I got some answers. He wants to look at ovarian reserve (egg quantity/quality). While there are several ways to do that, he wants to start with ultrasound, looking at antral follicles. This article explains this in depth: http://www.advancedfertility.com/antralfollicles.htm
. The author's opinion is that day 3 FSH levels and AHM blood levels are important variables with good egg quantity/quality, but antral follicle counts in addition to female age is the best tool for estimating ovarian reserve.
But along with answers brings more questions... *sigh*. I wonder if taking a look at this might also lend to diagnosing a luteal phase defect (LPD), and if LPD could be a function of good ovarian response or egg quality. LPD can be caused by 3 different breakdowns which can all occur in sequence: 1) poor follicle production (bad FSH levels follow), 2) premature failure of the corpus luteam (bad progesterone levels follow), or 3) failure of the uterine lining to respond.
Focusing on the first issue, follicle development, counts can tell us about reserve, but he can also measure them midcycle and test estradiol levels (blood test) to look at development. If the follicle development is normal, early extra progesterone might be the answer. We keep doing what we've been doing, but sooner, right after ovulation, not after a + test.
If follicle development is inadequate, Clomid can be used to help it mature, producing a better quality egg and a better functioning corpus luteum.
My insurance doesn't cover any of this (infertility/Poor pregnancy outcome isn't as tragic as erectile dysfunction to insurance execs... don't get me started). However, I think I'm going to plow down this road anyway. It's my life, my future baby's life... no price can be put on that. We'll see.