Endometrial biopsy

Endometrial biopsy is a procedure in which a tissue sample is obtained from the endometrium (the inside lining of the uterus), and is then checked under a microscope. The tissue is thoroughly examined for any cell abnormalities or signs of cancer.

This procedure may be performed with or without anesthesia. You will be asked to lie on your back with your feet in the stirrups. A pelvic examination will be done, and a speculum will be inserted into the vagina and opened slightly. The speculum is an instrument used to hold the walls of the vaginal canal open, in order to see the cervix.

The cervix is cleaned with an antiseptic solution and then grasped with an instrument (tenaculum) to steady the uterus. A small, hollow plastic tube is gently passed into the uterine cavity.

Gentle suction removes a sample of the lining. The tissue sample and instruments are removed, and the sample is examined under a microscope by a pathologist.

Adults:

There is no special preparation for the biopsy.

Adolescent test or procedure preparation (12 to 18 years)

The instruments may feel cold. There may be some pain as the cervix is grasped. Some cramping may occur as the instruments enter the uterus and when the sample is collected.

The test is done to determine the cause of abnormal menstrual periods (heavy, prolonged, or irregular bleeding), bleeding after menopause, or bleeding associated with taking hormone replacement medications. For any of these reasons, this test is usually perforemed in women over the age of 35.

This test can also be used to screen for endometrial cancer. Sometimes, it is used as part of the diagnostic work-up of women who have been unable to become pregnant (see infertility).

The biopsy is normal if the pathologist reports that the cells in the sample have no abnormalities.

Abnormal menstrual periods may be caused by endometrial cancer, uterine fibroids, uterine polyps, or other causes.

If the lining is being tested for infertility, the sample may determine if the lining is properly stimulated by hormones for implantation of the fertilized egg.

Additional conditions under which the test may be performed:

• Anovulatory bleeding
• Endometritis
• Abnormal bleeding if a woman is taking tamoxifen

It is common to have slight spotting after the procedure. Prolonged bleeding may occur after the procedure. There is also a small chance of infection. Very rarely there is a chance of perforating (creating a hole in) the uterus, or tearing the cervix.