WOMENS-HEALTH Messages for March, 1998: Re: Timing of endometrial biopsy

Re: Timing of endometrial biopsy

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Mon, 30 Mar 1998 17:51:04 -0600 (CST)

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At Mon, 30 Mar 1998, Liz wrote: >
>I am getting totally confused about the appropriate time for endometrial
>biopsy when looking for luteal phase defect. My doctor wants one done
>at 21 days, while I keep finding people saying it is to be done later
>on, closer to the next period.

The earliest it can be done and still confirm ovulation is day 21 but some physicians prefer day 23-26, so you're both right.

>He is also running a progesterone level,
>I think on the same day.

A common practice that will help in confirmation of ovulation.

>He has not made any mention of checking for
>ovulation. I have only had 1 period post D&C (D&C was Feb 14) and the
>period was light but long and there has been no indication physically or
>by OPK of ovulation so far this month (day 16 now). I am so
>frustrated!!! Is the test at this time appropriate?

If there's no sign of ovulation, an endometrial biopsy and progesterone level are not going to be helpful. They should be done about 10 days after ovulation (on a 28 day cycle, ovulation is day 24, hence the numbers given above).

>I cannot afford to
>mess around and waste time, but I don't want to have another miscarriage
>if progesterone may be the only thing I need. Would a test at this
>time, with these circumstances (ie: possibly too early and in a probable
>anovulatory cycle) be diagnostic, and if not, would it tend to give a
>false positive for LPD or a false negative.

Without ovulation, testing for ovulation would be ill advised.

>If a positive, I would be
>tempted to go on with the testing so I can be put on some progesterone,
>but otherwise it is just one more painful, frustrating, useless thing in
>this whole ordeal (HMO HELL!) that has been going on for a year now.
>Please, your advice....the biopsy is scheduled for 5 days from now.
>Thanks. Liz

Good luck.

--
Harvey S. Marchbein, M.D. FACOG
OBGYN.net U.S. Representative, New York
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.

**Thank you for your understanding ;-)

Next message: Sharon: "confused about estrogen"
Previous message: Mary: "New Mom's Chat - 1 hour later - Tonight only"
In reply to: Liz: "Timing of endometrial biopsy"
Next in thread: James Connerth MD: "Re: Timing of endometrial biopsy"

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