What it is

• ➤ An endometrial biopsy is a procedure in which a doctor collects a small sample of tissue from the lining of the uterus (endometrium) for microscopic examination.
• ✦ The goal is to evaluate abnormal uterine bleeding, investigate infertility, or rule out precancerous/cancerous conditions.
• ➟ The test can be performed in the clinic using a thin suction tube (Pipelle) or with a curette.
• Important: This biopsy checks only the endometrium, not the cervix or ovaries.

Why it’s done

• ➤ Main reasons:
  • ▪ Investigate abnormal or heavy menstrual bleeding.
  • ▪ Rule out endometrial hyperplasia or endometrial cancer.
  • ▪ Evaluate uterine response to hormone therapy.
  • ▪ Assess fertility problems, especially recurrent miscarriages.
• ✦ Benefits:
  • ✅ Provides a direct diagnosis of endometrial health.
  • ✅ Detects early signs of cancer or pre-cancer.
  • ✅ Helps guide treatment (hormonal therapy, surgery, etc.).
• ⟶ Limitations:
  • ▪ May miss localized lesions (sampling error).
  • ▪ Can be uncomfortable or painful for some patients.
• Bold takeaway: Endometrial biopsy is the gold standard for diagnosing abnormalities of the uterine lining.

Alternatives

• ➤ Transvaginal ultrasound: Shows thickness of the endometrium but cannot confirm cancer.
• ✦ Sonohysterography (saline infusion ultrasound): Improves visualization of polyps or fibroids.
• ➟ Hysteroscopy: Direct visual inspection of the uterine cavity, often with biopsy.
• Important: Imaging is useful but cannot replace biopsy for confirming cancer or precancer.

Preparation

• ➤ Schedule: Usually performed after menstruation but before ovulation for fertility cases, or anytime abnormal bleeding occurs.
• ✦ Pre-procedure instructions:
  • ▪ Avoid tampons, douching, or intercourse for 24 hours before test.
  • ▪ Inform your doctor about medications, especially blood thinners.
  • ▪ Take an over-the-counter pain reliever (ibuprofen/paracetamol) 30–60 minutes before, to reduce cramps.
• ➟ Tell your doctor if you:
  • ▪ Are pregnant or suspect pregnancy (biopsy is not performed in pregnancy).
  • ▪ Have pelvic infection symptoms.
  • ▪ Have bleeding disorders or low pain tolerance.
• Important: Arrange for transport if you’re prone to fainting during pelvic procedures.

How it’s done

• ➤ Step 1 – Setup: You lie on an exam table, and a speculum is inserted to view the cervix.
• ✦ Step 2 – Cervical cleaning: The cervix is gently cleaned with antiseptic.
• ➟ Step 3 – Sampling:
  • ▪ A thin catheter (Pipelle) is inserted through the cervix into the uterus.
  • ▪ Suction is applied to collect endometrial tissue.
  • ▪ In some cases, a curette or hysteroscope is used.
• ➤ Step 4 – Collection completed: The sample is sent to the lab for pathology.
• → Duration: 5–10 minutes in most cases.
• What you feel: Cramping similar to menstrual pain; brief but sometimes intense.

Recovery

• ➤ After biopsy:
  • ▪ Mild cramps and light spotting for 1–2 days are common.
  • ▪ Use pads, not tampons.
  • ▪ Avoid sex, tampons, and douching for 2–3 days or as advised.
• ✦ Results:
  • ▪ Normal → No abnormality found.
  • ▪ Endometrial hyperplasia → May need hormone therapy or minor surgery.
  • ▪ Endometrial cancer → Referral to oncology for treatment.
• ⟶ Seek urgent care if:
  • ➤ Heavy bleeding (soaking more than 1 pad/hour).
  • ➤ Fever, chills, foul-smelling discharge.
  • ➤ Severe abdominal pain unrelieved by medicine.
• Important: Always return for follow-up to review biopsy results—do not assume “no call = no problem.”

Treatment option in Korea

• ➤ Where available:
  • ▪ University hospitals in Seoul, Busan, Incheon, Daegu, Gwangju, and Daejeon.
  • ▪ Women’s health centers and international patient clinics.
• ✦ Why Korea:
  • ▪ Modern sampling tools like Pipelle biopsy for minimal discomfort.
  • ▪ Rapid pathology labs with results in a few days.
  • ▪ Bilingual support staff for international patients.
• ➟ If abnormal results are found:
  • ▪ Hormonal therapy (progesterone pills, IUD).
  • ▪ Hysteroscopic polyp removal if benign growths are found.
  • ▪ D&C (dilation and curettage) or hysterectomy for severe or malignant findings.
  • ▪ Oncology team care for confirmed endometrial cancer.
• ⟶ For international patients:
  • ▪ Can book one-stop gynecologic check-up packages including ultrasound, Pap smear, HPV, and biopsy.
  • ▪ Expect same-day biopsy with results ready within 2–5 days.
  • ▪ Reports can be issued in English for continuity of care abroad.
• Important: Korea’s integrated women’s health centers provide screening + diagnosis + treatment in one streamlined system—very efficient for both locals and medical travelers.