We just had our appt with Dr A. One thing can be said for Dr A - he really doesn't rush you out. We sat and talked for 45+ min - a faster doc could have had us out of there in <5 min.
The upshot of it all - he doesn't really think we should do IUI. But, he is really interested to see how many sperm make it out of washing. So the sperm washing is almost a diagnostic, in his view. While DH's number are now slightly above average, he says a washing will really show us what we have to work with. And then might as well time it and use it, so we agree on IUI #1.
Because otherwise he's sort of against it - he says a woman my age with my husband's (now good) counts can easily take 6-12 months to conceive. He wants us to keep trying another 6 months, and then we'll see. That is too long, from my point of view, to sit around not-doing anything. So IUI #1 it is.
The whole reason we went in for this talking appointment in the first place is that I want to do it un-medicated. He gives our un-medicated odds at 20-25% for this IUI cycle. I was expecting that. He said if I took the medication (not injectables, just pills), he'd put the odds at 40%. But I'm not ready for that yet. If everything is hunky-dory with me, we shouldn't need it, we'll just need patience. If everything isn't ok with me (aka, endometriosis), medication won't solve it.
He also puts our odds every month at 20% with doing nothing special, which is why he was against the un-medicated IUI to start with. This sort of messed with my poor DH's head a bit - he was starting to think I should take the medication, but the doc actually helped me to talk him out of it - Dr A could tell I didn't want the meds (at least yet).
If this cycle doesn't work, we'll keep trying naturally (of course!), and keep up with our vitamins and whatnot from Dr Nora, and we'll go in again in December for perhaps a medicated cycle.
Dr A did say he'll think I'll be a nightmare if we did IVF - well, not in those words, but essentially. I usually have a lot of follicles, they'll go gangbusters on mediation, and it will be awful for me. No thank you! Even with medicated IUI - I don't really want twins, and our odds go way up.
Interestingly, I asked a lot of progesterone questions - essentially, I want him to monitor me on several days past ovulation, and supplement with progesterone if need be. He's totally against it. He says my day 22 (about 7 dpo) progesterone level was 30.9, which is fine. I have a memory of being told my progesterone was "low", but maybe that was from my first RE? He said supplementing progesterone is very 10-years-ago. If you don't fix the follicular phase, the supplementing just in the luteal isn't going to work. But I'm not sure I agree with him - everything I've read + Dr Nora + all you lovely Catholic ladies love your progesterone.... I see this as maybe being a sore spot. We'll see. If my 7 dpo is really a perfect value, is that enough testing to say it is ok? Should I try to impo.rt ille.gal prog.esterone? (this might be a wee bit too extreme for now!)
So Monday (it will be CD10) I'll go in for my first wanding/blood work. Good, at least I'll be doing something! And in the meantime, I will try to relax and grow follicles.