Wentz, A. C. (1980). Endometrial biopsy in the evaluation of infertility. Fertility and Sterility, 33(2), 121-124. https://doi.org/10.1016/s0015-0282(16)44530-9
Wentz AC. Endometrial biopsy in the evaluation of infertility. Fertil Steril. 1980;33(2):121-124. doi:10.1016/s0015-0282(16)44530-9
Wentz, A. C. "Endometrial biopsy in the evaluation of infertility." Fertility and Sterility, vol. 33, no. 2, 1980, pp. 121-124.
For EndNote, Zotero or Mendeley:
License
No open license is recorded for this paper. Reuse terms are set by the publisher.
Endometrial biopsy found 29.5% out of phase in 149 infertile patients
A 1980 single-clinic case series of 149 infertility patients found that the first endometrial biopsy was out of phase in 44 patients, 29.5%. The biopsy checks the age of the uterine lining against the next period, to look for luteal phase inadequacy. Among patients not taking clomiphene citrate, 30.5% had an out-of-phase biopsy.
Key Findings
149 patients had 210 endometrial biopsies. The first was in phase for 92 (61.7%), out of phase for 44 (29.5%), and unclassifiable for 13 (8.7%).
Among patients not taking clomiphene citrate, 30.5% had an out-of-phase first biopsy.
Of 31 patients with an out-of-phase first biopsy who had a second one, 6 were in phase, 22 were out of phase, and 3 were sampled in the cycle of conception.
For about one-half of the patients with the defect, the author found no likely cause.
One ampullary ectopic pregnancy was the only unwanted event reported with a biopsy, and the author judged the biopsy unlikely to have caused it. Every attempted biopsy gave enough tissue to read.
Interpretation
This is a case series from one clinic in 1980, with no comparison group. The author describes a patient group with a high share of menstrual and ovulation problems and fewer than usual with tubal or pelvic disease. The rates describe that mix of patients. The author writes that these data cannot show whether finding or treating luteal phase inadequacy changes the chance of pregnancy or delivery. The numbers were too small for statistical analysis.
RRM Context
The author looked for a cause in infertility patients and scheduled each biopsy from cycle history or basal body temperature readings. RRM shares that cycle-informed, evaluation-first approach. About one-half of the patients found to have luteal phase inadequacy had no earlier sign of it.
Our editorial summary of this paper, not the article's abstract.
Abstract
One hundred and forty-nine patients presenting with infertility underwent two hundred and ten endometrial biopsies as part of a routine infertility evaluation. The initial biopsy was out of phase in 44 (29.5%), confirmed by subsequent biopsy to yield a total of 28 (19%) patients with luteal phase inadequacy. Of 44 patients taking clomiphene citrate, 13 (29.5%) had out-of-phase biopsies. Although hyperprolactinemia, recurrent miscarriages, extremes of reproductive life, and clomiphene citrate administration have been associated with an increased incidence of the defect, in this series a predisposing cause could not be detected in approximately one-half of the patients. The routinely obtained endometrial biopsy provides a safe, reproducible, and adequate means of providing histologic evidence for normal endometrial development for subsequent implantation.
05dq2gs74 