Awww, Jchic. I can hear your pain.
Listen, the NOT spotting is a GOOD thing. According to all the books I am reading, spotting is not so great before AF and is suggestive of low progesterone. The book, Making Babies, has parts of chinese medicine in it, and in chinese medicine, they consider pre AF spotting to be not such a great sign. In chinese medicine, AF should start as a light flow, then become heavier, then ebb away, with some spotting at the end.
As far as your thyroid, it sounds like it's being addressed with your meds. As far as everything else - further testing - it sounds like this guy wants to try IUI HIS way, with trigger and progesterone. If that fails, perhaps then you should lobby for further testing. My RE has ordered the basic tests only. As far as thyroid, he only tested TSH, not T3, T4. I'm going to ask about if further testing needs to be done to fully rule that out, as I am so low energy and cold all the time.
My sense is that these doctors aren't so into the testing, because no matter the results of the tests, they are going to recommend the same things anyway (meds, IUI then IVF). It's like a standard protocol. The books I've read have criticized that approach because there can be subtle things happening hormonally, or there could be an infection in the CM or semen, or you could have high levels of toxins (mercury) - there are all these reasons that could explain why it's not happening. It seems like few doctors are all that dedicated to determining the actual diagnosis, and focus more on treatment, and then if all the treatment fails, then they go back to square one and try to figure out what else could be going on. This probably works for them most of the time - people eventually get pregnant with IUI or meds, or IVF, but this is a very expensive and invasive way to get pregnant, especially if it can be avoided by fixing some underlying problem. It's so hard to know what to do, because you want to trust your doctor, he is the expert after all, but no one is infallible.
As far as you feeling down, it's only natural jchic. Don't beat yourself up for feeling angry and sad. Just try to breathe and try to appreciate the small things. Your husband who sounds terrific! I will be just devastated if I can't get pregnant (but I know I will, and i know you will too), but the other day I watched this horribly sad movie, Blue Valentine, and it made me so grateful that I have a wonderful loving relationship, and honestly, if it doesn't happen, my love with DH is enough to sustain me.