Endometrial Biopsy

During an endometrial biopsy, your healthcare provider takes a small
tissue sample from the lining of the uterus (endometrium) for study. The tissue is
viewed with a microscope to look for abnormal cells. Your healthcare provider can
also
check the effects of hormones on the endometrium.

Your healthcare provider may
suggest an endometrial biopsy if you have:

  • Abnormal menstrual bleeding
  • Bleeding after menopause
  • No menstrual bleeding

Biopsy results may show cell
changes linked to hormone levels. It may also show abnormal tissues such as fibroids
or
polyps. These can lead to abnormal bleeding. Your provider can also check for uterine
infections such as endometritis.

Your provider may also use an
endometrial biopsy to check the effects of hormone therapy. Or to find abnormal cells
or
cancer. Endometrial cancer is the most common cancer of the female reproductive organs.

Endometrial biopsy is no longer
advised as a routine part of testing and treatment for women not able to get pregnant
(infertility).  

Your healthcare provider may have
other reasons to do an endometrial biopsy.

Some possible risks may
include:

  • Bleeding
  • Pelvic infection
  • Puncture of the uterine wall
    (rare)

Tell your healthcare provider if
you are allergic to or sensitive to medicines, iodine, or latex.

Tell your healthcare provider if
you are pregnant or think you could be. Endometrial biopsy during pregnancy may lead
to
miscarriage.

You may have other risks based on
your condition. Discuss any concerns with your healthcare provider before the
procedure.

Certain things may interfere with
an endometrial biopsy. These include:

  • Vaginal or cervical infections
  • Pelvic inflammatory disease
  • Cervical cancer
  • Your healthcare provider will explain the procedure and you can ask questions.
  • You will be asked to sign a consent form that gives your permission to do the procedure.
    Read the form carefully and ask questions if something is not clear.
  • Generally, you won’t need to do any
    preparation before the procedure. But your healthcare provider may advise you to take
    a pain reliever 30 minutes before the procedure.
  • Tell your healthcare provider if you
    are pregnant or think you could be.
  • Tell your healthcare provider if you are sensitive to or are allergic to any medicines,
    iodine, latex, tape, or anesthesia.
  • Tell your healthcare provider of all
    prescription and over-the-counter medicines, and herbal supplements that you are
    taking.
  • Tell your healthcare provider if you
    have a history of bleeding disorders. Also tell your provider if you are taking any
    blood-thinning medicines (anticoagulants), aspirin, or other medicines that affect
    blood clotting. You may be told to stop these medicines before the procedure.
  • Your healthcare provider may ask you
    to keep a record of your menstrual cycles. You may need to schedule the procedure
    for
    a certain time of your cycle.
  • If your provider gives you medicine to
    relax (sedative) before the procedure, you will need someone to drive you home
    afterward.
  • You may want to bring a sanitary napkin to wear home after the procedure.
  • Based on your condition, your healthcare provider may call for other preparation.

An endometrial biopsy may be done in a healthcare provider’s office, on an outpatient
basis, or as part of your stay in a hospital. Procedures may vary based on your condition
and your healthcare provider’s practices.

Generally, an endometrial biopsy follows this process:

  1. You will undress fully or from the
    waist down and put on a hospital gown.
  2. You will empty your bladder before the
    procedure.
  3. You will lie on an exam table, with your feet and legs supported as for a pelvic exam.
  4. Your healthcare provider will put a
    tool called a speculum into your vagina. It’s used to spread the walls of the vagina
    apart to view the cervix.
  5. Your provider will clean your cervix with an antiseptic solution.
  6. Your provider may numb the area using
    a small needle to inject medicine. Or he or she may use a numbing spray on your
    cervix.
  7. Your provider may use a type of
    forceps to hold the cervix steady for the biopsy. You may feel some cramping when
    it
    is used.
  8. Your provider may put a thin, rod-like
    tool called a uterine sound through the cervical opening. This is done to find the
    length of the uterus and place for biopsy. This may cause some cramping. The sound
    will then be removed.
  9. Your provider will put a thin tube
    (catheter) through the cervical opening into the uterus. The catheter has a smaller
    tube inside it. The healthcare provider will withdraw the inner tube, creating
    suction at the end of the catheter. The healthcare provider will then gently turn
    and
    move the tip of the catheter in and out to collect small pieces of endometrial
    tissue. This may cause some cramping.
  10. The amount of and place where the
    tissue is removed depends on the reason for the endometrial biopsy.
  11. Your provider will remove the catheter
    and speculum. He or she will send the tissue to a lab for study.

After the procedure, you may rest for a few minutes before going home. If you had
any type of sedative, you will need someone to drive you home.

You may want to wear a sanitary pad
for bleeding. It’s normal to have some mild cramping and spotting or vaginal bleeding
for a few days after the procedure. Take a pain reliever as advised by your healthcare
provider. Aspirin or certain other pain medicines may increase the chance of bleeding.
Take only recommended medicines.

Don’t douche, use tampons, or have
sex for 2 to 3 days after an endometrial biopsy, or as advised by your healthcare
provider.

You may also have other limits on
your activity. This might be no strenuous activity or heavy lifting.

You may go back to your normal diet unless your healthcare provider tells you otherwise.

Your healthcare provider will tell
you when to return for more treatment or care.

Tell your healthcare provider if you have any of the following:

  • Excessive bleeding, or bleeding longer than 2 days after the procedure
  • Foul-smelling fluid drains from your
    vagina
  • Fever or chills
  • Severe lower belly pain

Your healthcare provider may give you other instructions after the procedure, based
on your situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would  happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure