The endometrial biopsy is performed to confirm ovulation and to determine whether the lining of the uterus (endometrium) is adequately developed to support pre-embryo implantation. Normal endometrial development depends upon secretion of the hormone progesterone by the corpus luteum (collapsed egg follicle) and the action of progesterone upon the uterine lining.

As progesterone production rises after an LH surge and ovulation, the endometrial biopsy is best performed 11 or 12 days following a urinary LH-surge. This is detected by daily testing with a urinary ovulation predictor kit.

To perform the biopsy, a thin, flexible catheter is passed into the uterus and a small fragment of tissue is removed. Since the catheter is a foreign body being placed in the uterus, some heavy cramping is usually experienced during this procedure. The procedure generally takes less than a minute to perform. Some of the cramping may be avoided by taking one or two Aleve or Advil tablets about one hour prior to the biopsy. In addition, prior to the procedure, an injection into the cervix with a local anesthetic minimizes discomfort. After the tissue is obtained, it is sent to the pathologist for examination to determine if the endometrium is adequately developed.

Since this procedure is performed late in the menstrual cycle, the possibility of pregnancy exists. Studies have reported that endometrial biopsy may increase the chance of miscarriage by about 1%. At GRS we recommend a pregnancy test prior to the procedure in order to minimize this risk. Although these tests are very sensitive, in about 3% of women tested they may not indicate pregnancy this soon after ovulation. If a couple wishes to be certain to avoid the possibility of pregnancy during a biopsy cycle, we recommend abstaining or using barrier contraception during this month.

Following the biopsy, spotting and cramping occur often. Both should lessen as time passes. If cramping remains severe or increases, or if your temperature rises higher than 100.0º F, please notify GRS at (404) 843-2229.

The onset of your next menses should be reported. This is necessary to interpret your biopsy results. Occasionally, it is difficult to determine when spotting from the biopsy ends and menses begin. If you are unsure, please call and speak with a nurse.

If an abnormality is found, treatment with ovulation induction medications or progesterone suppositories may be instituted. If medications are prescribed, it may be necessary to repeat the biopsy during a treatment cycle to ensure correction of the problem.