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Have you had any other testing done recently?

PCOS can cause hormones to be rather out of whack. It could be helpful to have a doctor track them throughout your cycle to see if you need to supplement at any point.

Are your cycles regular? Has your doctor ever considered treating the PCOS with something like metformin?

My old OB treated my PCOS with metformin (it made my cycles more regular and helped me ovulate)

I switched after two losses and IF, and my new doctor tracked my hormones for a full cycle. Then she started supplementing my post-ovulation hormones (first progesterone only, then HCG because estrogen was also low). Then I went on Femara because my pre-ovulation estrogen was low and it can help raise that.

IUI or IVF could help you get around whatever isn't functioning optimally, but I've been very interested in figuring out what isn't working so it can be fixed (and I've had some positives results that aren't TTC related...like better moods)

Working with this doctor, we got pregnant in two cycles (unfortunately she had trisomy and died at 13 weeks). We've just restarted the treatment cycles and haven't had success yet, but my P+7 hormone results are looking optimal for the first time ever.

I use a doctor trained in NaproTechnology. They monitor a full cycle (pretty much every other day)

Traditional OBs will usually at least look at cycle day 3 or 5 for a peak at early hormones and O+7 for a post-O baseline. The training my doctor has takes in a bigger picture though (and has smaller windows of what would be considered "normal").

You might also want a doctor to look at thyroid function. It can have an effect on reproductive hormones. For years doctors told me I was fine. But my NaPro diagnosed "subclinical" hypothyroidism. There's a lot of controversy over the "normal" ranges...so while mine wasn't considered high by lab standards, it was higher than it needed to be (especially during pregnancy...when it tends to rise even higher and is more important!)

I agree with the standard fertility work up. We had no issues getting pregnant with #1 but it took way longer to get pregnant with #2. We had just started the fertility testing (including HSG, blood work, ultrasounds etc) and got pregnant. AMH levels, follicle counts, day three testing could tell you more if there is an age related issues. I was surprised what a difference 3 yrs made in our experience ttc.

@LaughLines: I was going to saw switch doctors! That's so frustrating. I probably would give IUI a couple more tries. I think my RE recommended 3-6 cycles of IUI before moving on. I would demand the IUI cycles be monitored though to be sure you're ovulating and that the timing is optimal.

I just wanted to say that I'm sorry and I'm rooting for you The feeling of helplessness that TTC can bring is so hard...I've also heard the recommendation mentioned above for trying IUI for 3-6 cycles, and I'd probably only feel comfortable if it was monitored...

People with PCOS when in gestation are prescribed metformin till the 12th week at least. Since, you didn't mention it for your first pregnancy I assume you didn't need it back then. You can perhaps ask your attending gynae if you need to have metformin to prevent chances of miscarriage.