone to pathology. In this chapter, we review the physiology of this tissue and explore the mechanisms of the normal and abnormal menstrual cycle. The mechanisms of implantation and menstruation are discussed along with the clinical approach to the evaluation of the endometrium in health and disease..
