next step?

[iheartamerica]

Hi,

I have a quick question regarding what step to take next in my treatment/testing for IF issues.

I'm 27 and currently TTC#2. I have not used birth control since having my son who is 18 months old. I weaned him four months ago. I have had regular normal cycles back for 13 months.

When trying to get pregnant with him, it took 13 cycles, an x-lap (revealing open tubes and mild endometriosis) and one round of clomid. I ovulate on my own, and all preliminary bloodwork has come back normal.

I do have a diagnosis of Ankylosing Spondylitis, for which I'm currently off of Humira treatment.

I have done one round of Clomid (I hyperstimulated) with my PCP, and she is now referring me to OB/GYN.

What should be the next step? My periods have been awful since having my son, complete with vomiting and unmanageable pain. Another lap?

My husband is active duty Marine Corps and will be deploying for 12 months in March of 2011, so we would really like to have our next baby before he leaves.

Thank you in advance!

[Scott Roseff MD]

If a woman ovulates regularly and normally on her own, then if she's placed on Clomid it can potentially PREVENT her from getting pregnant or cause a miscarriage...

Severe pelvic pain can be due to several things, including (and not limited to) endometriosis. If your doctor suspects you have endometriosis, then he/she should discuss the various conception options available to women with endometriosis (such as treatment of endo vs. "bypassing" the endometriosis and moving ahead with assisted reproduction).

I hope this helps,
Dr. Roseff

[iheartamerica]

Thank you for your prompt reply!

In general, have you found that for women with endo that IUI is generally sufficient to "bypass" the problem? Or is it a matter of bypassing the tubes that is essential?

[Scott Roseff MD]

It depends on the degree of endo. My mild endo patients typically do well with injectable fertility drugs/IUI (assuming all else is OK), while my moderate to severe endo patients tend to do best with IVF.

Hope this helps,
Dr. Roseff