Hysterogram/IVF/IUI

Is hysterogram necessary?  2 years ago, I got pregnant through IUI, but it lasted to 4 months. Last year I had my ivf, but had a negative result. I still have 4 frozen embryos.  I've had an appointment with a new R.E and she advised me to have a hysterogram first before she can start what kind of treatment for me.   She said that I got pregnant with IUI, it's not impossible if I can't get pregnant using the same procedure again. Do I need to start on a new work up? Or would I continue for the ET of my embryos?  I'm hesitant with ET because I've read a lot on the net that ET has low success rate.
What other test should be done before IVF or ET.
Help I'm desperate already to get pregnant.
Thank you for taking the time to answer my questions.

[Forum-M.D.-SP]

It is difficult for me to answer your question about whether to try IUI or another IVF cycle without knowing everything. Since you have four frozen embryos, a frozen embryo transfer is definitely a consideration. The success chances with a frozen embryo transfer depend on several factors, including : 1) how old you were when you had the IVF cycle from which the frozen embryos came, 2) the quality of the frozen embryos (were they at least 6-cells with little or no fragmentation), 3) the success rates with frozen embryos of the program where you had your IVF, 4) your uterus. If you were under age 35, the embryos are of good quality, the program has a good success rate with frozen embryo transfers, and your uterus is healthy, then your chances of success with a frozen transfer are in the 25%-30% range. If you are older, the embryos are of poorer quality, etc. the chances of success could be much lower. If you decide to do IVF with the frozen embryos, then you might consider a saline sonohysterogram (an ultrasound done with saline injected into the uterus, similar to the hysterosalpingogram where x-rays are taken but gives more information about the uterine cavity and usually is not as uncomfortable as the hysterosalpingogram).

On the other hand, if you decide to do IUI, you have two choices - assume the tubes are still open since they were open a few years ago, or repeat the hysterosalpingogram first. Repeated the hysterosalpingogram will confirm current health of your fallopian tubes, and also give some information about the uterus. On the other hand, chances are that with a past intrauterine pregnancy a couple of years ago, your tubes are open. The decision about whether or not you want a second hysterosalpingogram is yours. You have to weigh the fact that the test will give current information agains the cost and perhaps even the discomfort of the test.

The other thing to consider is cost. Of your three choices, clomid-intrauterine insemination is the cheapest therapy but carries a success rate of at most 8%-10% per cycle, fertility injections (like the ones you took for IVF) with IUI offer perhaps 15%-20% success rates at an estimated cost of probably $3500-$4000 by the time you buy your medicines and also have a higher risk of triplets, and a frozen embryo transfer cycle should be around $3000 with a success rate of 25%, all assuming that you are under age 35.

All things considered, if your frozen embryos are good quality, I would consider the frozen transfer first, then reassess.