Patient and Procedural Factors Associated With Insufficient Office Endometrial Biopsy

Area of Science:

• Gynecology
• Pathology
• Reproductive Medicine

Background:

• Office endometrial biopsy is a crucial diagnostic tool.
• Insufficient samples can necessitate repeat procedures, increasing patient burden and healthcare costs.

Purpose of the Study:

• To identify patient-specific and procedural factors associated with insufficient office endometrial biopsy.
• To inform strategies for optimizing biopsy success rates.

Main Methods:

• Retrospective cohort study of 27,456 adult patients undergoing office endometrial biopsy.
• Analysis of demographics, menopausal status, BMI, medical history, and mental health conditions.
• Multivariable logistic regression to identify predictors of insufficient biopsy.

Main Results:

• Overall insufficient biopsy rate was 12.1%, significantly higher in postmenopausal patients (29.1%) vs. premenopausal (7.6%).
• Postmenopausal status (OR 5.27), leiomyomas, history of cesarean delivery, chronic pain, and anxiety were associated with higher insufficiency rates.
• Body Mass Index (BMI) of 50+ was associated with a decreased risk of insufficient biopsies.

Conclusions:

• Patient factors like postmenopausal status, leiomyomas, chronic pain, and anxiety are linked to higher rates of insufficient endometrial biopsies.
• Higher BMI (50+) appears protective against insufficient biopsies.
• Identifying at-risk patients can guide interventions to improve visualization and tolerance, reducing repeat procedures.