I appreciated all of your kind words so, so much after my last BFN. We are still in limbo re: the fellowship (probably more on that soon), but in the mean time, we have decided to move forward with the next cycle. Since I over-responded on Clomid in the past, which is obviously pretty lightweight as far as ovulation induction goes, we were hoping to keep with a low dose of Clomid a bit longer for our IUI cycles and then move to IVF if necessary when we felt ready, skipping IUI with injectables altogether. With IVF the over-response could obviously still be a big issue, but at least we would have control over how many embryos we transfer and if I did develop OHSS, we could always freeze everything and postpone ET. However, our RE suggested that we move on to FSH injectables for IUI #4.
It turns out that my health fund requires 3x FSH injectables/ IUI cycles before IVF for PCOS or unexplained IF. Our RE did say that he is worried about OHSS and HOM in my case with the injectables/IUI and that this is a common issue for lean PCOSers in particular, but that it's important for us to try it, starting at a low dose and with lots of monitoring, and see how it goes. I am a little nervous about producing a zillion follicles on FSH, but hopefully it will improve my egg quality over the Clomid, and it will be awesome if this is what gives us a viable pregnancy. In addition, I appreciate the logic that if what we have been doing so far hasn't been successful, and it's possible that IVF is in our not-distant future, it makes sense to be working towards that goal by fulfilling the health fund requirement of 3x FSH IUIs.
Of course, we really hope that I will get KU this cycle, but we figure if not, if the cycle is a technical success and we make it to IUI, I will continue with the injectables/IUI for 2 additional cycles and if the cycle is a disaster, we will pay OOP to go to IVF before the 3 injectables/IUI cycles are up (and if I am not feeling ready to make the leap to IVF now, I am sure if I make it to IUI #7 I will be MORE than ready). Much of this very hypothetical plan assumes that we stay in Israel and turn down the fellowship, so obviously this could all change completely. If anyone has more thoughts or experiences to share regarding the issue of FSH injectables/IUI vs. IVF among those of us with a tendency to over-respond, I would really love to hear it.