Endometrial Biopsy For Infertility – A Complete Guide

7 min read

Written by Aparna Hari

Aparna Hari

Endometrial Biopsy For Infertility

The increasing infertility rate due to lifestyle changes is becoming a cause of concern for doctors worldwide. In India, the infertility rate of reproductive-aged couples ranges from 3.9 to 16.8. There are several diagnostic methods, medications as well as procedures such as In vitro fertilization or IVF to cure infertility. Endometrial Biopsy is one such diagnostic method of infertility.

Before saying yes to an Endometrial Biopsy you need to know what Endometrial Biopsy is and how it works. You must know when to conduct the biopsy and what its result suggests. There are a few side effects and risk factors associated with this diagnostic test too. Thus know all about Endometrial Biopsy if you are suffering from infertility for a long time. pregnancy pillow

In This Article

What is Endometrial Biopsy?

Endometrial Biopsy is a diagnostic test conducted for the purpose of determining whether the wall of the uterus or endometrial cavity is ready to implant the embryo or not. It is a comparatively new procedure to find out more prominent reasons behind infertility in women.

In this procedure, a sample of your endometrium, the lining of your uterus, is taken for minute analysis. This test is often suggested for women who faced multiple failures in the IVF process or suffer from multiple miscarriages.

How is Endometrial Biopsy Done?

How is Endometrial Biopsy Done

The endometrial biopsy is done by a trained gynecologist who will insert a small instrument named pipelle in your vagina to scratch a little portion of the uterine lining for testing. There is nothing to do for the patient here. You will just have to lay comfortably on the procedure bed.

The process will take a minute or two and you can feel a little bit of pain or cramping. Some women also get light bleeding after the process. The biopsy procedure is conducted during the middle of your menstrual cycle when one of your ovaries releases a full-grown egg and your uterus lining gets prepared to hold it.

Endometrial Biopsy And Infertility – What is the Connection?

Endometrial Biopsy is closely related to infertility. Your doctor will suggest it if the reason behind your infertility is not outwardly visible by other diagnostic tests.

The connection of Endometrial Biopsy with infertility can benefit you to get a successful conception. This test will tell you the best possible time for embryo implantation is an IVF process. It can also tell you if your uterus lining is capable of holding the embryo and nurturing it or not. Other basic fertility testing includes testing of pregnancy hormone levels, blood, semen test, and several ultrasound tests for checking the functions of ovaries, fallopian tubes and uterus. If all of these test reports are normal yet you suffer from miscarriages then there can be a problem with the uterus lining.

[Read : Your Comprehensive Guide to an IVF Treatment]

What Does Endometrial Biopsy Help Determine?

Endometrial biopsy test can detect when your uterine lining is in the “window of implantation” phase. The “window of implantation” period is the time when your uterus lining gets fully prepared for the implantation and future nurture of the fertilized egg. It can also detect whether the uterine lining is the contributing factor behind the IVF implantation failure or not.

Who Should Get Endometrial Biopsy Done?

Who Should Get Endometrial Biopsy Done

Endometrial biopsy for those who have already gone through multiple miscarriages. It is not for all women who wish to conceive. Although the process is straightforward and takes only a few minutes it is not a part of common female fertility evaluation tests. Doctors even do not recommend this to first-time IVF patients. It is for women who have already gone through infertility treatment and yet get miscarriages. It is typically for women whose previous IVF process gets failed.

When in the Cycle is Endometrial Biopsy Done?

This test is done on the 4th or 5th day post-ovulation. In an ideal 28-day menstrual cycle ovulation occurs generally on the 14th day. The egg takes about 12 to 24 hours to travel from the ovary to the uterus through the fallopian tube. During this time the egg must get fertilized by the sperm. On the other hand, the uterus lining gets thick enough for the implantation of the fertilized egg. The 4-5 days after ovulation thus are known as the “window of implantation” and it is the best time to take the Endometrial biopsy test for fertilization.

Interpreting Endometrial Biopsy Results For Infertility

The endometrial biopsy help diagnose the receptivity of the endometrium.

It can show your endometrium as pre-receptive or receptive or post-receptive.

  • If the endometrium is pre-receptive, your uterus lining is still not ready to receive a fertilized egg. So, during this time, your uterus is not capable of implanting the embryo.
  • If the result is receptive, this means that the uterus is all set to embrace the embryo and you have increased chances of conception.
  • In case the result is post-receptive, you will have to wait for the middle of your next cycle as the suitable time for implantation in this cycle has surpassed.

Thus, the endometrial biopsy helps you to determine when to take action for embryo implantation to get a successful pregnancy.

Does Endometrial Biopsy Improve the Chances of Conceiving?

The endometrial biopsy test is a relatively new method of diagnosis of infertility. So there is less research on this topic. Yet the conducted ones show a high rate of success in achieving a successful pregnancy.

According to the NCBI report, the clinical pregnancy rate of women who conducted endometrial biopsies is considerably high (27.1%) than that of the control group (8.9%). The report also shows that endometrial biopsy injury has no difference in the miscarriage rates of a normal woman. So, this test can effectively enhance your chance of getting pregnant.

In the case of IVF, your doctor will strategically implant the embryo in your uterus when the lining is ready to receive it. Thus, endometrial biopsy can minimize the chance of IVF failure.

But while conducting the test you need to be sure that you are not pregnant by any chance as the biopsy can disrupt early pregnancy. Your doctor will advise you to take a pregnancy test before conducting the test to avoid such mishaps.

[Read : Everything About Pregnancy Tests]

Risks of Getting Endometrial Biopsy Done

Risks of Getting Endometrial Biopsy Done

There are certain risks associated with endometrial biopsy. These are as follows;

  • Bleeding or a little bit of spotting after the procedure. In some cases, it can last up to the beginning of the next period.
  • Pelvic infection due to the scratch during the endometrial biopsy.
  • Hole or puncture in the Uterine wall by the pipelle (the biopsy device). This though very rarely happens.

You should discuss your physical condition, allergies and pre-existing medical conditions to avoid complications later. Problems such as vaginal infection, cervical cancer, or any pelvic inflammatory disease can worsen the risks of endometrial biopsy. If you suspect you may be pregnant, do let your doctor know. This procedure can increase your chances of miscarriage if you are already pregnant.

How to Prepare For Endometrial Biopsy For Infertility?

Here is how you can prepare yourself before and during the endometrial biopsy procedure.

In general, you will not have to take any medication or preparation before the test. But one thing you will have to keep a record of, i.e. your menstrual cycle as everything will depend on your cycle duration.

  • Keep yourself stress-free. Trust your doctor and leave it entirely to them.
  • Be informed. You can ask the doctor questions before the test to understand the procedure and prepare yourself.
  • You may have to sign a consent paper to give your written permission for the diagnosis.
  • In some cases, your healthcare provider may suggest you have a painkiller 30 minutes before the test.
  • Inform your doctor if you are allergic to any particular medicine, anesthesia, iodine, tape, or latex.
  • Inform if you are taking any blood-thinning medicine such as anticoagulants, aspirin, etc or if you have any bleeding disorder. In such cases, you will have to avoid these medicines before the diagnosis.
  • You may need to bring a sanitary napkin with you as you may bleed a bit after the procedure.
  • During the procedure, lay down comfortably and relax. Stress can cause the procedure to get painful and uncomfortable.

Are There Any Side Effects of the Endometrial Biopsy Procedure?

The side effects of endometrial biopsy are:

  • Mild cramping
  • Spotting or bleeding for a few days
  • Fever and chills
  • Pain in the lower abdomen

When to Consult a Doctor?

You should call your doctor if anything unusual happens after the endometrial biopsy such as:

  • Heavy bleeding
  • Foul-smelling vaginal discharge
  • Severe pain in the lower abdomen
  • Infection after the procedure

Endometrial biopsy for infertility is a vital fertility diagnostic test for women who are suffering from infertility for a long time. Other than checking the fetus holding capacity of the uterus this test can also detect any abnormal or cancer cells, polyps or fibroids in the uterus. Thus, you can take an endometrial biopsy test if you suffer from irregular menstrual problems to avoid difficulties with conception.


1. How Long Does it Take to Recover From Endometrial Biopsy?

You can recover in between 2 to 3 days after the endometrial biopsy and get back to your normal routine. In case of complications, you will need your doctor’s advice.

2. Can an Endometrial Biopsy Tell You Why You Are Infertile?

Yes, an endometrial biopsy can find out the reason for infertility. If it is conducted at the proper time can be a reliable tool for the diagnosis of complicated endometrial factors and hormonal dysfunctions that cause infertility.

Read Also: Normal Endometrium Thickness In Pregnancy

Aparna Hari,MBA in Marketing,P.G. Diploma in Human Resource Management from IGNOU Bachelor of Sciences (Home Science) from Nagarjuna University

Her experience in impactful writing combined with her background in Home Sciences makes Aparna the perfect candidate for content writing in the pregnancy and parenting niche.Read more.

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