Abstract

Endometrial biopsy and histology are required for diagnosis of conditions that can lead to infertility such as endometrial hyperplasia, endometritis, and neoplasia. A novel technique for ultrasound-guided endoscopic transcervical endometrial biopsy (TCEB) is described in four non-human primate species and a southern tamandua (Tamandua tetradactyla). A 1.7-mm or 2.7-mm rigid endoscope (KARL STORZ Endoscopy-America Inc., El Segundo, CA, USA) is inserted through the cervical os for visual examination of the endometrium. Transabdominal ultrasound guidance is used to biopsy the endometrium with endoscope biopsy forceps. Ultrasound is used to evaluate for complications of the uterus and peri-uterine abdomen, such as hemorrhage. Rigid endoscopy TCEB confirmed processes such as endometritis, endometrial polyp, and normal cycling. Diagnostic biopsies were obtained in primates as small as a capuchin monkey (Cebus capucinus), though crush artifact using the 1.7-mm scope limited subtle cellular details. Subsequent histologic evaluation of three biopsied uteruses showed no lasting lesions secondary to biopsy. Although no complications with this technique occurred in these cases, potential risks include excessive uterine hemorrhage, infection, or possibly uterine perforation. Therefore, the use of sterile technique and ultrasound guidance are recommended. Current population sustainability challenges for many of AZA’s breeding programs may benefit from this technique to diagnose subclinical conditions at an earlier, more treatable stage.

Acknowledgments

We thank the Denver Zoo animal care and veterinary staff.