The endometrial pipelle sampling procedure

Endometrial pipelle sampling, also known as endometrial biopsy, scratching, or injury, is a common procedure often performed in women with abnormal uterine bleeding. The PIP study is designed to test whether this common procedure can also be used to help increase pregnancy rates in subfertile women or couples.

The endometrial pipelle procedure is similar to having a smear test done. First, the speculum is inserted into the vagina. Then the pipelle is inserted gently through the cervix and into the uterus. The pipelle procedure takes approximately one minute and involves gently moving the pipelle back and forth to obtain a sample. Some temporary discomfort or cramping may be experienced.

In approximately 5% of women is it necessary to dilate the cervix, and some of these women may prefer to have local anaesthetic. Rarely, sampling is not possible. Participants are often recommended to have a chaperone present during the procedure, who is often another member of staff. You may also wish to have your partner or a family member present.

Endometrial biopsy
Image kindly supplied by Krames StayWell 780 Township Line Road, Yardley, PA 19067 267-685-2500

Placebo proceedure

In PIP-UE and PIP-PCOS, women randomised to the control group will undergo a placebo procedure. The placebo procedure is similar to the endometrial pipelle procedure, except that no sample is taken from the endometrium. Some discomfort and cramping may be experienced with both procedures.

In PIP-IVF, women randomised to the control group will not undergo any additional procedure.


Endometrial pipelle sampling is a safe procedure that is usually well-tolerated by patients. However, if you take part in this study there are a number of small risks you should be aware of:

  1. Spotting or bleeding after the procedure (for less than 1 hour)
  2. Crampy period-like discomfort (which is usually short lived)

There is also an extremely small risk of infection or uterine perforation. If this happens, antibiotics and observation for fever may be recommended.


Research on pipelle sampling has shown that it may double the chance of pregnancy in subgoups of women undergoing IVF cycles. Endometrial pipelle sampling may also be beneficial in other groups of women. If you agree to participate in the PIP-IVF study you may benefit from a higher chance of pregnancy.

Participating in the PIP studies will provide extremely valuable information to researchers. This information can be used to help increase the chances of subfertile women and couples who seek fertility treatment in the future.

There is no cost for participating in the PIP studies.