When you’re trying to conceive without success, it’s easy to feel frustrated. You chart your ovulation, yet month after month, your period arrives on schedule, and you begin to wonder if you may suffer from infertility.
Doctors define infertility as not being able to conceive after one year of unprotected intercourse (six months for those women over 35). Some women can conceive but miscarry within a few months. If you experience difficulty getting pregnant or staying pregnant, you should consult with a fertility specialist to find out why.
For more than six million women in the US, infertility is a very real diagnosis. And there are many different reasons for that, and various conditions that contribute to infertility. Fortunately, thanks to medical intervention and advanced reproductive technology, there are ways couples today may overcome their infertility and grow their families.
The Role of The Uterus and Endometrium
One of the reasons some women can’t conceive or lose the pregnancy shortly thereafter is that there are issues with the uterus. The uterus is a pear-shaped organ in your lower abdomen. Once fertilization occurs, the embryo implants in the lining of the uterus, the endometrium, where it grows and develops throughout your pregnancy. When fertilization doesn’t occur, your endometrium sheds and exits your body through your monthly period.
When The Endometrium isn’t Healthy
In some cases, and for various reasons, the endometrium isn’t healthy enough to support a pregnancy. If the embryo can’t attach and grow, you will miscarry. Other issues with the uterus can also cause infertility or miscarriage. In fact, according to a publication by the NIH, 2.1% to 16.7% of women worldwide suffer uterine-related infertility.
If your doctor suspects that issues with your uterus are behind your inability to conceive, they may schedule an endometrial biopsy. This procedure helps your doctor identify issues associated with your endometrial tissue and determine the best course of treatment to overcome them.
The Endometrial Biopsy
The biopsy itself is somewhat like a typical examination at your gynecologist’s office. During this in-office procedure, your doctor uses a speculum to open your cervix. Then the doctor inserts a very small, very thin catheter into your vagina, through the cervix, and into your uterus.
Using suction, the catheter removes some of your endometrial tissue, which is sent to the lab. The entire process takes around 30 minutes. You may notice some mild cramping and spotting, but you can go about your normal activities after the biopsy. Results typically take one to two weeks.
Reasons for An Endometrial Biopsy
There are several reasons why your doctor may order an endometrial biopsy. Not all of them are fertility-related, but certainly, if there is an issue with your uterus or lining, it will impact your fertility. Here are some common reasons for an endometrial biopsy.
- Abnormal Bleeding: If you’re bleeding between your periods, or if your periods are extremely heavy, with large clots, or last for more than 7-10 days, your doctor will likely want you to have an endometrial biopsy.
- Abnormal Results from Your Pap Smear: If your yearly pap smear shows irregular results, the next step is usually an endometrial biopsy.
- A Change in Hormone Levels: A change or imbalance in your hormone levels may indicate endometrial or uterine abnormalities such as polyps or uterine fibroids.
- Recurrent Miscarriages: Two or more consecutive pregnancy losses before 20 weeks warrants an endometrial biopsy to find out the cause.
- Endometriosis: Endometriosis is a condition in which tissue, identical to endometrial tissue, grows outside of the uterus and attaches to other organs. Endometriosis is a painful and all-too-common condition that typically interferes with conception.
- Bacterial Infection: The presence of infection from STIs or other causes can affect the endometrium. These infections, if not caught and treated, may result in endometriosis.
- Failed IVF: When embryos are healthy but fail to implant, your doctor needs an endometrial biopsy to find out why.
- To Schedule IVF: Your doctor can schedule your IVF for the optimum time based on the results of the endometrial biopsy.
- Symptoms of Uterine Cancer: If a patient shows symptoms of uterine cancer, the doctor schedules an endometrial biopsy.
Next Steps
A biopsy usually comes after preliminary, less invasive tests indicate it is necessary. If an endometrial biopsy indicates changes that affect your fertility, then you and your doctor can determine the best treatment for you.
Your treatment may call for hormone medications to help your endometrium become stronger and healthier to support a pregnancy. You may need a more customized timeline for IVF success. Or, in the event your biopsy shows a medical condition such as polyps or uterine fibroids, surgery may be in order. And should your results show cancer may be present, your doctor refers you to an oncologist for further tests.
Find Out More
All in all, an endometrial biopsy is an essential tool to help your doctor diagnose the reason for your infertility. For more information or for any of your fertility concerns, please contact LA IVF today.
