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 Hi. I am 33 and have a history of irregular cycles since puberty. My cycles started to become normal in length and amount of menstrual flow after many years but have always remained at irregular intervals of 6 weeks apart or longer. I was diagnosed with a luteal phase defect by a fertility specialist. I have had ultrasounds and blood work for my thyroid, prolactin level, and tests to make sure my immune system was not attacking the pregnancies which were all normal. I have no other medical conditions. I had a missed abortion last year at eight weeks and a recent chemical pregnancy. On Monday I started on Clomid. I had spotting for a week previously while waiting for my period to come. On ultrasound, my uterine lining was thin. The doctor said we would call the spotting a period since it could be awhile before I get a normal cycle. I am assuming the lining of the uterus would be thin a few days after the onset of menstruation, but I have heard that Clomid can cause the lining of the uterus to become thinner once you take it. Is that something that can happen, and if so, can something be given to help build it up more if necessary? Also, I have heard so much varying information about progesterone. Does Clomid usually normalize the hormones enough in someone with hormonal imbalance so that progesterone supplementation is not usually needed during pregnancy or is progesterone supplementation a good idea?
Thanks for your time.
Answer Hello,
Someone who has periods 6 weeks apart or longer has something else going on other than a luteal phase defect. It's not normal to go so long without periods, and a qualified RE should be able to give you a diagnosis (and proper treatment plan). A luteal phase defect generally causes menstrual cycles to be too short rather than too far apart....
Clomid, IF it's the right drug for you, can indeed thin out the uterine lining, which is why it's important to measure its thickness on ultrasound during the Clomid cycle (this IS being done, isn't it?). While some docs give estrogen to help thicken the lining, that's often not of great help.
IF Clomid "works" for you, then it usually helps progesterone levels to be high enough so as to obviate the need for supplemental progesterone.
Hope this helps,
Dr. Roseff, Director - Palm Beach Center for Reproductive Medicine
PERSONALIZED/Individualized Successful care by a Board Certified Reproductive Medicine specialist in a warm and caring setting.... Visit us in Wellington, Florida!
www.reproendo.com/different.htm
===============
Since I don't know your entire history and haven't examined you, any medical information given to you may be incomplete
or inaccurate. Therefore, Dr. Roseff and his staff can not be responsible for any actions taken or not due to the information contained within these communications. These communications are for educational and informational purposes only, and should never be used to replace the information and care rendered by your own doctor. No part
of this message may be reproduced, printed, or posted anywhere else without the express written authorization of Dr. Roseff.
===============
