Hello ladies,
Thanks for your support and advice. Here, I hope to be clearer about D1, D2 and my ovarian reserve situation. Its gonna be a long message, I hope you have patience to read it through.
My gynec did day 3 tests on me but she only included FSH, prolactin and TSH. My results for these three hormones were very good and within normal range. Unfortunately, in the absence of day 3 estrogen level, FSH doesnt make much sense.
What we want on day three is a low FSH level in conjunction with a low estradiol level (<80). If the FSH is normal but the estradiol level is elevated, the elevated estradiol will often be artificially "suppressing" the FSH level down to the normal range.
In addition to E2 and FSH tests, Basal Antral Follicle count and AMH levels are observed on day 3 or in pre-follicular phase to determine ovarian health status.
While an abnormal result (high baseline FSH) tends to be very predictive of low egg quantity, a normal result does not necessarily mean that the egg quantity is good. There are a significant number of women with normal FSH values that have a reduced egg supply. The lower egg supply is not being reflected in their FSH value. This is why doing antral follicle counts and AMH levels can be useful. By doing multiple ovarian reserve tests, we are more likely to find an ovarian reserve problem if there is one.
Now D2s clinic has a policy of performing a diagnostic ultrasound for BAF count in addition to day 3 hormone tests, HSG and SA for DH. As a result of that u/s, D2 is one step ahead of D1 in terms of knowing my situation but that really doesnt mean he is any smarter than D1. Both are old and have decades of experience in infertility treatment. In fact, after visiting first clinic and meeting with D1, we were very satisfied and if we didnt have second option, we would have been happy to get treated at D1. D1 is just about 10 minutes drive from our house while D2 is about 30 minutes and if traffic is bad, it can get longer. D1 is cheaper than D2 to some extent. D2 is at a beautiful location and has fancier interiors.
Unfortunately, I was at CD7 on the day of appointment so we have to wait until next cycle to do day 3s and based on those results we move forward with our treatment.
OK, yes! we also questioned D1 and D2s sincerity in suggesting my treatment because as you pointed out doctors are business men too. So, clomid is way cheaper than FSH injections. D1 is not a fan of clomid and thinks it has more side-effects and less results; she pushed more towards injectibles. D2, on the other hand, did that U/S and scared both of us to death, we were so not ready to hear about my poor ovarian reserve. We were dumbfounded and at the end of it, didnt even know what to ask and expect. He talked and talked, gave us lots of published articles to take home and read, and finally, made a treatment regimen for us without our involvement (we were too shaken at that moment to participate). We came out of D2 clinic, very discouraged and I was in tears already. It was a long drive and we both went into denial stage, where we started to question D2s findings and felt it is probably his strategy to scare us into getting more expensive treatment. But after coming home, we both read articles and I searched internet and we figured that based on my BAF count, I do have problem and D2 was just telling us the truth. At least, now we are better prepared for a surprise in day 3 hormone test results in next cycle. I think D2 will also do AMF test on day 2 (he wants to start a day early, may be because I ovulate early??).
However, I do not think that D1 is any less experienced or less capable because she did say that my day 3 FSH is insignificant in the absence of E2 levels and was not willing to plan treatment regime without that information. Although, considering my medical background she expected it to be normal too...quoting her... "Her medical history is unremarkable for factors that would negatively affect her reproductive system.". She too will do bloods (FSH, LH, Estrogen) and U/S on day 3. We also meet her one more time before my periods start and she intends to perform infectious disease (HIV, Hepatitis etc) blood tests before we proceed.
Well, we have still not made a decision. We have been busy reading articles, calling insurance company for additional information and just getting over the initial shock.
About insurance coverage, it is pretty generous but IUI with injectables is so expensive and $8000 (max coverage for infertility treatment) will cover only 2 IUIs, at the most 3 and we will still be paying $150 deductible and 20% of the cost.
I am scared about my day 3 tests and I have to pray really hard that my ovary/follicles respond well to stimulation.
I will talk about IVF in next message because it's getting long here.
Thanks everyone for reading. Sorry, if I am still not clear. Let me know. Thanks for being there for me
you are the only one in the world who I am sharing my sorrow with
the more I read about my age and only 1 in 5 eggs are good I really dont want to waste any time. And theres always a chance I can get some freezies, if Im really lucky. and to be honest dew your news has made me even more determind to move things forward, as my results could go downhill at any time, as Im 39 in just over a month 
