Endometrial Biopsy

An endometrial biopsy is a medical procedure used to collect a sample of tissue from the lining of the uterus, known as the endometrium. The sample is then examined under a microscope for abnormal cell growth, cancer, or other conditions.

Purpose

The purpose of an endometrial biopsy is to:

• Diagnose abnormal uterine bleeding, such as heavy or irregular menstrual periods
• Investigate the cause of infertility or recurrent miscarriages
• Check for endometrial cancer or precancerous conditions
• Monitor the effectiveness of hormone replacement therapy (HRT)
• Evaluate the uterine lining in women with polycystic ovary syndrome (PCOS) or other hormonal imbalances

Types of Endometrial Biopsy

There are two main types of endometrial biopsy:

• Office endometrial biopsy: This is a simple procedure that can be performed in a doctor's office. A thin, flexible tube called a catheter is inserted through the cervix and into the uterus to collect a sample of tissue.
• Dilation and curettage (D&C) biopsy: This is a more invasive procedure that requires anesthesia and is typically performed in a hospital or surgical center. The cervix is dilated, and a special instrument called a curette is used to scrape away tissue from the uterine lining.

Preparation

To prepare for an endometrial biopsy:

• Avoid taking aspirin or other blood-thinning medications for at least 7-10 days before the procedure
• Stop taking any hormone replacement therapy (HRT) or birth control pills for at least 1-2 weeks before the procedure
• Have a full bladder to help the doctor visualize the uterus during the procedure
• Wear comfortable clothing and avoid wearing perfume, lotion, or powder on the day of the procedure

Procedure

The endometrial biopsy procedure typically involves:

• Lying on an exam table with your feet in stirrups
• A speculum being inserted into the vagina to hold it open
• A local anesthetic being applied to the cervix to numb the area
• The catheter or curette being inserted through the cervix and into the uterus
• A sample of tissue being collected from the uterine lining
• The procedure typically taking 5-10 minutes to complete

Risks and Complications

As with any medical procedure, there are risks and complications associated with an endometrial biopsy, including:

• Bleeding or spotting after the procedure
• Cervical stenosis (narrowing of the cervix)
• Infection
• Uterine perforation (a hole in the uterus)
• Adverse reaction to anesthesia

Results

The results of an endometrial biopsy are typically available within 1-2 weeks. The sample is examined under a microscope for:

• Abnormal cell growth or cancer
• Infection or inflammation
• Hormonal imbalances
• Other conditions, such as endometrial hyperplasia or polyps

Follow-up Care

After an endometrial biopsy:

• Avoid heavy lifting, bending, or strenuous activity for at least 24 hours
• Take pain medication as directed by your doctor to manage any discomfort or cramping
• Use sanitary pads or tampons to absorb any bleeding or spotting
• Follow up with your doctor to discuss the results and any further treatment or testing that may be needed