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 have had 6 failed IUIs but responded well to clomid & Follistim (based on follicles numbers and E2 levels). I did my first IVF cycle and had 9-10 follicles and an E2 over 1000. At the retrieval there were only 3 eggs. My RE says the other follicles were empty and that's why I haven't gotten pregnant in the past. I am wondering:
1. Why is this condition more prevalent in thin women? (as my RE stated). I am 5 ft; 103 lbs.
2. Could this mean that my egg reserve is low? I am 29.
3. Would a change in protocal possibly produce more eggs? I did Lupron two weeks, then dropped to half the dose when I started Follistim, 3 vials for 3 days, 2 vials for 7 days.
4. Another REs site states that there are no empty follicles, just that the doctor fails to find the egg. Could this be true?
I greatly appreciate any light you can shed on the subject. I had prepared myself for the worst, but I never anticipated this occurring.
Answer Hi Morena,
Since our IVF pregnancy success rates are amongst the highest in the world, and since many women come here from other states and countries to undergo IVF, I feel highly qualified to answer your questions (about IVF and empty follicle syndrome).
1. Why is this condition more prevalent in thin women? (as my RE stated). I am 5 ft; 103 lbs.
==> It's not. In fact, it may be more prevalent in heavy women and certainly is seen more often in older (>40) women.
2. Could this mean that my egg reserve is low? I am 29.
==> Our average IVF patient has peak E2 levels in the 2,000+ range. How high over 1,000 was your level? What did your cycle day 3 FSH/E2 ovarian reserve test show? How long ago was it done?
3. Would a change in protocal possibly produce more eggs? I did Lupron two weeks, then dropped to half the dose when I started Follistim, 3 vials for 3 days, 2 vials for 7 days.
==> At W.E. C.A.R.E. we HIGHLY individualize/personalize every patient's drug protocol. Without reviewing your records of your cd3 testing and failed IVF cycle, it would be impossible for me to say what protocol might be best tailored to you.
4. Another REs site states that there are no empty follicles, just that the doctor fails to find the egg. Could this be true?
==> Most RE's believe that there is such a possibility as having a follicle develop without an egg inside of it (and so there is an empty follicle syndrome). However, the most common likelihood of not getting an egg out at retrieval (assuming the patient took enough of an hCG shot), is failure of the egg to release from its attachment inside the follicle.
Hope this answers your questions -- If you would like to undergo a second opinion here, or want an expert review of your records performed, please let me know.
For comparison sake, you may want to view our updated IVF success rates at www.reproendo.com/pages/ivf_success.htm
