I am 25 and have been trying to conceive for two years. My husband's sperm count is around 10 million, and we are doing IUI. I'm taking 50mg of Clomid. The doctor also put me on 200mg progesterone because I didn't start my period at the end of my last cycle. When we went in for a scan to schedule the insemination, the doctor noticed my uterus was full of fluid. He was very specific about it being inside. He said this could be caused by a pregnancy, but he did a blood pregnancy test and it was zero. I have no idea what's wrong. Could the progesterone have caused this? I have never had a progesterone level done.

Danielle

This is a tough question for me to tackle, but I don't believe this is a result of the progesterone you are taking. It is hard for me to advise you without seeing the ultrasound pictures. Much depends on exactly where the fluid was found.

If the fluid is in the central, hollow endometrial cavity, it could indicate a build-up of old blood. This condition is rare, but if present, it deserves further follow-up and medical evaluation. Also, mucus in the cervical canal at midcycle can often be confused with fluid in the endometrial cavity by a less skilled ultrasonographer.

If the fluid is in the wall of the uterus, you may have a condition called adenomyosis, in which the endometrial glands grow into the wall of the uterus. This would be quite rare at your age. Adenomyosis does not always cause infertility; that would depend upon its location in the uterine wall and the appearance on transvaginal ultrasound.

As pregnancy rates with clomiphene IUI for male-factor infertility are so low, and you have cause for concern that was not addressed by your physician, I would consider a consultation for a second opinion with a fellowship-trained reproductive endocrinologist to review the fluid in the uterus and alternative treatment options that may be more effective.