THE OVARIANENDOMETRIAL CYCLE

Predictable, regular, cyclical, and spontaneous ovulatory menstrual cycles are regulated
by complex interactions of the hypothalamic-pituitary axis, ovaries, and genital tract (Fig. 5-1).
The average cycle duration is approximately 28 days, with a range of 25 to 32 days. The
hormonal sequence leading to ovulation directs this cycle. Concurrently, cyclical changes in
endometrial histology are faithfully reproduced. Rock and Bartlett (1937) first suggested that
endometrial histological features were sufficiently characteristic to permit cycle dating. In this
scheme, the follicular-proliferative phase and the postovulatory luteal-secretory phase are
customarily divided into early and late stages. These changes are detailed in Chapter 15 of
Williams Gynecology, 2nd edition (Halvorson, 2012).