I just got back from the RE's office. First off, I really like her. She seems like she is going to be very proactive and she realized very quickly that I am pretty familiar with a lot of this stuff, so she didn't talk down to me.
Bad news: She diagnosed me with PCOS, which I have asked other Drs about numerous times and have always been told that because my androgen tests are within normal range that I don't have it. She said that I have most of the clinical symptoms of PCOS (irregular ovulation, acne, weight issues, unwanted hair growth). She did an ultrasound of my ovaries and said that it is pretty clear that I do in fact have PCOS. My left ovary is larger than my right and was covered in cysts. It looked a little like swiss cheese on the ultrasound. She did say that it looked like I probably already O'd this cycle, which confirms my chart and symptoms. She also said that she was not concerned that I have never gotten a +OPK because apparently that is common with women who have PCOS.
She is going to run a bajillion tests tomorrow, including a fasting glucose and insulin tolerance test, some genetic test, a bunch of clotting tests, thyroid tests, and some antibody tests. We are going to meet again on the 18th to go over the results.
She is very concerned about my clotting factors. She said that it always a major concern in late losses, and since I have had a blood clot in the past and my mom has had several, this is a huge concern. She thinks that it could be the reason we lost the twins.
If I conceived this cycle, she wants me to start progesterone and a baby aspirin as soon as I get a BFP. She may also want to put me on Lovenox, depending on the test results. If I did not conceive this cycle, I will go back on Clomid (50mg CD 3-7), get an ultrasound on CD 12 or 13, get a trigger shot and timed intercourse. She did not seem at all concerned about the increased risk of twinning. She did say that she often uses Femara instead of Clomid, but since I used Clomid before with success we can go ahead and continue it. We are also going to discuss using Metformin depending on my test results.
She also recommended trying to lose weight, although she warned that it is more difficult when you have PCOS, so she gave me the names of a couple of Drs who specialize in helping women with PCOS lose weight.
Overall, I am feeling pretty good about the appointment. I am really annoyed that it took this long to diagnose a condition I was pretty sure I had because other Drs haven't kept up on the research. I am hoping that I got lucky this cycle and most of this becomes a moot point, but if it isn't, at least we have a concrete plan.