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The endometrium is the inside lining of the uterus, and an endometrial biopsy involves the removal of a tissue sample for testing. This procedure is used to screen for cancer, investigate irregular bleeding, fertility problems, infections, and monitor medication effectiveness. It can be done in a doctor's office without sedation, taking about 10-15 minutes. The doctor will first perform a manual exam, place a speculum in the vagina to visualize the cervix, and use a tenaculum to hold the cervix steady. Then, a flexible tube called a pipelle is inserted into the uterus to collect a tissue sample using suction.