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What Endometrial Biopsy

An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus (endometrium ). The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find any problems in the endometrium. It also lets your doctor check to see if your body's hormone levels that affect the endometrium are in balance.

The lining of the uterus changes throughout a woman's menstrual cycle. Early in the menstrual cycle, the lining grows thicker until a mature egg is released from an ovary (ovulation ). If the egg is not fertilized by a sperm, the lining is shed during normal menstrual bleeding.

There are several ways to do an endometrial biopsy. Your doctor may use:

  • A soft, straw-like device to suction a small sample of lining from the uterus. This method is fast and is not very painful.
  • A sharp-edged tool called a curette. Your doctor will scrape a small sample and collect it with a syringe or suction. This is called a dilation and curettage (D&C). A D&C may be done to control heavy uterine bleeding (hemorrhage) or to help find the cause of bleeding. This is done with general or regional anesthesia.
  • An electronic suction device (Vabra aspiration). This method can be uncomfortable.
  • A spray of liquid (jet irrigation) to wash off some of the tissue that lines the uterus. A brush may be used to remove some of the lining before the washing is done.

 

When a woman is having a hard time becoming pregnant, an endometrial biopsy may be done to see whether the lining of her uterus can support a pregnancy.

An endometrial biopsy may also be done to find the cause of abnormal uterine bleeding, to check for overgrowth of the lining (endometrial hyperplasia), or to check for cancer.

An endometrial biopsy is sometimes done at the same time as another test, called hysteroscopy, which allows your doctor to look through a small lighted tube at the lining of the uterus.


Why It Is Done
An endometrial biopsy is done to:
• Check for cancer. For example, an endometrial biopsy is done to help determine the cause of a Pap test result showing glandular cell changes that may lead to cancer in women older than age 35. Glandular cells are a type of cell found in the cervix and the endometrium.
• Find the cause of heavy, prolonged, or irregular uterine bleeding. It is often done to find the cause of uterine bleeding in women who have gone through menopause.
• See whether the lining of the uterus (endometrium) is going through the normal menstrual cycle changes.

How To Prepare continued...
Do not douche, use tampons, or use vaginal medicines for 24 hours before the biopsy. You will empty your bladder just before your biopsy.
You may want to take a pain reliever, such as ibuprofen (Advil or Motrin), 30 to 60 minutes before having the biopsy. This can help decrease any cramping pain that can be caused by the biopsy.
You will need to sign a consent form that says you understand the risks of an endometrial biopsy and agree to have the test done. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).
If you are having a dilation and curettage (D&C) and will go to sleep (general anesthesia) for the test, do not eat or drink anything for 8 hours before the test. If you are taking any medicines, ask your doctor what medicines you can take the day of the test.

How It Is Done


Endometrial biopsy
An endometrial biopsy is usually done by a gynecologist, a family medicine physician, or a nurse practitioner who has been trained to do the test. The sample will be looked at by a pathologist. The biopsy can be done in your doctor's office.
Your cervix may be numbed with a spray or injection of local anesthetic.

You will need to take off your clothes below the waist. You will be given a covering to drape around your waist. You will then lie on your back on an examination table with your feet raised and supported by foot rests (stirrups).

Your doctor will put an instrument with smooth, curved blades (speculum) into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. See an illustration of a pelvic examination with a speculum . The cervix is washed with a special solution and may be grasped and held in place with a clamp called a tenaculum.

The tool to collect the sample is guided through the cervix into the uterus. The tool may be moved up and down to collect the sample. Most women have some cramping during the biopsy.
An endometrial biopsy takes 5 to 15 minutes..

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