Endometrial Biopsy

What Is It?

Test of the endometrium, also called endometrial lining or uterine lining. The condition of the endometrium is crucial to implantation of a fertilized egg and to condition of resulting pregnancy. A sample of the lining is removed for closer examination.

Indications:

Infertility or one-partner conception with:

  • chronically abnormal or absent menstrual periods
  • concern about luteal phase defect, or other situations in which endometrium may be out of sync with ovulation
  • unexplained female infertility, with established functioning male fertility
  • suspected uterine cancer

How It Works:

A small sample of the woman's uterine lining is removed and inspected under a microscope for any cell abnormalities or other indications of pathology. This procedures in some instances replaces the D&C (dilatation & curettage) which was formerly most often used to detect various endometrial conditions. Should be performed a few days prior to expected menstrual period.

Results

Since biopsy requires tissue be thorougly examined by a pathologist, results will usually be delivered several days to weeks following the procedure via discussion between the physician and patient.

Typical Procedure Protocol:

Pre-procedure

  • semen analysis of male partner
  • determination with provider of type and amount of over-the-counter pain medication to be taken by patient the day of procedure, or to be used during procedure, if any
  • pregnancy test is administered in most cases for reassurance; procedure will be cancelled in cases of detected pregnancy

During procedure

  • patient lies on exam table with feet in stirrups
  • speculum, similar to that used in typical female exam, is inserted into vagina
  • soft, thin tube inserted into cervical opening; a tenaculum (surgical instrument) may be used to assist in holding the cervix open
  • a mild vacuum is used to remove endometrial cells through the tube
  • instruments are removed and patient remains on table for several minutes recovery period

Post-procedure

  • patient reports back to her physician when her menstrual period starts

Average Costs, excluding pre-procedure office appointments

  • US $350.

Expected physical effects

  • Mild discomfort during insertion of tube into cervical opening
  • Mild to moderate menstrual-like cramping which generally passes quickly once procedure is finished
  • Slight vaginal bleeding for remainder of day of procedure

Physical effects to report to your doctor after procedure

  • Pelvic or abdominal cramping that continues for more than 24 hours past procedure, or that is so severe as to restrict all activities of daily life
  • Fever
  • Foul smelling vaginal discharge
  • Heavy vaginal bleeding

Precautions/Risks

  • Slight risk of pelvic inflammatory disease (PID) resulting from bacteria introduced into body through procedure itself
  • Very uncommon risk of uterine perforation
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