QuestionHello and thank you for answering my question. I am a 26 year old female with one child. My husband and I have been trying for a second baby for about 2 years. I went through all of the testing for infertility and the RE told me that we had unexplained infertility. For the last three months we have been on 50 mg of clomid (because 100mg produced to many eggs) Ovidrel, IUI, and prometium so far we have been unsuccessful. My question is are we doing the right thing or am I just being impatient? Should we go to IVF or do we have more treatment options?
AnswerHello Kristin from the U.S.,
My first question to you is, did you have a laparoscopy? There is a high possibility that the reason why you are not getting pregnant is that you have endometriosis. In my experience, most patients who have no other explainable reason to not get pregnant, have endometriosis. If you did have a laparoscopy and that was not found, then you truly have "idiopathic" or unexplained infertility. Something is going on but we just do have the testing to find out what it is at this time.
The general recommendation with IUI is to do up to four IUI cycles. If that is not successful then the pregnancy rates drop drastically so it is recommended to proceed to IVF from that point. Of course, you can proceed to IVF sooner if you wish. There is no reason not to other than finances. So the bottom line is you can try one more IUI cycle, and if that is not successful, then proceed with IVF. If you have not had a laparoscopy then you have the option of doing the laparoscopy (an outpatient surgery) with the hopes of detecting and treating the endometriosis (or other possible pelvic abnormalities), then resume four more cycles of IUI, or not do the laparoscopy and proceed directly to IVF, since IVF bypasses the pelvis.
I hope this helps,
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 facebook and twitter with me at @montereybayivf
