American Society for Reproductive Medicine

View all recommendations from this society

Released April 13, 2015

Don’t perform endometrial biopsy in the routine evaluation of infertility.

Endometrial biopsy performed for histologic dating does not distinguish fertile from infertile women. Chronic endometritis on endometrial biopsy does not predict the likelihood of pregnancy in general nor is it associated with live birth rates in assisted reproductive technology cycles. Endometrial biopsy should not be utilized in the routine evaluation of infertility.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Practice Committee of the American Society for Reproductive Medicine (ASRM) reviewed evidence from ASRM’s practice documents to identify possible topics along with suggestions for possible topics from the ASRM Board of Directors. By consensus, the Practice Committee narrowed the list to the top five most overused tests within specified parameters. Additional input was sought from the ASRM Board of Directors and incorporated. The final list was reviewed and approved by the ASRM Board of Directors. The ASRM Board of Directors and Practice Committee are comprised of representatives from every aspect of reproductive medicine through our five affiliated societies including the Society for Assisted Reproductive Technology, the Society of Reproductive Surgeons, the Society for Reproductive Endocrinology and Infertility, the Society for Male Reproduction and Urology and the Society of Reproductive Biologists and Technologists.

ASRM’s disclosure and conflict of interest policy can be found at www.asrm.org.

Sources

Coutifaris C, Myers ER, Guzick DS, Diamond MP, Carson SA, Legro RS, et al; NICHD National Cooperative Reproductive Medicine Network. Histological dating of timed endometrial biopsy tissue is not related to fertility status. Fertil Steril 2004 Nov;82(5):1264-72.

Murray MJ, Meyer WR, Zaino RJ, Lessey BA, Novotny DB, Ireland K, Zeng D, Fritz MA. A critical analysis of the accuracy, reproducibility, and clinical utility of histologic endometrial dating in fertile women. Fertil Steril. 2004 May;81(5):1333–43.

Batista MC, Cartledge TP, Merino MJ, Axiotis C, Platia MP, Merriam GR, Loriaux DL, Nieman LK. Midluteal phase endometrial biopsy does not accurately predict luteal function. Fertil Steril. 1993 Feb;59(2):294–300.

Gibson M. Clinical evaluation of luteal function. Semin Reprod Endocrinol. 1990;8:130–41.

Dockery P, Li TC, Rogers AW, Cooke ID, Lenton EA, Warren MA. An examination of the variation in timed endometrial biopsies. Hum Reprod. 1988 Aug;3(6):715–20.

Kasius JC, Fatemi HM, Bourgain C, Sie-Go DM, Eijkemans RJ, Fauser BC, Devroey P, Broekmans FJ. The impact of chronic endometritis on reproductive outcome.Fertil Steril. 2011 Dec;96(6):1451–6.

Haggerty C, Ness RB, Amortegui A, Hendrix SL, Hillier SL, Holley RL, Peipert J, Randall H, Sondheimer SJ, Soper DE, Sweet RL, Trucco G. Endometritis does not predict reproductive morbidity after pelvic inflammatory disease. Am J Obstet Gynecol. 2003 Jan;188(1):141–8.