clomid timing

[maggiech]

Hello, I have had 2 miscarriages at around 6-7 weeks, and have 2 healthy children. The first miscarriage was prior to my first child, and my second miscarriage was after the birth of my 2 kids. I had extensive lab workup which was all negative but haven't had genetic testing done on myself or the fetuses. I don't have issues getting pregnant, all 4 pregnancies were on the first try, but the recurrent miscarriages is what I am concerned about. I had low progesterone when I was pregnant with my daughter, and I ovulate late, often later than day 21. I am going to try again and was given clomid 50 mg with the hope of moving my ovulation up and having better egg quality. I was told to take it d5-9, but this cycle I am going to be out of town on days 17-20. My questions are this: 1. If I take it on days 3-7, does that make it more likely that I will ovulate early, hopefully before I have to be out of town? 2. What is the difference between taking it day 3-7 vs day 5-9, or is it just physician preference? I have read about possible higher incidence of twins day 3-7 but lower egg quality, which concerns me b/c of my miscarriages.
Thank yo very much for any assistance you can give me, I really appreciate it.

[Dr. Wisot]

Hi:

The timing of your ovulation is unpredictable on Clomid but it should be earlier if you take it days 3-7.

We have done it both ways 3-7 and 5-9 and found no difference in its effects.

Clomid can improve progesterone levels but does nothing to improve egg quality. A low progesterone level in a pregnancy that does not continue may be due to the fact that the pregnancy had a problem.

Good luck.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California