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Endometrial biopsy

Medical expert of the article

Oncologist, radiologist
, medical expert
Last reviewed: 07.07.2025

The study of the endometrium is based on the appearance of characteristic changes in the mucous membrane under the influence of ovarian steroid hormones. Estrogens cause proliferation, and progesterone - secretory transformations. The study of the endometrium helps to diagnose latent tuberculosis, determine the condition of the uterine cavity and its walls.

The material for analysis is most often obtained by scraping, which should be as complete as possible, which also gives a therapeutic effect (for example, in case of dysfunctional uterine bleeding ). The vacuum aspiration method has proven itself as less traumatic and giving good results. The material is collected on the 21st-24th day of the cycle, in case of acyclic bleeding at the beginning of it, when the endometrium is preserved.

When evaluating histological preparations, the morphological features of the functional layer of the endometrium, the nature of the structure of the stroma and glands, as well as the features of the glandular epithelium are taken into account.

Normally, in the secretion phase, the glands are dilated, have a saw-tooth shape, and the compact and spongy layers are visible. The cytoplasm in the cells of the glandular epithelium is light, the nucleus is pale. Secretion is visible in the lumen of the glands. In case of hypofunction of the corpus luteum, the endometrial glands are slightly convoluted, with narrow lumens.

In an anovulatory menstrual cycle, the endometrial glands are narrow or slightly dilated, straight or twisted. The glandular epithelium is cylindrical, high: the nuclei are large, located basally or at different levels.

Atrophic endometrium is characterized by the predominance of stroma, sometimes single glands are visible. The scraping itself is extremely scanty.

Glandular-cystic hyperplasia of the endometrium is characterized by cystic-dilated glands, increased proliferation of the epithelium, it is often multinucleated, with thickened or cubic cells, the nuclei are at different levels.

Endometrial biopsy has great diagnostic value in assessing ovarian function. Secretory endometrium removed by endometrial scraping 2-3 days before the onset of menstruation indicates that ovulation has occurred with an accuracy of up to 92%.

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