Endometrial biopsy (uterine biopsy)

Endometrial biopsy is a diagnostic procedure that involves removal of tissue from the endometrium, the inner lining of the uterus.

There are several reasons why your doctor may recommend an endometrial biopsy. The most concerning indication would be to rule out uterine cancer or pre-cancer.

Abnormal bleeding includes bleeding between menstrual periods, excessive bleeding during a menstrual period, or postmenopausal bleeding.

An endometrial biopsy may also be performed as part of an infertility work up to rule out a condition called luteal phase deficiency, which is a treatable cause of infertility.

An endometrial biopsy may also be used to evaluate the possible cause of repeated early miscarriages.

Finally, an endometrial biopsy may be recommended prior to surgery including hysterectomy or endometrial ablation.

An endometrial biopsy is usually done in your doctor’s office without any anesthesia. If it is being done as part of a fertility work up then the procedure is done during the last few days prior to onset of patient’s menstrual cycle. This will help determine if ovulation is occurring.


You will lie on your back with knees apart and feet in stirrups. A speculum is inserted into the vagina to bring the cervix into view. The cervix is cleaned with an antiseptic solution and a tenaculum is applied to the cervix to stabilize it. The endometrial biopsy pipelle is a thin straw-like instrument used to suction out a small amount of tissue. The instruments are removed. The procedure may cause cramping which is minor and temporary.

You may use nonprescription drugs, such as Tylenol or Motrin for minor pain afterwards.

The laboratory examination of the tissue will generally determine if there are any abnormal cells found in the uterine lining. A normal (or negative) result shows no cancerous or precancerous cells.

An abnormal finding can indicate uterine cancer, or a benign condition like the presence of fibroids or polyps in the uterus. Your health care provider will discuss further testing or treatment options.