A 27-year-old woman with primary infertility is suspected to have endometrial tuberculosis. To maximize the diagnostic yield of endometrial biopsy for detecting tubercular lesions, the sample should ideally be taken:
- A During menstruation
- B In the early proliferative phase
- C In the late secretory phase, just before the expected menses ✓
- D At any random phase, since yield does not vary with cycle timing
Correct answer: C. In the late secretory phase, just before the expected menses
Explanation
Tubercles and epithelioid cell reaction are most numerous in secretory endometrium, so a biopsy taken in the late secretory or premenstrual phase gives the highest histological yield. Sampling during menstruation is avoided because tissue is shed and interpretation is difficult. A further practical point is that the biopsy should be taken from the fundus and cornual regions where deposits concentrate. This timing detail is a classic viva and MCQ point.
Reference: Shaw's Textbook of Gynaecology, 18th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.