Infertility/Fertility/Clomid Challenge Test

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Question
Hi Dr. Roseff,
 I asked you a question a month ago and you suggested that I make an appointment with an RE to get further diagnostic help.  My background is Ectopic pregnancy in April 2003 (got pregnant third month of trying on our own) saved both tubes.
Started on 50mg's of clomid suggested by my OB, got pregnant In November 03 and miscarried at 7 weeks.  Progesterone one week after ovulation with this pregnancy was 30 and at four weeks was 40.  (I think pretty high).
Continued on 50mgs of clomid and got pregnant again in March 2004 only to miscarry at 5 weeks, my progesterone with this pregnancy one week after ovulation was 11.9, didn't get progesterone at 4 weeks pregnant.  
   My RE has suggested quite a bit of testing, but the one that concerns me most is the clomid challenge test.  I thought that the clomid challenge test was for women who didn't respond well to clomid and I think my November pregnancy was a good response.  Do you have any idea why she wants to perform this test and what my statistics may be regarding having "poor egg quality"?  I am 33 years old, regular cycles, ovulate on my own without the clomid, etc.  
  As you can probably tell, the idea of the clomid challenge test is completely freaking me out and scaring me.  I can't do the test for another month and one-half because I just had my miscarriage and can't take clomid until my second cycle.  
    If you have any ideas on how my history may relate to my egg quality, it would be greatly appreciated.  By the way, thank you for your advice to go to an RE, she was very knowledgeable and thorough.  Thanks again, Heidi

Answer
Hi Heidi,

While I can't speak for your doctor, and therefore can't "get into her head" and tell you why she wants you to undergo a Clomid challenge test (CCCT), I can generalize.  One reason for recurrent pregnancy loss is poor eggs.  A 33 year old woman with regular menstrual cycles who conceives fairly easily and has great progesterone levels may have poor egg quality or quantity or both.  Why don't you ask her to tell you why she wants you to do the CCCT?

Hope this helps,
Dr. Roseff - Director of W.E. C.A.R.E. in West Orange, NJ
Personalized/Individualized Successful care by a solo practice specialist
in a warm and caring setting....
www.reproendo.com
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Infertility/Fertility

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Scott 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
Please be so kind as to see my CV at: www.reproendo.com

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.

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