hysteroscopy

with an vaginal ultrasound, they found a 20 mm endometrial stripe......I have no symptoms and a biopsy was clean.  a d and c is recommended.  what are any others procedures?

[Elaine Brown, MD]

HI!
If you were my patient, I might offer you a fews alternatives if you REALLY wanted to avoid a D&C.  One option would be to repeat the biopsy under ultrasound guidance--that would be a more reassuring sample, because we could watch where the sample was taken from.  Another possibility would be to treat with progesterone of some kind ( Provera or Megace) for three months and then repeat the transvaginal ultrasound.  If it looked good, then just follow.  The D&C should be combined with hysteroscopy if it is going to be performed.  It is not a very risky procedure, and won't keep you off your feet for more than a day. (I've had two).  It would give you a little more reassurance about what is causing the thickness of the lining.  I have to admit though, that about 90% of cases I see are totally benign proliferative endometrium, so I wouldn't Demand a D&C.
Hope this helps!

Dr B