@FeatherFeather11
Hello,
I'm 34 and my partner is 39. We've been trying to conceive since September 2011 to no avail. In 2007, I had my right Fallopian tube removed as emergency surgery - it had twisted on itself several times but it wasn't and ectopic. Last December, After lots of tests, both me and him, all came back fine (great sperm count, great egg reserves) except for the fact that I was diagnosed with pcos. I have very irregular periods (ranging from 8 day cycles to 54 days in the last year) I was on clomid from February this year for five months - first month 50mg, then on to 100mg. I ovulated twice in that time (using a trigger shot). Have taken a break from clomid and just went back on last week at 150mgs. My grist scan is on Friday to see if I've responded.
My question is: is it worth giving iui or injectibles a try before moving on to IVF? Or is the one Fallopian tube/pcos a straight sentence to the IVF cave? Really would like to try all other options before doing IVF as it just feels so invasive.
Also, is there any point in requesting I be put on metformin or femara?
Many thanks!
Feather
Mr Priddy responds:
There appears to be 2 problems making it difficult for you to conceive, you have 1 tube and have PCOS with irregular cycles such that you are not ovulating. Despite using clomid treatment for 5 months it appears you only ovulated in 2 months.
I agree with you that IVF should be a last resort.
You have not mentioned the option of laparoscopic ovarian drilling/diathermy, which is the most appropriate treatment at this time. It would be of benefit to you as it would check whether your remaining left tube is open/patent. Also it will treat your PCO and has an 80% chance of making you ovulate consistently (without clomid).
If you are ovulating regularly and your tube is open, you have a much better chance of conceiving naturally.
In addition it is unusual to have a spontaneous twisted tube, as you had on the right. The laparoscopy will also carefully check the left tube and look to see if it is normal or if you have a left para-fimbrial cyst which could make it more likely for the tube to twist (and the cyst can be treated). A hysteroscopy can be done at the same time to check the uterine cavity is healthy for embryo implantation.
I would not recommend IUI (as you only have 1 tube). Also FSH injections have potential side effects (including ovarian hyperstimulation syndrome and multiple pregnancy), are expensive and require regular ultrasound scan monitoring, so I would instead recommend laparoscopic ovarian drilling.
Patients who have only 1 tube such as after an ectopic, and are ovulating, can still conceive. Therefore I would recommend you try for 6-12 months after the laparoscopic ovarian drilling, before considering IVF.
If you are ovulating on clomid alone or in future with laparoscopic ovarian drilling, there is no need to take metformin/femara as well. However if the clomid at a dose of 150mg is not working, using metformin as well as clomid, has been shown to be more helpful in causing ovulation.
I wish you every success.