Expert: Scott Roseff, MD, FACOG - 11/25/2002

Question
I am 26 years old without major health problems diagnosed with infertlity in May due to anovulation. All of my fertility hormones were normal although my testosterone was high normal. I was started in clomid 50mg without ovulation then 100mg with a successful pregnancy which resulted in a miscarriage at 7 weeks. I had to take provera to resume my periods after it did not show for 7 weeks. This past month was my second round of clomid at 100mg.  On cycle day 23 my progesterone level was 10!  (This is the same as it was when I conceived.)  But I did not get pregnant this time.  Why could this be? Should I even waste my time doing another cycle?  Is there a cap on the number of time one could use clomid? Was it too soon after my miscarriage to try again?  I am looking for an explanation any information you can provide to me will be helpful.

Also I have read a few things about an herb called vitex.  Can you tell me what you think about this herb?

Answer
Hi Kim,
Sorry to hear about your loss :(

To answer:
Why could this be?
==> If everything is "perfect", it doesn't guarantee you will conceive on Clomid that cycle.

Should I even waste my time doing another cycle?
==> Since you're not my patient, I can't tell you if you should continue on your present course or not.  The only way I could tell you would be after a consultation here and review of your records.  You're certainly welcome to do so.

Is there a cap on the number of time one could use clomid?
==> Most women conceive within an average of 3-4 cycles.  Also, we "cap it out" after about 6 cycles or so, due to the report about increased ovarian cancer rates in women who took Clomid for prolonged periods of time (which I'm sure your doctor discussed with you).

Was it too soon after my miscarriage to try again?
==> I have my patients wait at least a month after miscarriage to try again.

Given the fact that you're not ovulating regularly, along with the fact that you lost your pregnancy, I HIGHLY recommend you seek the advice and care of a qualified reproductive endocrinologist.  Again, you're welcome to do so here.

Dr. Roseff, Director WECARE in NJ
Visit us at www.reproendo.com