Past cervicitis and trouble conceiving

I've been TTC for a year and my gyn has had me on Clomid twice with no pregnancy occurring. My blood tests were normal and indicate that I'm ovulating. I get a positive OPK every month. My hubbie's sperm analysis was normal too. The clomid is being used, I'm told, because my cycle lengths are irregular and I spot during a 10-12 day luteal phase. I've been more regular with less spotting with Clomid.

Here's my question. I had cervicitis a few years ago. Tested negative for all STDs so they thought it was some unidentifiable bacterial infection. It went on for about a month before I realized it wasn't a yeast infection and got treatment for it, then I was treated for another month or so.

I know cervicitis can hinder conception. I have two questions:
1. Should I be on Clomid before being looked at surgically to see if there is cervical scarring? My gyn hasn't done this yet.
2. Does it sound like my ovaries weren't affected, since the doc said the test indicated that I ovulated? Am hoping that, at the very least, I won't have to go the egg donor route.

Thanks very much.

[Elaine Brown, MD]

Hi!
I certainly hope that you have had an HSG (hysterosalpingogram) to be sure that your tubes are not blocked.  If you haven't--do that at your very next opportunity.  If you have, then the next thing I would do is to switch to Femara.  You could have your cervix dilated in the office--that would be very simple.  Cervicitis is much more likely to cause problems by scarring the fallopian tubes though.  The way to find out about your ovaries is to do a cycle day three FSH level and an ultrasound for antral follicles.  This will tell you what your "ovarian reserve" is.  Or in other words, if there are enough eggs in the ovaries to have a good chance of conception.  It does sound to me like you are deriving benefit from the ovulation induction, if it is making your cycles more regular.  Femara is a better agent than clomid though, because there are less adverse effects on the uterine lining and the cervical mucous.  Also, fewer multiples.

Good luck!
Dr B