Endometrial biopsy is a diagnostic method characterized by taking a small amount of tissue for microscopic examination.
Endometrial biopsy is based on the appearancepronounced structural changes in the endometrium in response to hormonal stimulation. Most experts argue that the correct diagnosis of endometrial dysfunction is possible only with close contact between the gynecologist and histopathologist. In the history of medicine, endometrial biopsy was first performed in 1937. In order to carry out the correct diagnosis of scrapings from the endometrium, it is necessary to create certain conditions.
To conduct a proper diagnosis, a doctor must adhere to some rules:
- in case of infertility, women with suspicion of anovulatory cycle are scraped before menstruation or during the period of menstruation;
- repeated bar scrapings are carried out with amenorrhea for four weeks with an interval of one week;
- for menorrhagia, scraping is taken on the fifth or tenth day after the onset of menstruation;
- in metrorrhages, scraping is usually taken immediately after the bleeding;
- For the diagnosis of neoplasm endometrial scrapings can be taken on any day of the cycle.
The purity of the experiment depends on the correct selection of the biomaterial.
If the examination received fragmentedpieces of tissue, it is extremely difficult to restore the structure of the endometrium. Proper scraping involves getting large, uncrushed endometrial strips. During the curettage process, after each curette is carried along the walls, the endometrium is removed from the cervical canal.
Endometrial biopsy can be done in several ways:
- complete diagnostic curettage of the uterus.Most often, scraping is done separately (first from the cervical canal, then from the uterus). When bleeding, especially in the perimenopausal period, the urethral tube corners are scraped with a small curette, since it is in these zones that the polypous growths of the endometrium are usually localized. It is in these areas begins malignancy. If a carcinoma is suspected (at the first injections of the curette, soft, crumbling tissue is scraped), the scraping stops immediately;
- endometrial aspiration biopsy is performed during mass examinations of women in order to diagnose endometrial cancer;
- endometrial stroke scrapes are produced for the purpose ofdetermine the reactions of the mucous membrane to the endocrine function of the ovaries, determine the causes of infertility, monitor the results of hormone therapy. The presented method does not apply to uterine bleeding.
Endometrial biopsy is done whenthe help of the tool Pipel (flexible tube with a diameter of three millimeters with a side hole at the end). Inside the tube is placed a piston, as in a conventional syringe. Indications for this type of biopsy: bleeding in women older than forty; bleeding due to the use of hormonal contraceptives; endometrial diagnosis for infertility; profuse bleeding in premenopause; bleeding in menopause.
