Endometrial biopsy, a simple office procedure, removes a few cells from the endometrium, the lining of the uterus. The procedure takes only a few minutes and usually requires no anesthesia, although an anti-inflammatory medication taken an hour or so before the procedure helps decrease pain. Microscopic examination of cells removed from the endometrium helps diagnose several different uterine problems.
Cancer Evaluation
Postmenopausal bleeding or an abnormal Pap smear, either of which can indicate uterine cancer, may require further evaluation with an endometrial biopsy. One third of women with postmenopausal bleeding have uterine cancer, the Merck Manual reports. Endometrial cancer, the most common type of cancer found in female reproductive organs, according to Lancaster General Health, can be diagnosed by the presence of cancerous cells in the endometrial biopsy. Endometrial biopsy is more than 90 percent accurate in diagnosing uterine cancer, according to Merck.
Abnormal Menstrual Cycles
Endometrial biopsy can diagnose several types of menstrual abnormalities. Women with heavy or prolonged menstrual flow may have polyps, which are small fleshy growths; fibroids, which are benign tumors in the uterus; or hormonal imbalances. All of thes conditions may be diagnosed through endometrial biopsy. Women who don't have periods at all or have periods very infrequently may develop uterine hyperplasia, an abnormal buildup of the uterine lining that occurs in women with irregular or absent periods. Checking the cells under the microscope ensures that the thickened cells aren't abnormal. Medical personnel may recommend taking medication to regulate menstrual cycles so that the lining doesn't become too thick. Hyperplasia occurs most frequently in women who are overweight or diabetic, or who have polycystic ovary syndrome.
Infertility
Women who have trouble getting pregnant or maintaining a pregnancy may benefit from endometrial biopsy to assess the changes in the uterine lining after ovulation. Endometrial biopsy is done during a cycle when the patient is not trying to get pregnant, to avoid disruption of a possible pregnancy. The cells are examined for changes related to an adequate amount of the hormone progesterone, which helps a pregnancy implant and grow. An embryo can only implant in a uterus if the lining is developed at the right phase of the menstrual cycle, with the right amount of progesterone. A biopsy that indicates an adequate amount of progesterone is considered "in phase," explains the Reproductive Medicine and Surgery Center of Virginia. Giving supplemental progesterone after a woman ovulates often corrects an out-of-phase endometrial lining.
