The Effect of Intrauterine Device on the Quality of Sampling Material in Patients Undergoing Endometrial Biopsy

Objective: This study aims to evaluate the effect of intrauterine device (IUD) use on the quality and adequacy of sampling material obtained during endometrial biopsy. The study compares the histopathological adequacy of endometrial samples between IUD users and non-users, identifying potential diagnostic challenges and implications for clinical practice. Methods: The study was conducted on 409 women aged 25–55 who presented with abnormal uterine bleeding (AUB) to the Gynecology and Obstetrics Outpatient Clinic at Kayseri City Hospital between April 1, 2021 and April 1, 2023. The patients were divided into two groups: IUD users (n=215) and non-IUD (n=194). Endometrial biopsies were obtained using the Pipelle curette technique without anesthesia, preserved in a 10% formalin solution, and analyzed for pathological categories and diagnostic adequacy. Pathological categories, endometrial thickness, and other parameters were statistically compared between the groups. Results: The proportion of unclassifiable pathological categories was significantly higher in IUD users (63.93%) compared to non-IUD (36.05%) (p=0.013). Additionally, a negative correlation was observed between pathological category and endometrial thickness (r=−0.3147,p< 0.001), suggesting that thinner endometrium was associated with more advanced pathological changes. However, no significant association was found between IUD use and endometrial thickness (p=0.073). Conclusion: The findings indicate that IUD use may affect the diagnostic adequacy of endometrial biopsy specimens, likely due to inflammatory or structural changes in the endometrium. These results underlines the importance of considering IUD-related alterations when interpreting biopsy findings. Further research is needed to refine diagnostic approaches and better understand the clinical implications of these effects.