Endo Comprehensive Panel Test - Is it useful in Recurrent Pregnancy loss (RPL)?

Patient: Dr. Malpani, my IVF doctor, suggested I do an Endo Comprehensive Panel to check if my endometrium is healthy for implantation. Do you think I should go ahead with it?

Dr. Malpani: Honestly? It’s a waste of time and money for most IVF patients. This test is just another way for some clinics to profit from unnecessary investigations.

Patient: But isn’t it important to check if my endometrial lining is receptive?

Dr. Malpani: No, not in most cases. A good-quality embryo in a normal uterus will implant naturally. The idea that histopathology can predict implantation success is misleading. Your uterine lining is dynamic, meaning it changes naturally throughout the cycle.

Patient: My doctor said this test can detect chronic endometritis (CE), which might be causing implantation failure. Isn’t that a valid concern?

Dr. Malpani: CE is often overdiagnosed. Many women have some inflammation in their endometrium, which is completely normal. Just because a biopsy shows mild inflammation doesn’t mean it’s causing implantation failure. Plus, CE is better diagnosed by clinical symptoms like abnormal bleeding or chronic pelvic pain, not by random biopsies.

Patient: What about infections? Can this test help detect endometrial tuberculosis or bacterial infections?

Dr. Malpani: In rare cases—like in countries where genital TB is common—an endometrial biopsy may help. But for most IVF patients, a biopsy to check for "hidden" infections is unnecessary. If there’s a real suspicion of an infection, simpler and more targeted tests exist.

Patient: My report might show whether my endometrium is "out of phase." Wouldn’t that help improve implantation chances?

Dr. Malpani: The idea of an "out-of-phase" endometrium is an outdated concept. The endometrial lining is dynamic and adjusts naturally. There’s no reliable way to prove that a biopsy from one cycle reflects what happens in another.

Patient: My doctor says this test will help "personalise" my IVF treatment. Shouldn't I trust their expertise?

Dr. Malpani: Personalisation sounds great, doesn’t it? But in reality, many of these so-called "customised" treatments are just expensive gimmicks. IVF success depends on high-quality embryos and a well-prepared uterine lining, not on unnecessary, expensive tests.

Patient: But if my lining looks abnormal, won’t the results help improve my treatment plan?

Dr. Malpani: Not really. The only true measure of endometrial receptivity is a thick, trilaminar lining on ultrasound during embryo transfer—not a biopsy. If your lining is thin, we already have ways to improve it using oestrogen therapy or adjusting the protocol.

Patient: So, what should I focus on instead of this test?

Dr. Malpani: Focus on what actually matters—ensuring good embryo quality, choosing a skilled IVF lab, and preparing your body for pregnancy. Don’t let clinics exploit your anxiety with expensive, unnecessary tests that don’t improve your chances of success.

Patient: That makes me feel a lot more empowered. Thank you, Dr. Malpani.

Dr. Malpani: I’m glad to hear that! If you’d like a second opinion, you can fill out the form on our website with your reports, and I’ll provide a free second opinion here. For direct advice, you can also book a video consultation with me for ₹ 3000/-. This could help ensure you’re on the right path and potentially save significant costs in the long run.

The Endo Comprehensive Panel (Histopathology Report) is marketed as a way to check implantation potential, but Dr. Malpani debunks this as a useless and misleading test in IVF.