Dr Gordon,

Hi, and thanks for your work on here :-). Here is the situation....

I am 32, BMI of 20.7, no pregnancies, no known fertility issues, my husband has 1 child from a previous relationship.

We tried IUIs 4 times (2 clomid, 1 letrazole, 1 injectibles that was canceled due to me ovulating before IUI). Each time I had multiple follicles, but my lining was never over 6. During the last two IUIs, I was put on estrase vaginally and viagra vaginally, and my lining still never got over 6 and I believe it was actually closer to 5.

I had a HSG and 3D ultrasound, both were normal. My husbands sperm count was normal.

Day 3 testing
FSH 7.6
AMH 3.83
Hemoglobin A1C was 4.9

I am not sure what other values during day 3 would be used....

At my initial work up at the RE, he said I had 28 antral follicles which he suspected PCOS, but then said my blood work came back and he didnt think I had PCOS.

On to the current information...

I did a saline ultrasound and mock transfer, along with an endometrial biospy (that came back normal), on day 6. I was put on BCP for 3 weeks, the last 5 were overlapped with Lupron 10 units. I had some spotting during the last week of BCP and lupron, but never really had a period. I started stims 6 days after my last BCP, 2 vials menapor in the AM and 150 units of follistim in the PM and dropped the lupron to 5 units. On day 4 of stims, I went to RE for E2 and it was only 62, they dropped my lupron to 2.5 upped menapur to 3 vials and for that PM i did 300 units of follistim and the next night (yesterday) i did 225 units of follistim. Oh, and I have been doing 25 mg viagra vaginally 4 times a day.

Today, I went in for an ultrasound and my lining was only 4.2 :-(.... I have 4 follicles over 10 mm, and they said about 14 follicles total. Also, they said I have 1.2 mm of fluid in my uterus (which is completely new to me - even after 6 months of doing all these ultrasounds). My RE, basically told me that the fluid "may become a problem but wait and see" - that my lining "is a problem but we might just freeze my eggs and hope for the best next cycle". I know he hates me because I ask 50 questions, but I kept asking what we could do and finally he threw some estrogen vaginally into the mix. I just got my E2 and its 192 (on day 6 of stims).

So I guess my questions are -

Am I headed down the right path?
Any suggestions for the lining issues? I have read about Neupogen and spoke with my RE about it and he said that they dont have enough evidence that it works. But, in my mind I keep thinking, well is it going to hurt anything???

What is causing this fluid? I asked, they gave me a couple reasons, none of which apply to me. Could it be from the endometrial biospy? The nurse said no, but, I cant seem to figure out what else I would have done different this month....

I am so frustrated, and going through all of this, and feel as though I made the wrong decision when picking my RE because they dont give me answers to any of my questions, which I think are valid. I will switch to somewhere else if this cycle fails, but it is too late right now and I dont know what to do.

Oh, a couple of other things.... my WBC is always 3.7, a little low, and I am slightly anemic. I keep thinking, blood counts are low, maybe its hurting my lining??? but he doesnt think so. Also, I take synthroid 88 mcg, for controlled hypothyroidism.

Sorry for the long post, but its a lot of info and I wanted to give it all to you to see if you have any other suggestions. I have worked in hematology/oncology sales for 10 years, and know that I met with many doctors that didnt stay up to date on new studies, and I hope that my doctor is just missing out on something new and great that can fix my issues.

Hope all is well, and thank you for your time.

Amanda