Biopsy - endometrium
This procedure may be done with or without anesthesia. You will lie on your back with your feet in stirrups.
The health care provider will do a pelvic examination, and will insert an instrument (speculum) into the vagina to hold it open and see the cervix.
The cervix is cleaned with an antiseptic liquid and then grasped with an instrument (tenaculum) to hold the uterus steady. A device called a cervical dilator may be needed to stretch the cervical canal if there is tightness (stenosis). Then 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. A specialist called a pathologist examines the sample under a microscope.
There is no special preparation for the biopsy. You may want to take ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) 1 hour before the procedure to reduce cramping.
The instruments may feel cold. You may feel some pain when the cervix is grasped. You may have some cramping as the instruments enter the uterus and the sample is collected.
The test is done to find the cause of:
The test is usually done in women over age 35.
The biopsy is normal if the cells in the sample have no abnormalities.
Abnormal menstrual periods may be caused by:
If the lining is being tested for infertility, the sample may determine if hormones are properly stimulating the lining so that the fertilized egg can implant.
Other conditions under which the test may be performed:
Katz VL. Diagnostic procedures. Imaging, endometrial sampling, endoscopy: indications and contraindications, complications. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007:chap 11.
Bulun SE. Physiology and pathology of the female reproductive axis. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 17.