Why am I not able to conceive normally?

Q: I am a 42 years old married woman and last year I had a miscarriage after 4 months of pregnancy. After 8 - 9 months when I didn't conceive, a lap was done 6 months back and a cornual block in the right side was found. I was given Fostine 75 for 3 - 9 days last month as 2 follicles were growing in left ovary. On the 9th day, there size was 16/1 and 9/2, which became 19/1 and 11/1 on 11th day. And, therefore, Ovidac 10000 IU IM injection was given. On 14th day, ovulation was confirmed, but there was C.L. of 16 mm. I was advised to try normal process to conceive but I failed. Now I am taking Novelon for 21 days. No follicular study is done in this cycle. Am I not conceiving due to C.L.? Why another injection was not given to rupture the smaller follicle?

A:The treatment, which you got was the standard treatment and HCG is not given twice to rupture any follicle big or small. Whether you follicle had ruptured or not cannot be picked up by ultrasound always. If after good ovulation you did not conceive with times intercourse, then it would be advisable to go to IUI in the next cycle. You must have at least 4-6 trials of ovulation induction with IUI to have reasonable chance of pregnancy.