Hi. We decided two years ago to start trying. I started with my ob. When you're 35 or older, they say you should consult your doc after trying for a year with no success. So, after 6 months, using clomid & charting, my ob referred me to an RE (reproductive endocrinologist). You could probably go straight there depending on your insurance since you've been trying for a while. Our RE did a semen analysis, HSG & other testing on me & now we're doing iui (intrauterine insemmination) before moving on to IVF. Unfortunately most insurance, like mine, don't cover anything relating to iui or IVF. They usually cover diagnosis & treatment, but infertility doesn't seem to be an issue to them. Imagine that! Anyway, you could start with charting your temps, using opks (ovulation predictor kits) and talking to your ob about where to go from here. Good luck to you & your dh (dear husband)! It's a difficult journey at times, but there are so many wonderful women on this site who are more than willing to offer their experiences & support. Best wishes!!!
At our age, we don't have time to mess around. Many drs won't even consider us for IVF at this point. The best place to start is with a cycle day 3 panel. This will check your FSH, Lh, & E2. These #'s will give an idea of ovarian reserve. It will not tell you quality. But, over 40, there is not much good news about quality. If you are serious, you will want to consult an RE as soon as possible and see what your options are. My dh & I have been trying since I was 39. Last month, my dr basically said (as well as 2 others), if you really want it, donor eggs or donor embryos are the only route for women over 40. You can spend a lot of money on IVF with your own eggs and still only have about a 5% chance of conception. From there, we run a very high mc rate as well as genetic problems. I wish the news were better.
We opted for donor embryos vs donor eggs. Donor egg IVF was going to run about $25,000. Our donor embryo transfer is at about $5000. right now. I will still need refills on meds until about 10-12wks. We just found out Monday the embryo transfer worked. Just a few more weeks until we find out if it's one or two :)
I'm happy to help with any questions you have. I have pretty much "been there, done that" at this point.