Unexplained subfertility

A case of primary infertility, 26 yr old, 7 yrs married life, staying together, had already received ovulation induction five to six cycles one year back outside, HSG and semen parameters normal done one year back,but no endocrine evaluation was done. came to me . Should I shall reinitiate Ov induction or handle the case in some other way?? Can I proceed for ovulation induction with IUI for few cycles or more aggressive investigations are warranted at this stage and age ?? Pl suggest. on how to proceed further and management...

I hope previous records of Ov stimulation ate unavailable not to speak of how many DF appeared on which day f stimulation or day of simulation wise ET . This is a common scenario. However, followings warrants evaluation and assessment: like 1) BMI, 2) Cyclicity, 3 ) level of AMH, 4) PRL .5) Ovarian morphology, 6) any clinical suspicion of minimal endometriosis or Pelvic adhesive diseases(then early resort to Laparohysteroscopy) or 7) Any contact with Kochs? All these have to be elicited prior to forget active treatement.

: Plan your treatement as per clinic-Lab reports: Problem identified  1) For high BMI- Diet control, Exercise, Lifestyle : Problem identified  2) If H/O oligomeno –then there is a strong suspicion of Insulin resistance -->may prescribe insulin sensitizers with low threshold for Myo inositol & Vit D. Problem identified 3:- If AMH is low < 1 then ART specialist  backed BY ESTIMATION F DAY 3 Inhibin B, AFC estimation :  . Problem identified 4:-If everything is normal then 2 cycles of gonadotrophin & IUI . Later when she achieves 29 yrs then ART but if AFC AMH are low then early resort to IVF.