What is an endometrial biopsy?
An endometrial biopsy is a procedure performed to obtain a small tissue sample from the lining of the uterus, called the endometrium. After the biopsy, the endometrial tissue is examined under a microscope to identify the presence of abnormal cells, or the effects of hormones on the endometrium.
Other related procedures used to evaluate and treat endometrial problems include dilation and curettage (D & C), hysteroscopy, and endometrial ablation. Please see these procedures for additional information.
The menstrual cycle:
With each menstrual cycle, the endometrium prepares itself to nourish a fetus, as increased levels of estrogen and progesterone help to thicken its walls. If fertilization does not occur, the endometrium, coupled with blood and mucus from the vagina and cervix (the lower, narrow part of the uterus located between the bladder and the rectum) make up the menstrual flow (also called menses) that leaves the body through the vagina. After menopause, menstruation stops and a woman should not have any bleeding.
What are female pelvic organs?
The organs and structures of the female pelvis are:
Endometrium - the lining of the uterus
Uterus - also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.
Ovaries - two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sex hormones estrogen and progesterone are produced
Cervix - the lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body
Vagina - the passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia).
Vulva - the external portion of the female genital organs
Reasons for the procedure
An endometrial biopsy may be performed for several reasons. In the evaluation and treatment of infertility (the inability to conceive), a biopsy of endometrial cells several days before menstruation can show the endometrial response to the hormones estrogen and progesterone and can determine if ovulation has occurred.
An endometrial biopsy may be recommended for women with abnormal menstrual bleeding, bleeding after menopause, or absence of uterine bleeding. Biopsy results may indicate cell changes related to hormone levels, or the presence of abnormal tissues such as fibroids or polyps, which can lead to abnormal bleeding. Endometrial biopsy may also be used to check for uterine infections such as endometritis.
An endometrial biopsy may also be used to check the effects of hormone replacement therapy or to detect the presence of abnormal cells or cancer. Endometrial cancer is the most common cancer of the female reproductive organs.
There may be other reasons for your physician to recommend an endometrial biopsy.
Risks of the procedure
As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following:
Puncture of the uterine wall with the biopsy device - rare
Patients who are allergic to or sensitive to medications, iodine, or latex should notify their physician.
If you are pregnant or suspect that you may be pregnant, you should notify your physician. Endometrial biopsy during pregnancy may lead to miscarriage.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Certain factors or conditions may interfere with an endometrial biopsy. These factors include, but are not limited to, the following:
Acute vaginal or cervical infections
Acute pelvic inflammatory disease