Expert: Lawrence Jay Rappaport <B>M.D.</B> - 3/8/2006
Question Dr. Rappaport,
If I am ovulating every month, would you still recommend Clomid? I gather that Clomid is for those who are not ovulating or have irregular ovulation. I do not have this. I ovulate every month like clockwork. Unless Clomid can help me produce the best quality egg that will increase the progesterone level naturally? My problem is that I have low progesterone, is that an indication that I have poor quality eggs?
Thank you!
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Followup To
Question -
Hello Dr. Rappaport,
Thank you so much for answering my questions.
I am 31 in a couple of weeks and have a 3 year old. I recently had a miscarriage (a month ago) and has not gotten my period since. I have 2 questions:
1. My miscarriage was a missed one and thus induced by medication. Exactly a month ago. I have been taking my BBT for a week now and I have not notice a rise for ovulation. Should I be concerned?
2. From the progesterone level draws that I had during this past pregnancy, you concurred that I do have low levels of progesterone and will benefit from supplementation. Do you feel that taking progesterone supplements is safer then taking Clomid and hope for a healthier egg to produce higher progesterone on it's own? I am worried about another case of DES in 30 years if I take the progesterone supplement during pregnancy.
Thank you very much for your time.
Answer -
If your progesterone level is low, you will benefit from taking progesterone supplementation while you are trying to conceive and once you conceive. Once you conceive you should stop taking the progesterone when you reach 12 weeks gestational age. The progesterone supplementation has nothing to do with the Clomid you can take to help increase the probability of ovualtion. I would take both. They are both safe. If you had the miscarriage a month ago, you probably will not ovulate until two weeks after your next period. If you do not get your period in two months, ask your doctor to induce your period for you.
Answer If you are, indeed, ovulating every month, you do not need to take Clomid. Clomid interferes with the negative feedback mechanism in your hypothalamus which allows more FSH to be produced by your pituitary gland, thus increasing the probability of ovulation. If you are ovulating, Clomid will not be necessary. Clomid will not increase your level of progesterone nor will it produce "better" eggs. A low progesterone level does not mean that you have poor quality of ova.
