AboutScott Roseff, MD, FACOG Expertise I can answer questions relating to ALL aspects of female infertility.
Experience I am Board Certified in Reproductive Endocrinology/Infertility.
Organizations Medical Advisory Board, Serono Labs, Inc.
Speaker's Bureau, TAP Pharmaceuticals, Inc.
The American Society for Reproductive Medicine
American Association of Gynecologic Laparoscopists
The International Society for Gynecologic Endoscopy
The Society of Laparoendoscopic Surgeons
The International Federation of Gynaecologic Endoscopists
U.S. International Foundation for Studies in Human Reproduction, Inc.
The Endometriosis Association
Fellow, The American College of Obstetricians & Gynecologists
American Medical Association
The Academy of Medicine of NJ
NJ Obstetrical & Gynecological Society
The NY Reproductive Medicine Society (Steering Committee)
The Society of Reproductive Endocrinologists
Resolve - National Chapter
Resolve - New Jersey - Executive Board
Publications Kettel LM, Roseff SJ, Berga SL, Mortola JF, Yen SSC. Hypothalamic-pituitary-ovarian response to clomiphene citrate in women with polycystic ovary syndrome. Fertil Steril. 1993;59:532-8.
Fischer UG, Wood SH, Bruhn J, Roseff SJ, Mortola JF, Rivier JE, Yen SSC. Effect of human corticotropin-releasing hormone on gonadotropin secretion in cycling and postmenopausal women. Fertil Steril. 1992;58:1108-12.
Kettel LM, Roseff SJ, Bangah M, Burger HG, Yen SSC. Circulating levels of inhibin in pregnant women at term: simultaneous disappearance with oestradiol and progesterone after delivery. Clin Endocrinol. 1991;34:19-23.
Kettel LM, Roseff SJ, Chiu TC, Bangah ML, Vale W, Rivier J, Burger HG, Yen SSC. Follicular arrest during the midfollicular phase of the menstrual cycle: a gonadotropin-releasing hormone antagonist imposed follicular-follicular transition. J Clin Endocrinol Metab. 1991;73:644-9.
Roseff SJ, Kettel LM, Ulmann A, Bangah ML, Rivier J, Burger HG, Baulieu E, Vale W, Yen SSC. Accelerated dissolution of luteal-endometrial integrity by the administration of antagonists of gonadotropin-releasing hormone and progesterone to late-luteal phase women. Fertil Steril. 1990;54:805-10.
Roseff SJ, Murphy AA. Laparoscopy in the diagnosis and therapy of chronic pelvic pain. In Clinical Obstetrics and Gynecology. JB Lippincott Co., Philadelphia. 1990.
Roseff SJ, Murphy AA. Pelviscopy. In Manual of Endoscopy, by the American Association of Gynecologic Laparoscopists, Edited by DC Martin, GL Holtz, M Wenof. Santa Fe Springs. 1989.
Roseff SJ, Bangah M, Kettel LM, Vale W, Rivier J, Burger HG, Yen SSC. Dynamic changes in circulating inhibin levels during the luteal-follicular transition of the human menstrual cycle. J Clin Endocrinol Metab. 1989;69:1033-9.
Roseff SJ, Bernard JM. Seasonal changes in carbohydrate levels in tissues of Carex lacustris. Can. J. Bot. 1979; 57:2140-44.
Education/Credentials Postgraduate Fellowship training in Reproductive Endocrinology & Infertility was done at The University of California, San Diego, School of Medicine.
Awards and Honors Mellon Fellow in Reproductive Endocrinology and Infertility, 1988, awarded for academic excellence in the Reproductive Sciences, for research efforts aimed at development of novel contraceptives.
Wyeth Service Award for Physician Education and Training in Norplant Contraceptive Implants.
Certificates of Service and Appreciation from Our Lady of Mercy Medical Clinic, Guadalajara, Jalisco, México, 1978-1982.
Question I take natural bio-identical progesterone cream from day 14-18 of my cycle, but something seems to be off and not only did I have a 12 day period last cycle, but when I began taking the cream again, on day 22 I began to see a brown spotting.
Usually once I see this I stop the cream and wait 14 days to start again, but this time I am confused. Is this due to a lack of progesterone? If so, should I take the cream until day 28 or until the brown becomes a regular period?
Or is this from too much progesterone? I get the progesterone from a compounding pharmacy and it is metered in serenges, so that I take the right amount twice a day...
I am concerned that I won't be able to get pregnant if this keeps up and I want to understand how to know what is going on a little better.
Thank you!
Answer Hi,
Several pharmaceutical companies produce "natural", bioidentical vaginal progesterone supplements, and these are strictly controlled by, and overseen by, regulatory agencies to assure the quality of those products. So, when they say they contain a certain amount of progesterone per application, one can be assured they are getting what they are supposed to be getting.
Pharmacies that compound their own progesterone vaginal products do so potentially without the same quality control and oversight, so one can't be absolutely certain they are getting what they are supposed to be getting. IF this is the case, then one can imagine that unexpected bleeding may occur.
IF someone is ovulating on cycle day 16, then starting progesterone on day 14 can "throw a total wrench" into the system, as starting it before ovulation is not appropriate. Finally, if it's being prescribed due to a hormone imbalance, just taking progesterone alone sometimes is not the best treatment for the condition, and correcting the underlying abnormality may be more effective.
If you're not seeing a board certified RE, consider doing so.
I hope this helps,
Dr. Roseff, Director - Palm Beach Center for Reproductive Medicine
PERSONALIZED/Individualized Successful care by a Board Certified Reproductive Medicine specialist in a warm and caring setting.... Visit us in Wellington, Florida!
www.reproendo.com/different.htm
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Since I don't know your entire history and haven't examined you, any medical information given to you may be incomplete or inaccurate. Therefore, Dr. Roseff and his staff can not be responsible for any actions taken or not due to the information contained within these communications. These communications are for educational and informational purposes only, and should never be used to replace the information and care rendered by your own doctor. No part of this message may be reproduced, printed, or posted anywhere else without the express written authorization of Dr. Roseff.
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