Endometrial Biopsy

An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus (endometrium ). The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find problems in the endometrium. It also lets your doctor check to see if your body’s hormone levels that affect the endometrium are in balance.

The lining of the uterus changes throughout a woman’s menstrual cycle. Early in the menstrual cycle, the lining grows thicker until a mature egg is released from an ovary (ovulation ). If the egg is not fertilized by a sperm, the lining is shed during normal menstrual bleeding.

There are several ways to do an endometrial biopsy. Your doctor may use:

  • A soft, strawlike device (pipelle) to suction a small sample of lining from the uterus. This method is fast and is not very painful.
  • A sharp-edged tool called a curette. Your doctor will scrape a small sample and collect it with a syringe or suction. This is called a dilation and curettage (D&C). A D&C may be done to control heavy uterine bleeding (hemorrhage) or to help find the cause of bleeding. This is done with general or regional anesthesia.
  • An electronic suction device (Vabra aspiration). This method can be uncomfortable.
  • A spray of liquid (jet irrigation) to wash off some of the tissue that lines the uterus. A brush may be used to remove some of the lining before the washing is done.
  • When a woman is having a hard time getting pregnant, an endometrial biopsy may be done to see whether the lining of her uterus can support a pregnancy.

An endometrial biopsy may also be done to find the cause of abnormal uterine bleeding, to check for overgrowth of the lining (endometrial hyperplasia), or to check for cancer.An endometrial biopsy is sometimes done at the same time as another test, calledhysteroscopy, which allows your doctor to look through a small lighted tube at the lining of the uterus.

What is an endometrial biopsy

At the time of ovulation, the progesterone secretion from the ovary effects changes in the endometrium of the uterus. In this way, the uterus prepares for the possible implantation of a fertilized egg. If the progesterone output after ovulation is inadequate, then the development of the endometrium may not be adequate for implantation to occur.

A biopsy of the endometrium will determine whether its stage of development isin line with the stage of the cycle. If there is a lag of more than 2 days, (e.g. on 26th day of the cycle the endometrium has the maturity of only a 23-day cycle), it may indicate insufficient secretion of progesterone. This could be a possible cause of infertility. An endometrial biopsy has limited utility as it only gives information about one cycle.

When and how is the biopsy carried out

The biopsy is generally scheduled 2-3 days before the expected period. The cervix is examined in the same way as for a post-coital test and a fine suction curette is gently inserted into the uterus. It is usually performed as an outpatientprocedure and causes only minimal discomfort.

How To Prepare
Tell your doctor if you:

• Are or might be pregnant. An endometrial biopsy is not done during pregnancy.
• Are taking any medicines.
• Are allergic to any medicines.
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin (Coumadin).
• Have been treated for a vaginal, cervical, or pelvic infection.
• Have any heart or lung problems.