Endometrial Biopsy

The endometrium is the tissue that lines the inside of the uterus. Its major function is to allow for the implantation of the embryo and to provide an appropriate environment for the embryo’s growth.

Indications

An endometrial biopsy may be done as part of an infertility evaluation. The endometrial biopsy may also be performed to evaluate causes of abnormal bleeding (including the absence of bleeding) or to diagnose an infection of the endometrium (known as endometritis).

Alternatives to this procedure

D&C (dilation and curettage, which means opening the cervix and scraping the inside of the uterus for a tissue sample.)
Hysteroscopy (exam of the uterus using a thin telescope like tube with a camera and a tool to remove part of the endometrium).

Preparing for an Endometrial Biopsy

In some cases, it is important that the endometrial biopsy be scheduled for a particular point in the cycle. As part of an infertility evaluation, it is usually done 10-13 days after ovulation. Your nurse will help you make sure that you schedule yours in the appropriate time frame.
This procedure is performed in the office and you will most likely be able to return to work that day, and to drive to and from the office. There is no particular preparation required. If you do not have any problems taking ibuprofen, you may take 800 mg ibuprofen (4 Advil tablets) or 2 Aleve tablets with a light snack about 1-2 hours before the procedure.

The Procedure

The procedure usually takes about 10 minutes. The following steps are representative of a typical procedure:

If appropriate, a pregnancy test may be done to determine that you are not pregnant.

A speculum is placed in the vagina and the cervix is cleaned with a disinfecting solution.

The biopsy instrument – which is hollow tube about the thickness of a single spaghetti noodle, is introduced into the cervix.

Gentle suction is applied for few moments and the instrument is rotated to collect small samples of the lining of the uterus.

You may experience mild period-like cramps during these few minutes. This will resolve shortly after the procedure is finished.

You will be asked to rest for a few minutes, and then you may resume your daily activities.

What to Expect Afterwards

For up to 24 hours after the procedure you may experience some bleeding/spotting. You can resume intercourse 24 hours after the procedure. It will take up to seven (7) days for us to receive the results of your test and when we do, we will contact you. Call the office right away if:

  • you are bleeding heavier than a period
  • you develop a fever over 100° F
  • you develop a lot of pain

What are the benefits of this procedure?

It is a simple office procedure that does not require any anesthesia
Your doctor may learn more about what is causing your symptoms. This will help your doctor choose specific treatment for your problem.

What are the risks associated with this procedure?

The uterus may be injured or punctured by the tool used to get the sample.
You may develop and infection or bleeding.

You should ask your doctor how these risks apply to you.