American Journal of Obstetrics & Gynecology
Volume 197, Issue 6 , Pages 578.e1-578.e4, December 2007

A pilot study to evaluate the relative efficacy of endometrial biopsy and full curettage in making a diagnosis of endometriosis by the detection of endometrial nerve fibers

Department of Obstetrics and Gynaecology, Queen Elizabeth II Research Institute for Mothers and Infants, Faculty of Medicine, College of Health Sciences, University of Sydney, Sydney, Australia

Received 7 December 2006; received in revised form 11 February 2007; accepted 18 April 2007.

Objective

The purpose of this study was to evaluate endometrial biopsy and curettage in detecting small nerve fibers in eutopic endometrium for diagnosis of endometriosis.

Study Design

Endometrial biopsies with precise, consistent technique and curettings were taken from 37 women (20 with endometriosis and 17 without endometriosis). Sensitivity, specificity, and positive and negative predictive value were formally calculated. Endometrial nerve fibers were immunohistochemically detected using the pan-neuronal marker PGP9.5.

Results

Small nerve fibers were detected in all endometrial biopsies and curettings from all 20 women with endometriosis, but were not detected in endometrium taken from 17 women without endometriosis. Mean (±SD) nerve fiber density in the endometrial biopsies was 26.8 per mm2 ± 55.9 (range, 1.6-125) and for curettings was 21.6 per mm2 ± 33.1 (range, 0.8-250), with 100% specificity, sensitivity, and positive and negative predictive value.

Conclusion

Careful endometrial biopsy combined with immunohistochemical staining for nerve fibers may be a reliable means of diagnosing or excluding endometriosis.

Key words: endometrial biopsy, endometrial curettage, endometriosis, immunohistochemistry, nerve fibers

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 Funding was provided by the Department of Obstetrics and Gynaecology, Faculty of Medicine, College of Health Sciences, University of Sydney, Sydney, Australia.

 Cite this article as: Al-Jefout M, Andreadis N, Tokushige N, et al. A pilot study to evaluate the relative efficacy of endometrial biopsy and full curettage in making a diagnosis of endometriosis by the detection of endometrial nerve fibers. Am J Obstet Gynecol 2007;197:578.e1-578.e4.

PII: S0002-9378(07)00553-4

doi:10.1016/j.ajog.2007.04.032

American Journal of Obstetrics & Gynecology
Volume 197, Issue 6 , Pages 578.e1-578.e4, December 2007

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