Patient age 37 struggling with fertility low ovarian reserve. TTC for one year. She had multiple IUI cycles. AMH 0.7. FSH 11. Also she had blood clotting (taking Lovenox). HSG was OK. She had treatment in my office for four months. Clomid not responsive and had to try Letrozole. TSH was elevated to 5 and took medication. IVF positive for pregnancy.