A biopsy is often necessary when there is a need to examine tissue for abnormal cells, such as in cases of abnormal uterine bleeding, suspicious lesions, or thickening of the endometrium. It helps in diagnosing conditions like endometrial hyperplasia, cancer, or chronic endometritis. Procedures like endometrial biopsy, colposcopy-guided biopsy, or laparoscopy can be employed depending on the suspected condition.