Well, you see...

Quick recap of the last doctor's appointment:

• we (I say we, obviously it's me, but it affects Mr. Spouse too) can switch to Prometrium from the generic progesterone - it comes in capsules which the doctor, but not the pharmacist, said to pierce with a needle. I have about another week to work out if I need to do this. It is actually not much more expensive for us than the generic.
• Suppositories of the blue triangular anti-ED medicine - she's not confident about trying them. This is mainly, and I appreciate this, on safety grounds. The only research with recurrent miscarriers is of a very high dose, and in conjunction with pregnancy, it is very untested and I'm happy with that decision.
• Hysteroscopy - she doesn't think it would add anything. The most comprehensive paper I've read suggests that HSG combined with laparoscopy and US is pretty OK. You can see an anomaly with HSG but you can't tell what it is, but you need laparoscopy to tell what it is. I'm going to keep thinking about this and perhaps do something when we are back in the UK.

As I say, this leaves us with the "go away and try" instruction.

I don't know how much longer I can go on doing that. But I am also in a somewhat different position to a lot of people - I'm not sure I know of anyone (and if you are in that position please let me know how you overcame this) who has the same issues, even in a general sense.

If we want to adopt (and even adoption preparation is up to a year away), because of what happened last time we started the process, we do not want to risk another pregnancy and another miscarriage during that time. However, we are not people who definitely need treatment in order to be able to conceive, or at least people who "as far as they know" are in that position. I think this means that to avoid risk we'd have to use contraception.

Unless we are very unlucky with our adoption social worker, we aren't going to be asked to use contraception while we go through the adoption preparation process. I have heard of people in this position, but it is mainly once they have a match with a child, and for many of them they just nod and go "yes, yes" while knowing they have blocked tubes or endo or have been trying to get pregnant for 10 years without a sniff of a positive. What's mainly frowned upon is actually doing treatment while doing the preparation process.

I think they'd be a bit cross if you were subfertile and started the prep process after 2 years of trying on your own, and then had a successful pregnancy, but no child has been told they have new parents, oh no they don't, so no harm done really.

But in another sense we are slightly nearer to "needing treatment" than we were. I am no longer confident that just taking my vitamins is all the pre-pregnancy preparation I need. I would not be too happy if we were actively "trying" but I wasn't checking at least the day of my cycle and making sure I started the progesterone at some point. So we have an even sharper divide between "trying" and "not trying".

I don't know if I can switch it off - that's my problem. Last time we decided "right, go for adoption" we just thought "well, we aren't getting pregnant, so to not get pregnant we just keep doing what we're doing". Now I'm not so sure. "Trying" and "not trying" are now so different that I don't really know when, or how, to take the leap. And I'm also concerned my nerve will fail if it takes months or a year or more and I'll wheedle Mr. Spouse into "trying" again.