I'm seeking some advice or direction and am hoping you can offer some.

I am 32 and have never been pregnant. My husband is 46 and has 2 adult children from a previous marriage. I had my first period at age 9, almost 10, and did not get it again for just over a year, when I started every other month for 9 mos. I started mensturating monthly with a fairly heavy flow by age 12. When I was 20 I began having an extra period. I only allowed this to happen for a couple months before I sought out my doctor and he put me on BCP. At that time I visited with an internal specialist who measured my testosterone level, which was high. It was lowered with the BCP. I have had my testosterone measured from time to time since and it has always been within the normal range. I do have some light facial and belly hair, but it is common with the women on both sides of my family. The internist mentioned possible PCOS but never did anything more about it because I was not trying to conceive.

Since coming off the pill 7 years ago, I have been very regular. I do feel some sharp pains mid-cycle in the area of my ovaries, usually always on my left side and not usually on my right. From time to time I feel similar pains during my period. My cycle is usually 24-28 days. I've had them as short as 23 days and as long as 32, but usually I'm around 26 days. I have a heavy flow days 2 & 3, and often day 3-4 I will feel a cramp then pass large clots. I have noticed that my periods sometimes last a full 7 days and other times are only 5 days. I tried to see if it was one side or the other but have had two shorter periods in a row, and usually the shorter periods are lighter than the longer with less cramping. I have had the HSG, horomonal testing, vag ultra-sound (with a few small cysts found), even a 17-OHP.

I was treated with 6 cycles of ABVD chemotherapy for Hodgkin's disease 10 years ago. My oncologist does not think the ABVD chemo is the culprit, and neither do I, but who knows? I was 22 when diagnosed with Hodgins. I do sometimes wonder if the ifertility and Hodgkins are related in terms of my immune system, which is good.

I live in South Dakota and my options here are very limited. I see a great gynecologist, who is very good, but he's stumped, too. I'm at the point where I just want to know why I can't get pregnant. I just need an answer. I'm thinking about reproductive immunology next, but have seen quite a bit about endometriosis, and also wonder about atypical PCOS.

Any insight, further direction, testing, etc, you can offer would be greatly appreciated. Many thanks for your time.