Is having conceived before a sign that things are open?

[Daffodil]

Hi,

I've had a couple of HSGs and both showed that tubes were open. However I can't seem to figure out a reason for my infertility. Everything is coming up rosey. (all testing including the sonohysterogram and all bloodwork, etc.) I have PCOS but even when I'm ovulating I still don't get pregnant. I'm wondering if maybe I have excessive scar tissue from prior abdominal surgeries - maybe the tubes are open, but maybe there is scar tissue between the ovary and the tube? However, my RE doesn't think so because I've had a couple of chemical pregnancies and said those wouldn't have occurred if that were the case. Is this true? I can't seem to find anything online about it.

Frustrated.

[Scott Roseff MD]

Sorry to hear you're frustrated. I HIGHLY doubt there's nothing wrong with you and your partner. For example, you have PCOS, but were you tested for insulin resistance? Did you have two hour glucose tolerance and insulin testing done?

Was your partner's sperm DNA function testing done? What was his strict/Kruger sperm morphology?

You said you had chemical pregnancies, meaning you've lost more than one pregnancy. That constitutes a diagnosis of "recurrent pregnancy loss". What did your RPL workup show as a reason for the losses?

Dr. Roseff in Florida

[Daffodil]

I am not insulin resistant; however my testosterone was high so I am on 1000mg Metformin. That has lowered it rather quickly, and now my testosterone level was 23...it *was* 79. I've only been on Metformin for a few months.

Hubby's semen analysis was perfect. I don't know if they tested DNA fragmentation. I will ask about that, thanks.

I haven't had any RPL workup. They don't really count the chemical pregnancies as losses. I was just told they're extremely common.

[Scott Roseff MD]

If sperm DNA fragmentation is high, it can lower the odds of getting pregnant and significantly increase the risk of miscarriage if someone tries to conceive on their own.

Sorry to disagree, but the American Society for Reproductive Medicine states that RPL is the failure of two or more pregnancies. You can read their official definition HERE.

Hope this helps,
Dr. Roseff in Florida