Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The uterus (womb) is lined by a special type of tissue known as the endometrium. Endometrial biopsy, or endometrial sampling, is a technique of removing a piece of tissue from the inner lining of the uterus. The sample of tissue is analyzed under a microscope in the laboratory by a pathologist, a doctor with special training in diagnosis of diseases based upon tissue examination.
Why is endometrial biopsy done?
An endometrial biopsy is most often performed to help determine the cause of
abnormal uterine bleeding. It can also be done to help evaluate the cause of infertility, test for uterine infections, and even monitor the response to certain medications.
Endometrial biopsy has many advantages over the more complicated procedure known as
dilation and curettage (D&C), which is a more extensive removal of the uterine lining that requires dilation of the cervical opening with special instruments. Unlike D&C, endometrial biopsy may be performed in the doctor's office and typically does not require anesthesia or hospitalization.
Endometrial biopsy cannot be performed during pregnancy, and sometimes may not be recommended when certain other conditions are present, including
cancer of the cervix or abnormal narrowing (stenosis) of the cervical opening.
How is an endometrial biopsy performed?
Endometrial biopsy is most often done in the physician's office, but it can be
performed on women in the hospital. The patient lies on the examining table in a
position similar to that used for obtaining
Pap smears. The doctor uses a speculum to open the vaginal canal and visualize the
cervix, the opening to the uterus. During endometrial biopsy the doctor inserts a thin plastic or metal tubular device through the cervix into the uterus to remove a tiny piece of the inner lining tissue.
Usually no anesthesia is required, but taking a
nonsteroidal anti-inflammatory
medication (NSAID) 30 to 60 minutes prior to the procedure can help reduce cramping and pain. In some cases, a small amount of lidocaine anesthetic is inserted into the uterine cavity to minimize discomfort.
What are the risks of endometrial biopsy?
There are very few risks with endometrial biopsy. The leading risk is pain or cramping, but this typically subsides rapidly following the procedure. Other less common risks are feeling faint or light-headed, possible infection, bleeding, and rarely, perforation of the uterus.
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
Pelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Trying to get conceive, or become pregnant can be challenging, frustrating, and an emotional rollercoaster for some couples. There are things you can do to chart progress, which may ultimately lead to a successful healthy pregnancy, or, when necessary, lead to discussions with a fertility specialist. Being aware of your menstrual cycle, charting your fertility pattern, knowing the reasons for infertility, and treating infertility are key points to discuss with your partner and physician.
Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of
the uterus, but in a location outside of the uterus. Endometrial cells are cells that are shed each month during menstruation. The cells of endometriosis
attach themselves to tissue outside the uterus and are called endometriosis
implants. These implants are most commonly found on the ovaries, the Fallopian
tubes, outer surfaces of the uterus or intestines, and on the surface lining of
the pelvic cavity. They can also be
found in the vagina, cervix, and bladder, although less commonly than other
locations in the pelvis. Rarely,
endometriosis implants can occur outside the pelvis, on the liver, in old
surgery scars, and even in or around the lung or brain. Endometrial implants,
while they can cause problems, are
benign (not cancerous).
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