Controlled analysis of factors associated with insufficient sample on outpatient endometrial biopsy

We examined the relative significance of hysteroscopic and ultrasonographic evidence of endometrial atrophy in relation to insufficient sample on outp atient endometrial biopsy in women with abnormal uterine bleeding. Multivar iate logistic regression modelling was used to evaluate the independent eff ects of age, menopausal status, hysteroscopic findings and sonographic endo metrial thickness on outpatient endometrial sampling (sufficient or insuffi cient) used as the binary dependent variable. Insufficient sample on endome trial biopsy was associated with hysteroscopic finding of endometrial atrop hy (OR 4.79, 95% CI 1.05-21.91, P = 0.04) and sonographic endometrial thick ness below 5 mm (OR 0.19, 95% CI 0.07-0.53, P = 0.001). There was no associ ation with patient's age and menopausal status. In conclusion, when reassur ing women with insufficient sample on outpatient endometrial biopsy, one ca n be confident about absence of pathology provided the hysteroscopic and so nographic endometrial assessment is consistent with endometrial atrophy.