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