Endometrial biopsy

Alternative names
Biopsy - endometrium

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

How the test is performed

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 (an instrument used to hold the walls of the vaginal canal open in order to see the cervix) will be inserted into the vagina and opened slightly.

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.

How to prepare for the test
There is no special preparation for the biopsy.

Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
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.

Why the test is performed

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.

It can be used to screen for endometrial cancer. The test is sometimes used as part of the diagnostic work-up of women who have been unable to become pregnant (infertility).

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

What abnormal results mean
Abnormal results means 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

What the risks are
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 the uterus or tearing the cervix.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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