Infertility/Fertility/2 miscarriages


QUESTION: Dr. Roseff,

I emailed you in the past. I am 31 yr old female. Husband is 40 yr old. We are married for 2 years. I got pregnant 2 times spontaneously but the first one ended up as a blighted ovum and the second one lead to an ectopic pregnancy that resulted in tubal abortion. I had a key hole surgery and my tubes were fine.

My lab work is as follows- fsh -8.7, lh 4.1, amh- 4.5, hsg - patent.

Husband's semen analysis- 2ml, 60 million, 70% motile, 69% normal morphology.

My BMI IS 32. I am overweight by 40 pounds- 5ft 4" and 180 pounds.

Is my overweight causing poor quality eggs that are not developing properly. Will losing weight improve my shot at getting pregnant successfully.

Also my fsh was 10.27 1 year ago and it dropped down to 8.7. I used metformin 500mg bd for about 6 months.

I look forward to you advice.



ANSWER: Obesity can cause all types of problems, including poorer eggs/sperm.  An AMH of 4.5 (at least in the U.S.) is considered normal, and I would believe it to be more accurate for eggs compared to an FSH level.

Hope this helps,
Dr. Roseff in FL, USA

---------- FOLLOW-UP ----------

QUESTION: Thanks. How much weight should I lose and how soon can I lose the weight.

Is rapid weight loss a dangerous thing?

How soon after the weight loss can I expect spontaneous ovulation??

I noticed that after using metformin my fsh lowered from 10.27 to 8.7 and cycles reduced from 42 days to 35 days.

How much weight should I lose and how soon can I lose the weight.
==> I suggest a BMI under 30, if possible.

Is rapid weight loss a dangerous thing?
==> Yes.

How soon after the weight loss can I expect spontaneous ovulation??
==> It's impossible to predict.

Hope this helps,
Dr. Roseff in Florida, USA


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Scott Roseff, MD, FACOG


I can answer questions relating to ALL aspects of female infertility.


I am Board Certified in Reproductive Endocrinology/Infertility.

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

Please be so kind as to see my CV at: or

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.

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