Having a healthy endometrium is an important part of conception; otherwise, implantation could not occur. If you are having difficulty becoming pregnant when all other testing is within the normal range and you are responding well to the hormonal stimulation, the doctor may recommend that a biopsy of your uterine lining should be done. Some clinics may still require this as a prerequisite for anyone about to undergo IVF, even though current research no longer supports the efficacy of this practice.
An endometrial biopsy is used to define the quality of your uterine lining. This test will tell your doctor if your uterine lining is capable of sustaining a pregnancy. If there are problems found, you may need treatment with hormones to supplement your uterine lining.
Do not perform this test if you could be pregnant, as it could disrupt your pregnancy. If there is any possibility that you could be pregnant, make sure to let you physician know beforehand.
This test is an in-office procedure and can be done by your doctor or the nurse practitioner. It is typically done one to three days before you expect your period. During this time your uterus should be thick and full of nutrients designed to sustain a pregnancy.
What to Expect During an Endometrial Biopsy
You will lie back on an exam table and a speculum will be inserted into your vagina. The doctor will look at and clean your cervix with a mild solution. A small catheter is then placed inside the uterus and moved back and forth, gathering a sample of the uterine lining. The doctor will likely want to take samples from a few locations within the uterus. The tissue is collected in a special container and sent to a lab for analysis. The procedure only takes a few minutes and does not require anesthesia; mild cramping is usually the only side effect. Check with your doctor, but it is probably okay if you take a mild pain killer like Tylenol two hours before your procedure to minimize the cramping.
The technicians in the lab will check a few things. First, they will want to make sure that the endometrial tissue they received is in phase and appropriately developed. Remember that the endometrium is a tissue that responds to hormonal stimulation and therefore changes over the course of your menstrual cycle. The endometrial tissue should be sufficiently developed according to where you are in your cycle.
The lab techs will also check that special proteins called integrins are found within the tissue. Integrins are proteins that are thought to aid in implantation, so if the integrins are absent, it may explain why you are not getting pregnant. Integrin expression and its relevance in conception is still somewhat controversial. More studies are necessary to flesh out the exact role of integrins in the uterine lining.