Endometrial Biopsy

If your doctor recommends an endometrial biopsy, that means that he or she wants to obtain a small sample of lining (endometrium) inside your uterus. During a fertility evaluation, the purpose of this test is to determine if and when ovulation has occurred.

Typically, the endometrial biopsy is performed just a few days prior to the start of your next menstrual period. It is assumed that at that time, ovulation has already occurred and progesterone levels should be adequate within the uterus.

The endometrial biopsy is almost always performed in your doctor's office. For the procedure itself, you will be placed in a position very similar to when you are having a Pap test performed. The doctor then inserts a thin plastic strawlike tube through your cervix and into the uterus to obtain a piece of the uterine lining. You may experience some discomfort and cramping during the procedure. You may also have some slight spotting for a few days afterward.

The endometrial sample tissue is sent to the laboratory, where it is examined under the microscope. The examining pathologist will closely look at the tissue and see what progesterone effects it may or may not have. The examiner will be able to determine if ovulation occurred earlier that month. If adequate amounts of progesterone are present, then ovulation has likely occurred. It implies that your uterine lining should be capable of properly implanting a fertilized egg. However, if progesterone changes within the uterine lining are not adequate, it's concluded that your uterus cannot properly prepare for egg implantation. In many cases, the pathologist can even pinpoint the exact day that ovulation occurred just by examining progesterone's effects on the tissue.

Your endometrial biopsy results will provide information about your ovulation, progesterone levels within your uterus, and also the exact timing of your particular menstrual cycle.

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