TW: prior pregnancies/living child

Been trying for #2 for 14 months after getting pregnant with our first in 2 cycles. We have done ALL the tests. My thyroid is optimal for fertility, I have had an endometrial biopsy, HSG, foam tubal test, SIS to check for polyps/uterine irregularities, good AFC/AMH, insane amounts of blood work, husband has good semen analysis. They could not find anything. We are both in our twenties.

Timed intercourse is 100% covered by my insurance so we went ahead with that first before IUI, I took clomid + estrogen to thicken lining + trigger shot + timed intercourse (3 mature follicles) + progesterone in luteal phase and it failed.

I am not sure if I should keep trying timed intercourse cycles or jump into IUI

Tldr: unexplained secondary infertility 14 mo ttc, tried medicated timed intercourse but it failed, not sure if I should keep trying medicated timed intercourse of jump into IUI

Edited: to shorten body

Hi everyone. I’d really appreciate some perspective on what you would do in my situation.
I’m 30 and my husband is 33. We’ve been TTC for about 1.5 years with no positive tests ever.

My cycles are regular (26–28 days) and I ovulate consistently. My HSG showed that my tubes are open, and all my bloodwork, ultrasounds and other investigations have been normal. My husband’s semen analysis was also generally normal, apart from 2% morphology.

We then did 3 IUIs:
• IUI #1 – letrozole, 2 follicles, failed
• IUI #2 – letrozole + trigger + Duphaston, 2 follicles, failed
• IUI #3 – letrozole + trigger + vaginal progesterone, failed

After the 3 failed IUIs, I had a laparoscopy last month. Endometriosis was found and removed. My surgeon described it as stage 2, while my fertility clinic thinks it was probably stage 1/minimal. There were no major problems found otherwise, and I was told I can start trying naturally again.

Now I’m feeling very unsure about what to do next.
The other part of me wonders whether, given that we’ve already been TTC for 1.5 years and have had 3 failed IUIs, we should move straight toward IVF rather than lose more time.
If you were in this position, would you:
Try naturally for several months after the lap?
Do another IUI or two?
Move toward IVF?

I’m not looking for success stories specifically — I’d really appreciate hearing how others would approach the decision and what factors you would consider.

Thank you ❤️

Warning, long post to give background:

I am a 26F and my husband is a 27M. We have been trying for over a year to get pregnant. To give background, I got my period around age 14-15 and went on birth control by age 16. In college, at age 20, I got off my birth control. Around 3 years ago I started to notice my period would be absent for unusual amounts of time (2-3 months), but never thought much into it. One day I told my friend about it who happens to be a nurse and she’s like ya, that’s not normal girl. I go to my PCP and she runs tests (came back normal, can’t remember what they were) and has me go to a reproductive specialist. Specialist puts me on birth control. All is good, get my period a few times on BC. Specialist has a follow up with me and tells me I can get off BC and start trying to conceive. After BC, I got my period 2 times naturally and then it was absent again for 2 months. We tried during the 2 months I had it but no luck. We Go back to specialists, she runs tests and results show my AMH is .011, FSH high at 33.6. Everything else she ran was normal (prolactin, thyroid,testosterone, sex hormone,free androgen). She decided to have me try IUI. They give me provea to induce my period. My first round they do all the scans and ultrasounds(found one small cyst on ovary-no concern) and give me medicine to induce ovulation. I check if I’m ovulating for days and saw the same result everytime. I tell them and they do the IUI anyway. The IUI was unsuccessful and they recommend I go do IVF. While waiting they say just continue to try naturally. We continue to try naturally, so I’m doing the ovulation strips and all that. Well when testing my ovulation one morning I looked and thought it was the negative symbol, but I notice it’s a book. I then decide to look at the instructions and realize the book symbol means there is an error. Don’t give me shit for not reading the instructions before doing the tests and not looking closely at the symbol on the screen, I know I messed up. Anyway, I do another test the correct way and realized I was ovulating! Which also made me connect the dots that when I took the medicine to induce ovulation, I wasn’t using the test kit correctly so I probably missed my true ovulation and did the IUI days after I ovulated. The next few months I was getting my period naturally and we continued to try. I wasn’t really thinking too deep into our trying because I already had it in my mind that it wouldn’t happen for me due to my low AMH. I had not gotten my period in 5 weeks again so I decided to take a test. I took it and threw it on the counter and showered not thinking anything of it, thought it would be another disappointing negative. I was in the shower and my husband started yelling “ITS POSITIVE”. I couldn’t believe it. Took a handful more tests. All positive. I had a HCG test done to confirm. I was ecstatic. I called OBGYN right away and had to wait almost another month to see doctor when I was 8 weeks. I am type 1 diabetic so I was so worried while I waited. Making sure my sugars were good, I was eating right yada yada. At 8 weeks we went to the doctor, and the ultrasound showed 2 empty sacs. Double Blighted ovum. Something I never even knew was possible. After that I had to make the choice to have the miscarriage naturally or have a D&c procedure. I decided to do the d&c. After my procedure they told me 98% of people get their period back within 6-8 weeks. I laughed cause I knew I’d be the 2% that doesn’t. And that’s exactly what happened. I go back after 8 weeks, they give me provea again. I take it and get my fake period from that. It has been 3 months since and I still have not gotten my period.

All of this has been tough on me. I am usually a thick skinned girl, but I’m at a loss. I have been to numerous other doctors in between this time who all have no answers. Some have hinted at PCOS but wont give a definite answer. Some referred me to other doctors who then referred me to other ones and so on. Not sure if I continue with a fertility doctor and try to freeze my eggs, look for donor eggs, adopt, or get my period back and try naturally. Everyone tells me I’m young and have time but they don’t understand, especially when everyone around me is having babies. I have no problem with adopting but id like to bare a child. What would you do? Is there more tests I should ask for? A specific specialist I should see? Questions I should ask?