QuestionHello. I am 27 years old and my husband and I have been trying to get pregnant for 4 years. We have recently begun fertility treatments, but, after numerous tests, neither my husband or I have any diagnosed fertility problems. Last month we did an IUI after I detected my LH surge with OPK. We were not successful. This month I took 100mg of Clomid from days 3-7 and then IUI after I detected my LH surge. My period has arrived 3 days early. Is this typically normal after taking Clomid? In your experience is Clomid and IUI usually successful for undiagnosed infertility? How long does it usually take to achieve pregnancy with Clomid and IUI? Thank you.
AnswerHello Christine from Canada,
"Undiagnosed infertility" means that the cause has not been found, which implies that you either have not done all the testing or there is no testing available to find out what is wrong. In a lot of my patients that have tested negative on almost all the basic tests, laparoscopy reveals that endometriosis is present in the pelvis or there is pelvic scar tissue. In some patients, there is an immunological disorder or a sperm-egg interaction disorder that is not found. IUI is a good "natural" treatment to try, and often the treatment of choice by general Ob/Gyn docs because that is the maximum that they can do. It is "natural" in the sense that it still relies on your body to go through all the 9 natural steps it takes to become pregnant. The only advantages are that more than one egg is ovulated per cycle, the timing is better and the sperm is placed where it needs to be to meet the egg. The fault could still lie in the egg getting to the tube, fertilization, embryo development, passage into the uterus, embryo hatching or implantation. The only statistic I can give you is your chances of pregnancy based on your age, which is a maximum of 24% per cycle. Most (almost 90%) will be pregnant by four attempts. Unfortunately, I don't know of a statistic that breaks it down by cause or lack of cause of infertility. If you don't get pregnant by four cycles, then there is a problem that has not been diagnosed that is preventing pregnancy. I usually will then recommend proceeding to IVF because IVF will bypass and insure most of the steps except for the last two.
I know in Canada, because of the socialized medical system, you are not at liberty to go see any specialist without a referral, but I think that is where you need to go at this point.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
