Endometrial biopsy collection from women receiving Norplant®

This paper reports a series of 191 endometrial biopsy procedures performed on Indonesian women who had received between 3 and 12 months exposure to Norplant®. 87 biopsy procedures were attempted with a microhysteroscope using biopsy forceps, and 104 procedures were attempted with either Pi pelle or Karman suction curettes. Regardless of biopsy method, diagnosable endometrium was only obtained in approximately 50% of procedures. Myometrium was often found in microhysteroscope but not suction biopsies. Analysis of a number of clinical characteristics showed that women from whom diagnosable endometrial tissue was obtained had higher mean peripheral oestrogen levels in the 2 weeks prior to biopsy (439 ± 35 v 289 ± 33 pmol/l. P=0.0018), and significantly more days when endometrial bleeding occurred in the 90 days prior to biopsy (26.5 ± 2.1 v 16.2 ± 1.8. P=0.0003). These results suggest that after 3-12 months exposure to Norplant® about 50% of women have an endometrium that too thin to sample, and that this group is characterised by lower peripheral oestrogen levels and reduced menstrual bleeding.