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Concept
Endometrial biopsy
Summary
The endometrial biopsy is a medical procedure that involves taking a tissue sample of the lining of the uterus. The tissue subsequently undergoes a histologic evaluation which aids the physician in forming a diagnosis.
There are a number of indications for obtaining an endometrial biopsy from a non-pregnant woman:
Women with chronic anovulation such as the polycystic ovary syndrome are at increased risk for endometrial problems and an endometrial biopsy may be useful to assess their lining specifically to rule out endometrial hyperplasia or cancer.
In women with abnormal vaginal bleeding the biopsy may indicate the presence of abnormal lining such as endometrial hyperplasia or cancer.
In patients with suspected uterine cancer, the biopsy may discover the presence of cancer cells in the endometrium or cervix.
In female infertility the assessment of the lining can determine, if properly timed, that the patient ovulated, however, the same information can be obtained by a blood test of the progesterone level.
Transvaginal ultrasonography is generally done before obtaining an endometrial biopsy as it may help in the gynecologic diagnosis, or even make the taking of a biopsy superfluous if the lining is thin. If the endometrial lining is less than 5 mm thick on sonography, it is highly unusual to encounter endometrial cancer.
The test is usually done in women over age 35. A more thorough histologic evaluation can be obtained by a dilatation and curettage, which requires anesthesia.
The procedure is contraindicated in pregnancy. Therefore, women in the reproductive years may need a pregnancy test before a biopsy is taken to assure that the test is not done during a pregnancy. Other contraindications are pelvic inflammatory disease and coagulopathies.
An endometrial biopsy usually cannot be done as an office procedure in children, young women, women with vaginismus, or women with cervical stenosis. If necessary, an examination under anesthesia could be performed at which time a biopsy could be taken.
Official source
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