Semen ello, Thanks for writing in. Let me answer your basic concern first. A.I don t think you need to be treated for Koch s for the second time just on presumption that the disease may still be persisting. Currently there are no proper set of guidelines to dictate when genital Koch s has to be treated. As lot of tests used for diagnosis indicate only presence of bacteria but not an ONGOING INFECTION which is very important to differentiate. So I recommend you to not opt for it unless 1. Your RNA PCR for kochs in endometrial sample comes positive. 2.There is direct evidence of Koch s on hysteria laparoscopy which your doctor will let you know. 3. TB bacteria is seen on histopathology slide made from endometrial biopsy sample. Other tests done for Koch s should only support diagnosis but should not be the basis for unnecessary treatment. B. I would also suggest you to not take DHEA preg as it is meant for women with very low ovarian reserve. Your AMH value which talks about your ovarian reserve is well above 2 meaning you have good number of eggs in your ovaries. C.Its difficult to opine regarding your chances of natural conception as you haven t mentioned your age and duration of infertility, semen report, indication for icsi, tubal function test report and other relevant information in your query.But if your tubes are fine and no ovulatory problem , semen analysis is normal, and if you are trying for less than 2 or 3 years you may try another 6 months. You may conceive naturally even without treatment but it may take few months to many years which can t be predicted. Hope this helps. Take care.