A novel technique for transcervical biopsy of the myometrium†

Our objective was to establish a minimally invasive technique for transcervical myometrial biopsy suitable for tissue collection from the nonpregnant or immediately post-pregnancy human uterus. We recruited pregnant patients undergoing surgical abortion up to 26 weeks, pregnant patients undergoing cesarean section at term, and nonpregnant patients of reproductive age undergoing laparoscopic bilateral salpingectomy for permanent contraception. Immediately following completion of the primary procedure, we introduced the CorVocet™ Biopsy System (Merit Medical, South Jordan, Utah) transcervically to the fundus under transabdominal ultrasound (abortion) or laparoscopic guidance, or directly via the hysterotomy during cesarean section. We obtained up to five 18-gauge core needle biopsy samples from each participant at a 1 cm core depth. Our primary outcome was successful sample collection (at least 1 sample, yes/no). Additional outcomes included total biopsy collection time, number of samples collected, ability to perform histology and molecular techniques on the samples, and adverse events. All biopsy attempts (29/29) yielded at least one sample suitable for analysis. Median biopsy collection time was 4 minutes (interquartile range 3-7 minutes). No adverse events occurred. We successfully obtained adequate myometrial tissue using a novel transcervical biopsy technique. This technique has applicability for future investigations that require myometrial samples of the pregnant and nonpregnant uterus.