The Options as Presented

I'm trying to get this written down so that I remember it for the future. I really like my RE. He met C for the first time today and C likes him. He is honest and explains everything in that just-enough-detail-so-as-to-not-overwhelm type of way. He is prudent and forthright. I would say that he is our savior, but that isn't necessarily true. He's got the medicine and the science behind him. And he's nice. You often underestimate how important that is in a doctor.

We asked our questions: C about his swimmers and me about all of my nonsense. Bottom line (and it is a long bottom line) is that we are probably okay on the sperm issue. C has really only produced one low count and it was still enough to work with. The RE said that there did not seem to be any reason for C to see a urologist. As for me, he thinks that my ovulatory system is still the problem. The concern is the random response of my ovaries to the exact same medication and protocol. It's like my ovaries are the alcoholic uncle at Christmas: we don't know when or if he'll show up, if he'll be drunk, or who all is coming with him. The RE said he did not want me on the magic white pills anymore.

Our options:
A. Different type of oral fertility medication, with monitoring and IUI. Less risk of crazy superovulation, less side effects, and same risk of multiples. Same success rates and same cost as previous oral medication.
B. Laparoscopy. Minor surgery to check out all of the abdominal and reproductive parts. The only conclusive way to determine endometriosis is to see it and with a laparoscopy, the RE could also remove the endometrial tissue outside of the uterus and eliminate some scarring. The RE mentioned that at least two of the worse cases of endometriosis he found were in women that didn't have symptoms. Clearing this up can increase the chances of conception significantly. This surgery is expensive and I am unsure if my insurance covers any part of it.
C. Fertility shots with IUI. Advanced monitoring. The RE has had a very high outcome of pregnancy with this method. Due to the high cost ($2000-$3000 per cycle due to the medication), the RE recommends doing this following a laparoscopy to ensure the highest success rates. I think my insurance would cover 50% of this, except there is a lifetime cap at $10,000.
D. IVF. The clinic has terrific success rates and has been written up in regional magazines. The RE estimates $14,000 per cycle. Good news is that we could probably orchestrate another superovulatory response from me and create enough embryos that we wouldn't have to do it again because we could freeze them. My insurance does not think they cover IVF, but are unsure if that includes the entire protocol or not. There is also assumed risk financing.

The suggestion was to try A. if we wanted to. Then the option was between B. and C. or D. It was said that our most direct route to baby via pregnancy was option D.

Again, it was really good to have C hear all of this. It is our decision after all. The RE does want a quick phone call as to when we want to start any of these options (I mentioned the year long break), but besides that, he was just really straight forward. We have some huge decisions to make and thankfully, some time in which to make them.

I am tired today and C is tired today - we both donated blood and while I do it because it is needed, I have good veins, and much desired blood (universal donor), I think that I am just barely capable. It is still a good deed. Glad that C joined me. He's got beautiful veins too.