When do I need to look at infertility and taking the next step?

Hi everyone! I'm not sure if anyone remembers me but I have been TTC twin girls since January 2015. I am currently on cycle 17 of swaying (don't worry! there was a break from diet and swaying in there!) and am wondering when I need to start really looking and evaluate if there is a real, medial reason I am not getting pregnant.

I started fertility meds primarily for swaying. I am being seen by an OB and have done 4 cycles of clomid, followed by 3 cycles of Femara. I personally feel at least 1, maybe even 3 of the medicated cycles resulted in a chemical. My progestrone has been awesome on all cycles and all other bloodwork has been checked and is within normal range. Dh has had 1 sperm analysis (also normal) and has been cleared by 4 doctors.

Sigh. My OB would like to do a HSG x-Ray and then refer me to a specialist for iui. I am just not sure if I am emotionally and mentally prepared for that. Should I be insisting on running more tests to look for something medical? Should I stop swaying for a while? See if that makes a difference? Should I go ahead with the x-Ray and iui (if we don't conceive in the mean time)? If not, how much longer should I TTC before taking the next step? If yes, do I still sway while doing iui?

I honestly didn't think it would take us this long to conceive and am feeling so confused. I'm just very conflicted right now and any insight would be appreciated!

Honeybug can you give more detail as to what you've been doing swaying wise? How many attempts? J&d? Supps you & dh have been taking etc?

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How old are you and DH? Did you have any trouble conceiving your DS?

I think if you've been trying for that long, it's time to add in attempts (unless you're already doing that). I don't think it would hurt to get the HSG done. I had one done and it gave me peace of mind knowing it was all clear. Is your DH doing anything like FR or abstaining that could reduce sperm count/quality? If you're using any lubes, I'd ditch those and maybe even add in pre-seed (boy friendly I know, but if you've been swaying that long I don't think it'd hurt). Are you underweight? Have you had your iron levels checked?

You need the HSG done at this point.

Can you please give me a recap? I know we've talked many times before but I keep finding things that people forget to tell me or are still doing against my suggestions.

If you're doing anything like shallow release, j and d, tighty whiteys, those things need to go.

If you've truly dropped everything (and I feel like I recall you haven't, yet, but I may be mixed up!) then we need to try doing things like adding in female O, Preseed, and guanefesin, and even going to SMEP. I would do that before I had an iui!! IUI sounds like no fun to me. :)