Uterine Lining Evaluation

Endometrial Assessment

A focused ultrasound assessment of the endometrial lining – essential for diagnosing abnormal bleeding, fertility issues, and gynaecological conditions.

Overview

Understanding your endometrial health.

Endometrial assessment is a specialised ultrasound evaluation of the endometrial lining – the inner layer of the uterus that thickens and sheds during the menstrual cycle. It measures the thickness, echogenicity, and pattern of the endometrium, and identifies abnormalities such as polyps, hyperplasia, fibroids, and malignancy. This assessment is critical for women with abnormal uterine bleeding, infertility, and those at risk of endometrial cancer.

The endometrium changes predictably throughout the menstrual cycle and in response to hormones. Accurate assessment helps diagnose conditions like endometrial hyperplasia, polyps, submucous fibroids, and endometrial cancer. It is typically performed via transvaginal ultrasound, which provides the highest resolution images of the endometrial stripe.

At Amytri, our endometrial assessments are performed by experienced consultant radiologists using state‑of‑the‑art transvaginal ultrasound. We measure endometrial thickness, assess its texture, and evaluate for focal lesions. When indicated, we may recommend saline infusion sonography (SIS) for further evaluation of the uterine cavity. We provide a clear report and compassionate support, guiding you through the results and any necessary next steps.

What endometrial assessment covers

  • Measurement of endometrial thickness (mm) – in the sagittal plane
  • Assessment of echogenicity – homogeneous, heterogeneous, or cystic
  • Detection of endometrial polyps, hyperplasia, or focal masses
  • Identification of submucous fibroids and intrauterine adhesions
  • Evaluation of endometrial pattern relative to menstrual cycle phase
  • Saline infusion sonography (SIS) – for enhanced cavity visualisation (if needed)
  • Guidance for endometrial biopsy, hysteroscopy, or further imaging
Why it matters

The endometrium – a window into uterine health.

Accurate endometrial assessment helps detect conditions early, enabling timely treatment and preserving reproductive health.

Detection

Detect endometrial pathology early

Endometrial assessment can identify polyps, hyperplasia, submucous fibroids, and other conditions that cause bleeding and affect fertility – often before symptoms become severe.

Fertility

Essential for fertility evaluation

Endometrial thickness and pattern are critical for embryo implantation. Assessment helps optimise the timing of fertility treatments and diagnose conditions that interfere with implantation.

Safety

Guide biopsy and treatment

Endometrial assessment helps target biopsy sites, reducing the need for blind sampling and improving diagnostic accuracy.

What we assess

Detailed evaluation of the endometrial lining.

We use transvaginal ultrasound to obtain the highest resolution images of the endometrium, measuring and characterising it in detail.

Endometrial Thickness

We measure the maximum thickness of the endometrium in the sagittal plane. Normal values vary with cycle phase and menopausal status. A thickened endometrium may indicate hyperplasia or malignancy.

Echogenicity and Texture

We assess whether the endometrium is homogeneous, heterogeneous, or contains cystic spaces. A hyperechoic or inhomogeneous pattern may indicate polyps, hyperplasia, or other pathology.

Focal Lesions

We identify and characterise focal lesions – such as polyps (hyperechoic, with a stalk), submucous fibroids (hypoechoic, with shadowing), or intrauterine adhesions.

Endometrial‑Myometrial Interface

We evaluate the junction between the endometrium and myometrium – a smooth, well‑defined line is normal; irregularity may indicate invasion (in malignancy) or adenomyosis.

Saline Infusion Sonography (SIS)

If a focal lesion is suspected, we may perform SIS – infusing sterile saline into the uterine cavity to distend it, providing a clearer view of polyps, fibroids, and adhesions.

Cycle Phase Correlation

We correlate the findings with your menstrual cycle phase – ensuring that the thickness and pattern are appropriate for the timing, and avoiding false positives.

How it works

Your endometrial assessment journey, step by step.

01
Prepare

Preparation

For transvaginal ultrasound, we ask you to empty your bladder. For the best assessment, we recommend timing the scan between days 5‑12 of your menstrual cycle (or after any bleeding has stopped).

02
Scan

Ultrasound examination

We perform a transvaginal ultrasound, measuring the endometrial thickness in the sagittal plane and assessing its texture and any focal lesions. If indicated, we may perform SIS for enhanced visualisation.

03
Interpret

Interpretation and reporting

We compare your endometrial thickness with age‑ and cycle‑appropriate reference ranges. We evaluate for any abnormalities and provide a detailed, actionable report.

04
Plan

Guidance and follow‑up

We discuss the results with you. If abnormalities are found, we recommend further steps – which may include endometrial biopsy, hysteroscopy, or referral to a gynaecologist.

Is it for you?

Endometrial assessment is recommended if any of these apply.

It is a key investigation for women experiencing abnormal bleeding, infertility, or with risk factors for endometrial pathology.

Abnormal uterine bleeding

Heavy, prolonged, inter‑menstrual, or post‑menopausal bleeding – endometrial assessment is essential to rule out polyps, hyperplasia, or malignancy.

Infertility / Recurrent implantation failure

Endometrial thickness and pattern are critical for embryo implantation. Assessment helps identify polyps, adhesions, or insufficient thickness.

Post‑menopausal bleeding

Any bleeding after menopause requires urgent evaluation. Endometrial thickness >4‑5 mm warrants further investigation (biopsy).

Tamoxifen or HRT use

Women on tamoxifen or hormone replacement therapy are at increased risk of endometrial changes – regular assessment is recommended.

Obesity and metabolic syndrome

Obesity increases the risk of endometrial hyperplasia and cancer – assessment is advised for symptomatic women.

Sonographic suspicion of endometrial pathology

If a routine pelvic ultrasound shows a thickened endometrium or focal lesion, a targeted assessment provides definitive characterisation.

Dr. Abhishek at Amytri Diagnostics & Healthcare
Dr. Abhishek Consultant Radiologist & Fetal Medicine
Meet your specialist

Expert in endometrial imaging with precision.

Dr. Abhishek has extensive experience in gynaecological ultrasound, with a special interest in endometrial assessment and fertility imaging. He is skilled in both standard transvaginal ultrasound and saline infusion sonography, providing accurate diagnoses that guide effective treatment.

Qualified consultantMBBS · DMRD · DNB (Radiodiagnosis)
Gynaecological expertiseEndometrial ultrasound, SIS, and fertility assessment
Advanced technologyHigh‑resolution transvaginal and SIS equipment
Patient‑centred careClear explanations and compassionate support
Share the journey

Your partner is welcome to join.

Endometrial assessment is often performed for fertility evaluation – having your partner with you provides support and shared understanding.

We welcome partners to be present during the scan. We ensure your privacy and comfort, and we explain the findings so both of you understand the results. Your partner's presence can be especially helpful when discussing fertility implications.

Be present togetherShare the experience
Ask questions togetherGet clarity as a couple
Take home imagesPrinted images of your scan
Emotional supportNavigate the journey together
Gentle answers

Questions about endometrial assessment.

Book with confidence

Take control of your uterine health – book your endometrial assessment today.

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