I was on Metformin and bcp for a few months and then I had to have outpatient surgery to remove some uterine polyps. They weren't cancerous, just preventing us from getting pregnant. After the 1st surgery, we did 1 IUI with Femara instead of Clomid. It didn't work , so we tried Femara again. When I went in for my 1st u/s, we found out that the polyps had grown back AND I had a cyst on my ovary. I was devastated.
My RE told me that since I was 35, he wanted us to go ahead and do a second surgery to remove the polyps, then schedule IVF right afterwards so that we wouldn't have to worry about those damn polyps coming back!!! IUIs might have worked for us, but my stupid polyps complicated our situation. I do have a friend who got pregnant with IUI and she had the same doctor I did. Plenty of women have success with Clomid, injectable stim drugs, and IUIs. We just didn't have the time to spend on these treatments. I already feel like an old woman going to the high-risk OB because of "advanced maternal age". (I'm also going there because we're having twins, but I still feel old LOL!! )
I'm glad that my RE was able to help us. I never ovulated on my own. My hormones were sooo screwed up. Talk to your doctor about what your options are. You guys can probably come up with a game plan, and when we did this, it made my husband and me feel so much better.
Also, a side note about having a house-full of kids: My OB told me that even if you have trouble having a baby, once you have one, sometimes hormonal problems correct themselves and you might just become more fertile!
(sorry for writing a book!)