4th IUI negative, one miscarriage, what to do?

[babybb83]

I am 31 years old with unexplained infertility. I have a lot of cysts on both ovaries (30+ on each is what they tell me) but my 21 day progesterone showed that I do ovulate so I don't have PCOS according to my RE. Everything else in my work up was normal (AMH slightly elevated, testosterone slightly elevated but RE says not enough to be concerned). My husbands sperm analysis was normal.

We just had our 4th IUI and I found out yesterday that it was negative.

Our first IUI was with 50mg Clomid (18mm follicle, triggered on Day 17, IUI Day 18) BFN

Second IUI we increased to 100mg Clomid (15mm follicle and 20mm follicle, triggered on day 14, IUI day 15) BFP, betas doubled but had a miscarriage at 5 1/2 weeks, took a month off

Third IUI we stayed with 100mg Clomid (23 mm follicle, triggered day 13, IUI day 14) BFN

Then we switched to Femara 5mg and I had "no response" (besides the 30+ immature follicles on each ovary)

Fourth IUI went back to the 100mg Clomid (18mm follicle and 24mm follicle, triggered day 12, IUI day 13) BFN

My RE feels like since it's worked once it should again but I'm pretty frustrated today. He told me last month that he typically doesn't use injectables with his patients who have a response to Clomid or Femara. And he also said that Femara is typically stronger than Clomid so he is not sure why I didn't respond. Anybody have any advice or personal experience on this?

 

[k4th]

Hi - I'm so sorry to hear your iui didn't work this time around. & even sorrier to hear about your miscarriage.

I have diagnosed pcos. I have cysts on ovaries, some mild acne & irregular periods. My lh levels are also double my fsh on early cycle blood tests. I'm not sure I really understand why you've been so conclusively ruled out as far as pcos is concerned. Not that it matters if you're getting treatment - but do you know what your lh/fsh levels were on blood tests?

I've had 3 rounds of clomid at 50mg and all bfn. Not iui or monitored. I'm just about to go up to 100mg on monitored cycles. I saw one guy for the first prescription but saw the "head" consultant for my recent consultation.

Is there any way you can get a second opinion? Your RE can't be thinking of staying on clomid indefinitely???!! My consultant reckons I can only have 3-6 rounds of clomid after they've found the right dose. What are his/her thoughts longer term? (Although hopefully you won't need anything longer term!).

I can understand your frustration. Ask some more questions & push harder for answers if you need to. And get a second opinion if you're not 100% sure that this RE is making the right decision for you. And don't be afraid to let yourself feel cr*ppy for a little while - you need that before picking yourself up for another cycle. It's such an emotional rollercoaster isn't it???

Are you back on clomid & iui next cycle?

 

[babybb83]

Thanks for your response. I didn't have LH or FSH levels drawn. He said that the only reason PCOS causes infertility is that it causes people not to ovulate. So since I do ovulate, I don't have PCOS. And apparently, either way, it doesn't change what they recommend for treatment. I personally think I am a weak ovulator because of all of those cysts but who knows.

The plan right now is another month of clomid and IUI and then I will meet with him and discuss the next step if that is negative. And I'm assuming the next step is IVF. It is such a rollercoaster!

Good luck to you!!