The neurologist I saw basically said that the choice is up to me. I can't remember the exact numbers he quoted (so this may be wrong), but he basically said the risk of stroke on any birth control is like 1 in 10,000 and the risk of stroke in people who have migraine with aura and are on birth control is like 2 in 10,000. So though the risk goes up, the overall risk is still on the low side. He said that I could have an MRI if I wanted to, since I've never had official imaging done for my headaches, but I opted not to - My insurance made it so I would potentially have to pay $1,300 for it, the odds of something being wrong given how long I've had migraines without symptom changes are small, and I actually had some imaging on my brain done while I was a control for a research trial and it showed nothing. I basically decided to hold off for now, and if my symptoms change, I'll reconsider.I'm not sure if I'm going to go back on seasonale. I'm not a huge fan of the progesterone only pills, but it seems to control my IBS symptoms and I haven't had a migraine since starting them. I see my GYN in February and maybe I'll ask for a seasonale prescription in case I change my mind. The progesterone isn't horrible, though I have had occasional breakthrough bleeding. At this point, I think I'm hoping that it keeps me stable till we start trying to have kids.