The Potential Role of Endometrial Nerve Fibers in the Pathogenesis of Pain During Endometrial Biopsy at Office Hysteroscopy

Attilio Di Spiezio Sardo, Pasquale Florio, Loredana Maria Sosa Fernandez, Germano Guerra, Marialuigia Spinelli, Costantino Di Carlo, Marco Filippeschi, Carmine Nappi
Reproductive sciences (Thousand Oaks, Calif.) · 2014 · vol. 22(1) , pp. 124–131 · doi:10.1177/1933719114534536 · PMID:24807378 · PMC4527421 · W2109730098
article OA: bronze CC0 ⤵ 14 in-corpus citations
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-09 ⓘ

Endometrial nerve fibers are expressed in the functional layer and may contribute to pain during hysteroscopy, especially in women with endometriosis or adenomyosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective case–control study evaluated whether nerve fibers in the endometrium are present and may contribute to pain during office hysteroscopy biopsy in 198 cycling women undergoing infertility workup, stratified by reported procedural pain using a 0–10 VAS (0–5 vs >5). Endometrial samples were analyzed by morphology and immunohistochemistry for multiple nerve fiber marker proteins (including S100, NSE, neuropeptides, and neurokinin receptors), and several markers were immunolocalized at higher levels in the high-pain group and positively correlated with VAS scores. The prevalence of endometriosis and/or adenomyosis was also higher in the high-pain group, with the authors concluding that functional-layer endometrial nerve fibers may underlie biopsy pain particularly in women with these diagnoses. This paper is centrally about endometriosis and/or adenomyosis — it links higher endometrial nerve fiber marker expression and office hysteroscopy pain with increased prevalence of endometriosis and adenomyosis.

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Condition tags

endometriosis

MeSH descriptors

Adenomyosis Ambulatory Care Biopsy Endometriosis Endometrium Hysteroscopy Pain Adenomyosis Adenomyosis Adult Biopsy Case-Control Studies Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Humans Hysteroscopy

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