4th and FINAL round of Clomid ... BFN!! ..Now what?

I agree, if you have PCOS or insulin resistance, try Metformin. My doctor put me on it 6 months before even adding another medication because she had so much better luck with Metformin in addition to Clomid/Femara with PCOS. Also, consider Femara. It is similar to Clomid but without the side effects and does not cause thinning of the uterine wall so you can take it longer. It took me 9 cycles of Femara but we were dealing with low sperm count on my hubby's end too.

Also, losing weight does help if you are overweight. A 10% weight loss can work wonders. I lost 30 pounds in preparation for IUI and that's when I finally got pregnant after 2.5 years of trying...

Also, did they do any testing? You should have had blood work. After 6 failed cycles, I was referred for a sonohysterogram to make sure my tubes weren't blocked and I didn't have any uterine abnormalities. Are you sure the Clomid was working and making you ovulate? My sister was on it for 6 months at the wrong dosage because her first doctor never bothered to do any ultrasounds/testing to make sure she was actually ovulating. She got a new doctor, got the right dosage, and got pregnant the first cycle she ovulated.

Don't give up. It is a long journey, but there are many options to exhaust before giving up.

I don't know your personal situation, but there are many instances where Insulin Resistance is the cause of many women's infertility issues. Talk to your doctor about taking a medication called Metformin. And I don't mean to sound rude or insensitive, but could you be over weight? I was slightly, and my doc suggested I shed a few pounds to help with my cycles. I lost about 10 lbs. and tada! I conceived the following month. I have PCOS and insulin resistance often accompanies this issue. This will prevent you from ovulating. But some women have insulin resistance without having PCOS. I know some women that Metformin did the trick whereas Clomid yielded no success. No harm trying :-)