Endometrial Biopsy

  I have just been told that I have a low progesterone level and that after my tubes are checked my Gyn wants to put me on clomid. After the little research I have done, It seems that an endometrial biopsy should be done, however, doesn't my low progesterone level already tell us that I have "abnormal changes" before my menstrual cycle? Or is it necessary to find out why, and/or what abnormal changes occur before Clomid treatment?
Dear Sharon:
A mid-luteal progesterone measure is a screening test for luteal phase deficiency. This means that following ovulation, there is a less than expected amount of hormone to prepare the lining of the uterus to be a nourishing tissue to host a fertilized egg. The "gold standard" test is an endometrial biopsy: many physicians react to the progesterone level rather than putting patients through a biopsy because you need to repeat the test used to make the diagnosis after starting treatment.
Luteal phase defect, like many things is medicine, can be diagnosed without us fully understanding why it happens. (Analogy: we do not know the cause of diabetes but we can diagnose and treat the condition). Clomiphene is a standard treatment to correct luteal phase deficiency.
Keywords: low progesterone; luteal phase deficiency
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please contact your physician.