Dear Professor Winston,
I am 33, my AMH levels are reported to be 20 pmol/L, I have Rheumatoid Arthritis, but it is in remission and has been for 5 years. (Positive ANA is only significant findings on my blood tests.) We were having no luck with natural conception and after 1 year of trying, we have seen a fertility specialist who has done a Hysteroscopy, Laparoscopy, Semen analysis, Karyotype testing and Ultrasound (all attached, Karyotype was normal). Everything looked normal on the hysteroscopy and ultrasound however the Laparoscopy revealed that one of my tubes was blocked and the other was very sluggish using the blue dye test, which she says is the most likely cause of my infertility. I have no history of STDs, Pelvix inflammatory disease, severe endometriosis, fibroids, cysts or polyps. My doctor has prescribed me Letrozole for 5 days and I will be having a trigger shot around day 13/14 for the next few months. If no success after 3 months, then she said we will need to go to IVF.
After reading many of your Q&As and wise words about IVF clinics, I was wondering if you think my doctor is doing the right course of treatment and whether there is anything else that she should be testing for prior to IVF e.g. FSH etc.? Also, if we do fall pregnant in the next 3 months and are planning for a second is it better to try sooner rather than later and would you recommend we go straight to IVF using frozen embryos, or do a fresh cycle even though I will be older or continue to try naturally again (and for how long before seeking help?)? I had originally thought it would be better to go straight to IVF for our first and use a frozen egg later on but having read your information I have concerns about the success rates of frozen embryos.
I would be grateful for your advice.
Best wishes,
L