Never been pregnant after TTC for more than a year. One failed IUI and now confused about the next step
Hi everyone,
I’m 31 years old, and my husband and I have been trying to conceive for more than a year. Unfortunately, I’ve never had a positive pregnancy test or even a chemical pregnancy.
Here’s my history:
Age: 31
TTC: More than a year
AMH: 5 ng/mL
Regular cycles (~30 days)
HSG: Both tubes are open
Mild arcuate uterus (2 fertility specialists said this is not a concern)
Husband’s semen analysis is normal
Previously diagnosed with PCOS, but my recent ultrasound showed an AFC of 6, and my fertility specialist said my ovaries don’t currently have a typical PCOS appearance.
Thyroid and other routine fertility blood work are normal.
I underwent my first IUI with Letrozole, a trigger shot, and progesterone support. I developed multiple mature follicles, but unfortunately, the cycle failed and I got my period.
I recently sought a second opinion from another fertility specialist. She reviewed all my reports, performed another ultrasound herself, and said she doesn’t think I need laparoscopy or hysteroscopy at this stage. Instead, she advised me to spend the next 3 months focusing on improving egg and sperm quality with supplements, diet, and exercise, and then proceed directly to IVF instead of trying another IUI.
What worries me the most is that I’ve never been pregnant—not even once—despite having open tubes, a normal semen analysis, and no obvious abnormalities on my fertility work-up. It makes me wonder if there could be something hidden like mild endometriosis, fertilization issues, implantation problems, or egg quality issues.
Has anyone had a similar experience of:
Never getting a positive pregnancy test?
Open tubes and normal semen analysis?
First IUI failing but later conceiving?
Hidden endometriosis that wasn’t visible on HSG or ultrasound?
If you were in my situation, would you:
Try another IUI?
Go for laparoscopy/hysteroscopy?
Follow my doctor’s advice and focus on egg quality for 3 months before IVF?
I’d really appreciate hearing your experiences and advice. Thank you so much. ❤️