Endometrial Biopsy

What is it?
The endometrial biopsy is a minor office procedure to obtain a sample of the endometrium. The endometrium is the inside lining of the uterus which is shed each month with the menstrual period.

Why is it done?
An endometrial biopsy is taken in order to look for abnormal conditions of the endometrium. As an infertility test, it will help diagnose hormonal imbalance conditions such as luteal phase defects. A luteal phase defect is a condition where the production of hormones (such as progesterone) by the egg capsule (corpus luteum) after ovulation is not adequate and the endometrium does not develop properly to nourish a beginning pregnancy. Luteal phase defects can cause infertility or early spontaneous miscarriage. As a test in women who are bleeding abnormally, the endometrial biopsy can diagnose infections, hormonal problems, and cancer or precancerous changes. This procedure is considered more than 90% accurate in diagnosing problems of the endometrium.

How is it done?
A pelvic examination is performed and the vagina and cervix are cleansed with an antiseptic (Betadine) to prevent infections. If a woman has not previously been pregnant or had a vaginal birth, a series of small injections of a local anesthetic (called a paracervical block) are placed around the cervix to numb it. This is similar to what is done for minor procedures in a dental office. A thin plastic catheter is then inserted through the cervix into the uterus and a small sample of the lining is taken. The tissue obtained by this procedure is sent to a pathologist for examination. There will be a separate lab fee for the pathology report.

Is it painful?
The majority of our patients say that this procedure is not painful, even if they have had it done before in another office and had an unpleasant experience. The endometrial biopsy is very quick, and you may feel mild pressure or cramping for a few moments when the sample is taken. If you normally have severe cramps with your periods, you may find that taking two Advil or Aleve tablets one hour before the procedure is helpful. Most women find this procedure easy, short, and not associated with any significant discomfort.

Are there any side effects or complications?
The endometrial biopsy is one of our most common minor office procedures and is generally considered to be very safe. Rare complications of any biopsy could include infections, bleeding problems, perforation or damage to the uterus, or reaction to medications. All of these problems are extremely uncommon. Common minor side effects can include light bleeding and mild cramps for 1-2 days.

What if I have an early, unsuspected pregnancy?
The endometrial biopsy is not done in the presence of a known pregnancy. There is always a small chance of an early pregnancy in an ovulating woman. At this very early stage, it is extremely unlikely that the biopsy would disturb a pregnancy because the embryo is like a drop of water in the ocean. Several good studies have shown that an endometrial biopsy may actually increase the chance of continuing a pregnancy, apparently by causing better blood flow to the uterus. If you are a fertility patient, you will be asked to bring in a first-morning urine specimen for a pregnancy test on the day of your endometrial biopsy. If the pregnancy test is positive, the procedure will be canceled.

What activities can I do after the biopsy?
All activities after the endometrial biopsy should be normal. We usually recommend that you avoid sexual intercourse for 24 hours after the procedure in order to protect against possible infections. Tampons may be used immediately, and bathing, swimming, etc. can be done anytime. You may call the office about two weeks after the endometrial biopsy for the results or we will call or send you a note as soon as the results are available.