u/Successful-Worry9426

Hi everyone, very long post ahead . Please help me if you can 🙏

We started trying towards the end of 2024.
My husband and I are both 32 and trying to decide whether we should continue trying naturally, do 1–2 more IUIs, or move to IVF.
Here is my history:
I have polycystic ovaries (AMH 11.9, very high follicle count), but my periods are regular.
I have mild insulin resistance and take Metformin+ Myo-Inositol and folic acid.

I ovulate regularly, either naturally or with Letrozole.
My first pregnancy ( may 2025) was conceived naturally and ended in a missed miscarriage. At the 8-week scan, there was no heartbeat.

After that, we were rushed fairly quickly to fertility treatment rather than trying naturally again. ( going to change this doctor now as i feel her approach is very rushed.)

I have completed 2 IUIs:
IUI #1 resulted in a chemical pregnancy. ( March 2026)
IUI #2 was unsuccessful.
All my blood work seems normal .
My HSG showed that my left tube is fully open and patent.
My right tube is considered “doubtful,” but contrast spillage was seen, so it is not completely blocked.
My first natural pregnancy likely came from ovulation on the left side.

My husband’s semen analysis is generally good 98 mil/ml) , but progressive motility is around 20%.
In IUIs- his post wash numbers were 58 mil/ml, 100% motility, 1% morphology. 75 % viability.

My fertility specialist feels we can try:
A few natural cycles again (with or without Letrozole),
1–2 more IUIs,
And then start considering IVF if needed.

Since I know I am able to conceive naturally, my biggest issue seems to be either achieving consistent fertilization or sustaining the pregnancy.

My questions:
If you were in my situation, how many more natural cycles would you try?

Would you do 1–2 more IUIs given the prior chemical pregnancy?

At what point would IVF make more sense?
Since I’ve already conceived twice, should I even go for another IUI or start with IVF?

We both are working tremendously on our lifestyles and overall health .

I’d especially appreciate hearing from anyone with PCOS/high AMH, mild male factor (low motility), prior miscarriage, and a history of both natural conception and chemical pregnancy.

Thank you so much.

Hi everyone, very long post ahead . Please help me if you can 🙏

We started trying towards the end of 2024.
My husband and I are both 32 and trying to decide whether we should continue trying naturally, do 1–2 more IUIs, or move to IVF.
Here is my history:
I have polycystic ovaries (AMH 11.9, very high follicle count), but my periods are regular.
I have mild insulin resistance and take Metformin+ Myo-Inositol and folic acid.

I ovulate regularly, either naturally or with Letrozole.
My first pregnancy ( may 2025) was conceived naturally and ended in a missed miscarriage. At the 8-week scan, there was no heartbeat.

After that, we were rushed fairly quickly to fertility treatment rather than trying naturally again. ( going to change this doctor now as i feel her approach is very rushed.)

I have completed 2 IUIs:
IUI #1 resulted in a chemical pregnancy. ( March 2026)
IUI #2 was unsuccessful.
All my blood work seems normal .
My HSG showed that my left tube is fully open and patent.
My right tube is considered “doubtful,” but contrast spillage was seen, so it is not completely blocked.
My first natural pregnancy likely came from ovulation on the left side.

My husband’s semen analysis is generally good 98 mil/ml) , but progressive motility is around 20%.
In IUIs- his post wash numbers were 58 mil/ml, 100% motility, 1% morphology. 75 % viability.

My fertility specialist feels we can try:
A few natural cycles again (with or without Letrozole),
1–2 more IUIs,
And then start considering IVF if needed.

Since I know I am able to conceive naturally, my biggest issue seems to be either achieving consistent fertilization or sustaining the pregnancy.

My questions:
If you were in my situation, how many more natural cycles would you try?

Would you do 1–2 more IUIs given the prior chemical pregnancy?

At what point would IVF make more sense?
Since I’ve already conceived twice, should I even go for another IUI or start with IVF?

We both are working tremendously on our lifestyles and overall health .

I’d especially appreciate hearing from anyone with PCOS/high AMH, mild male factor (low motility), prior miscarriage, and a history of both natural conception and chemical pregnancy.

Thank you so much.