Endometrial biopsy | Diagnosis of uterine problems in Turkey 2025

Endometrium: Definition and structure

The endometrium is a critical part of the uterus that plays a key role in reproduction and women's health.  This inner layer consists of two parts:

• The basal layer: composed of epithelial cells and connective tissue, it houses the uterine glands and serves as the basis for mucosal regeneration.
• The functional layer: develops during the menstrual cycle and plays an essential role in embryo implantation and the onset of menstruation.

The endometrium is tightly regulated by ovarian hormones, especially estrogen and progesterone. These hormones regulate its thickness and vascularization, preparing the uterus for eventual pregnancy.

If fertilization occurs, the endometrium allows the embryo to implant. If fertilization does not occur, the lining disintegrates, triggering menstruation.

Why monitor endometrial health?

The endometrium is a key indicator of reproductive health. Hormonal imbalances or gynecological pathology can affect it and lead to a variety of disorders, including:

• Endometriosis: abnormal development of endometrial tissue outside the uterus.
• Endometrial hyperplasia: excessive thickening of the lining, sometimes a precursor to cancer.
• Endometrial cancer: the most common is adenocarcinoma, but there are also rarer forms such as sarcoma and leiomyosarcoma, which mostly affect postmenopausal women.

Symptoms such as unusual bleeding, pelvic pain, or irregular menstrual cycles should be taken seriously. Regular gynecological exams can help detect any abnormalities early and keep the uterus healthy.

Are you concerned about your gynecological health? Schedule an appointment with one of our partner specialists for an accurate diagnosis and personalized care.

Endometrial biopsy: What is it?

Endometrial biopsy is a minimally invasive diagnostic procedure that involves microscopic analysis of the lining of the uterus. The goal is to assess the composition and condition of the endometrium and the effect of hormones on its physiology.

In an endometrial biopsy, a small portion of the endometrium is removed. This sample is then analyzed in the laboratory using two main methods:

• Endometrioculture: The tissue is cultured to detect the presence of germs or bacteria in the uterine cavity that may indicate infection.
• Microscopic analysis: The tissue is examined under a microscope to assess its structure and verify its synchronization with the menstrual cycle. This step allows us to date the endometrium and determine if it is ready for embryo implantation.

In Turkey, endometrial biopsy is particularly important in the context of assisted fertilization, where it ensures that the endometrial maturation is optimal for embryo implantation. A properly prepared endometrium is crucial for the success of fertility treatments.

Indications for endometrial biopsy

Endometrial biopsy may be recommended in several clinical situations, including:

• Evaluating the effects of hormone therapy: To evaluate the effects of hormone therapy before artificial insemination or in vitro fertilization (IVF).
• Monitoring of hormone replacement therapy: Especially during menopause, to assess endometrial response.
• Abnormal bleeding: When there is irregular bleeding, either during menopause or during the menstrual cycle.
• Detection of infection or pathology: In cases of suspected uterine infection (such as endometritis) or abnormal tissue growth such as fibroids, endometrial thickening or the presence of endometrial polyps. In these cases, the biopsy is often performed under hysteroscopic guidance for greater accuracy.

Contraindications to diagnosis

Endometrial biopsy is contraindicated in certain cases, including:

• If you are pregnant: The procedure may be harmful to the fetus.
• In the presence of acute gynecological infections: Active infection must be treated prior to any procedure.
• Major uterine abnormalities: Certain anatomical conditions may make the procedure risky.

Your gynecologist will evaluate your medical situation to determine whether a biopsy is appropriate for you.

Endometrial biopsy side effects

Endometrial biopsy is a quick procedure performed during a gynecologic exam, usually in just a few minutes. Although the procedure is generally well tolerated, it may cause temporary cramping similar to menstrual pain. Local anesthesia may sometimes be given to increase patient comfort.

Although endometrial biopsy is considered a safe procedure, some temporary side effects may occur. The most common are minor bleeding or abdominal cramping, which usually disappear within a few hours. These symptoms are not unusual and should not be a cause for concern, but they may require special attention if they are severe.

Endometrial sampling results in Turkey

After an endometrial sampling procedure, the pathologist prepares a detailed report that provides important information about the analysis of the tissue sampled. This report describes the shape, size and number of cells present, highlighting any abnormal features that may indicate a specific pathology. It also includes a thorough explanation of the normal or abnormal growth of the endometrial cells.

In the event of abnormal results, Turquie Santé offers personalized support for optimal medical management. Our team of experienced professionals will guide you every step of the way, from interpreting the results to implementing the appropriate treatment. Thanks to our expertise and network of partner clinics in Turkey, we can guarantee you quality care and comprehensive medical follow-up.