Expert: Scott Roseff, MD, FACOG - 5/12/2004

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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