TTC at 40+

[mollyjones]

If this is the wrong place to post something like this please let me know! Long story short, I turned 40 and decided I want to try to have kids. I was always ambivalent about it and so was H, but I sort of woke up one day and was like, “I want this”. Problem is, I’m 40. Would be 41 giving birth if all went well.

I don’t know where to start. I have a history of endometriosis which could complicate things. I don’t currently see an Ob/Gyn, just a gynecologist.

Do I meet with a ob first? I know there’s a chance I could get PG right away but chances are I won’t. I don’t want to waste time I don’t have. I just don’t know if there’s testing they can do ahead of time or if I just have to try on my own for 6 months and if nothing happens see an RE.

Any advice is welcome! Also anyone who did get pregnant in their late 30s early 40s that have something to share, I’d appreciate it. There’s a lot of risks and all the reading I’m doing is making me nervous.

[VacayVaca]

There was a really good thread recently on Married Life about what to do when first trying to conceive in mid to late 30s. Take a look there to begin getting some ideas.

pandce.proboards.com/thread/613363/pregnant-mid-late-30s


Additionally, I would schedule an appointment with your gynecologist and say you're beginning down this path and would like some guidance. I mentioned that to my obgyn at my annual appointment and he ordered some easy blood tests to check to see where my hormones were. I think we checked AMH (a marker of ovarian reserve), thyroid levels, and sugar levels. Otherwise, I think you just have to jump in and see what you're working with. You should go ahead and start taking a daily prenatal vitamin now as well.

Good luck--the women here are so knowledgeable and supportive.

[katespade]

I was 29 when we started TTC, but I went into it with a similar thought process as you have. I have one ovary, severely irregular periods, and probable endometriosis, so we knew that I might have been able to get PG right away but chances were high I would need some help.

I started with my GYN because she already knew me and my medical history, and we were able to put together a plan that I felt comfortable with as a starting point. I did end up moving on to an OB later in the TTC process, but my GYN was able to help me with the first steps and some baseline testing. You also might want to look into your insurance benefit details. A lot of them will only cover testing/procedures after you've been TTC for a certain amount of time.

[joenali]

Go straight to a Reproductive endocrinologist. Don’t waste any time. We started at 38 and I’m 42, with no baby. 3 rounds of failed iui and 2 rounds of failed IVF. I would not rule out using an egg donor right off the bat. I’m not meaning to sound harsh, I’m just speaking from experience.

[mollyjones]

Oct 3, 2019 11:52:46 GMT -5 VacayVaca said:

There was a really good thread recently on Married Life about what to do when first trying to conceive in mid to late 30s. Take a look there to begin getting some ideas.

pandce.proboards.com/thread/613363/pregnant-mid-late-30s


Additionally, I would schedule an appointment with your gynecologist and say you're beginning down this path and would like some guidance. I mentioned that to my obgyn at my annual appointment and he ordered some easy blood tests to check to see where my hormones were. I think we checked AMH (a marker of ovarian reserve), thyroid levels, and sugar levels. Otherwise, I think you just have to jump in and see what you're working with. You should go ahead and start taking a daily prenatal vitamin now as well.

Good luck--the women here are so knowledgeable and supportive.

Thank you, I will check it out!

[mollyjones]

Oct 3, 2019 18:25:09 GMT -5 joenali said:

Go straight to a Reproductive endocrinologist. Don’t waste any time. We started at 38 and I’m 42, with no baby. 3 rounds of failed iui and 2 rounds of failed IVF. I would not rule out using an egg donor right off the bat. I’m not meaning to sound harsh, I’m just speaking from experience.

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

[joenali]

Oct 3, 2019 20:59:16 GMT -5 mollyjones said:

Oct 3, 2019 18:25:09 GMT -5 joenali said:

Go straight to a Reproductive endocrinologist. Don’t waste any time. We started at 38 and I’m 42, with no baby. 3 rounds of failed iui and 2 rounds of failed IVF. I would not rule out using an egg donor right off the bat. I’m not meaning to sound harsh, I’m just speaking from experience.

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

I waited. And in hindsight I wish I didn’t.

[mollyjones]

Oct 3, 2019 21:03:11 GMT -5 joenali said:

Oct 3, 2019 20:59:16 GMT -5 mollyjones said:

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

I waited. And in hindsight I wish I didn’t.

Thanks for the advice and I’m sorry for what you are going through.

[seeyalater52]

Oct 3, 2019 20:59:16 GMT -5 mollyjones said:

Oct 3, 2019 18:25:09 GMT -5 joenali said:

Go straight to a Reproductive endocrinologist. Don’t waste any time. We started at 38 and I’m 42, with no baby. 3 rounds of failed iui and 2 rounds of failed IVF. I would not rule out using an egg donor right off the bat. I’m not meaning to sound harsh, I’m just speaking from experience.

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

I hate to sound panic inducing but at 40 6 months is a LONG time. Better to know now anything that is knowable so you can make informed decisions about next steps. Best of luck to you.

[scm1011]

Oct 4, 2019 9:54:19 GMT -5 seeyalater52 said:

Oct 3, 2019 20:59:16 GMT -5 mollyjones said:

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

I hate to sound panic inducing but at 40 6 months is a LONG time. Better to know now anything that is knowable so you can make informed decisions about next steps. Best of luck to you.

That's where I'm at. This may be flameworthy advice, but if it were me I might just lie and say we'd been trying 6 months already. 

[mollyjones]

Oct 4, 2019 9:54:19 GMT -5 seeyalater52 said:

Oct 3, 2019 20:59:16 GMT -5 mollyjones said:

Thanks for your advice! Not harsh at all. I just don’t know if I should see an RE right off the bat or wait til we’ve tried 6 months.

I hate to sound panic inducing but at 40 6 months is a LONG time. Better to know now anything that is knowable so you can make informed decisions about next steps. Best of luck to you.

No I get it; I feel panicky thinking about it.

[mollyjones]

Oct 4, 2019 10:35:24 GMT -5 scm1011 said:

Oct 4, 2019 9:54:19 GMT -5 seeyalater52 said:

I hate to sound panic inducing but at 40 6 months is a LONG time. Better to know now anything that is knowable so you can make informed decisions about next steps. Best of luck to you.

That's where I'm at. This may be flameworthy advice, but if it were me I might just lie and say we'd been trying 6 months already. 

Not flame worthy to me, I have an IUD currently or else I would do that. They would see in my chart when it was removed. That’s why I’d like to meet with someone first to see what my options are. I don’t want to remove the IUD without knowing the plan.

[joenali]

Oct 4, 2019 11:46:39 GMT -5 mollyjones said:

Oct 4, 2019 10:35:24 GMT -5 scm1011 said:

That's where I'm at. This may be flameworthy advice, but if it were me I might just lie and say we'd been trying 6 months already. 

Not flame worthy to me, I have an IUD currently or else I would do that. They would see in my chart when it was removed. That’s why I’d like to meet with someone first to see what my options are. I don’t want to remove the IUD without knowing the plan.

I think you could still go to a Reproductive endocrinologist if you haven’t been trying for 6 months. They’ve seen all kinds of situations!

[cherryvalance]

Do you have insurance coverage for fertility treatments? That's the thing that would make the biggest impact to me about where I started. Some require a certain length of trying, etc, so better to know that off the bat, especially since you IUD would be documented.

If you have no restrictions, I'd start with an RE to discuss preliminary steps and testing. It's so much better, IMO, to have a lot of information and be able to discuss what steps are logical to take than to just figure it out as time keeps ticking.

Good luck!!

[msmerymac]

Oct 4, 2019 10:35:24 GMT -5 scm1011 said:

Oct 4, 2019 9:54:19 GMT -5 seeyalater52 said:

I hate to sound panic inducing but at 40 6 months is a LONG time. Better to know now anything that is knowable so you can make informed decisions about next steps. Best of luck to you.

That's where I'm at. This may be flameworthy advice, but if it were me I might just lie and say we'd been trying 6 months already. 

This. 

I mean, OP, you're talking to people who are experiencing worst case scenario here, so plenty of other people would tell you not to panic. My SIL had healthy pregnancies and gave birth at 37, 39, and 41, and easily got pregnant, like within a few months of trying, every time. And that's with her mother having a history of early menopause. 

BUT the history of endo and age are both red flags. Tell your gyno you've been trying for almost a year and explicitly say you want a referral to an RE (if you need one). At the same time, check what kind of insurance coverage you have. It may take you several months to get an initial consult and testing done, and you can work on trying all that time anyway on your own. Personally, knowing what I know now, I'd try for those 3 months, maybe do a few IUIs or monitored cycles, and then maybe move on to IVF in about 8 months if that doesn't work. 

Good luck!

[mollyjones]

Oct 5, 2019 10:39:14 GMT -5 cherryvalance said:

Do you have insurance coverage for fertility treatments? That's the thing that would make the biggest impact to me about where I started. Some require a certain length of trying, etc, so better to know that off the bat, especially since you IUD would be documented.

If you have no restrictions, I'd start with an RE to discuss preliminary steps and testing. It's so much better, IMO, to have a lot of information and be able to discuss what steps are logical to take than to just figure it out as time keeps ticking.

Good luck!!

Yes, I have coverage for testing to get a diagnosis and up to 3 IUIs. No IVF coverage.

I guess I feel like an RE is going to find it strange that I have an IUD and obviously haven’t been trying (though I’ve never used BC until now and have endo and history of ovarian cysts). Will they think I’m neurotic if I want any testing they can do sooner rather than waiting? My health system is all connected so they’ll see I had an IUD put in and when.

[megstoo]

I agree with everyone else, don't bother with the OB and go right to an RE. You might also want to consider having a laprascopy since that's the only true way to diagnosis endo. My RE and OB assumed I didn't have it because I had no sypmtoms but when I had a lap is when they found it.

They're going to do a lot of testing and also make sure you get an analysis done on your husband before moving forward with treatment.

Good Luck!! I'm 39 and it's a huge emotional rollarcoaster.

[mollyjones]

Oct 7, 2019 10:42:44 GMT -5 msmerymac said:

Oct 4, 2019 10:35:24 GMT -5 scm1011 said:

That's where I'm at. This may be flameworthy advice, but if it were me I might just lie and say we'd been trying 6 months already. 

This. 

I mean, OP, you're talking to people who are experiencing worst case scenario here, so plenty of other people would tell you not to panic. My SIL had healthy pregnancies and gave birth at 37, 39, and 41, and easily got pregnant, like within a few months of trying, every time. And that's with her mother having a history of early menopause. 

BUT the history of endo and age are both red flags. Tell your gyno you've been trying for almost a year and explicitly say you want a referral to an RE (if you need one). At the same time, check what kind of insurance coverage you have. It may take you several months to get an initial consult and testing done, and you can work on trying all that time anyway on your own. Personally, knowing what I know now, I'd try for those 3 months, maybe do a few IUIs or monitored cycles, and then maybe move on to IVF in about 8 months if that doesn't work. 

Good luck!

Thank you. I don’t need a referral to see a RE and it’s covered under my insurance. I’m stuck on removing the IUD because my pain is so severe from the endo. So I was thinking leave it in until I see a RE and really see what they think about my fertility and run any tests they can. If they’re like “this will never happen without lots of help” then I have some things to think about. I feel like my mind is going in circles.

[cherryvalance]

Oct 7, 2019 11:20:01 GMT -5 mollyjones said:

Oct 5, 2019 10:39:14 GMT -5 cherryvalance said:

Do you have insurance coverage for fertility treatments? That's the thing that would make the biggest impact to me about where I started. Some require a certain length of trying, etc, so better to know that off the bat, especially since you IUD would be documented.

If you have no restrictions, I'd start with an RE to discuss preliminary steps and testing. It's so much better, IMO, to have a lot of information and be able to discuss what steps are logical to take than to just figure it out as time keeps ticking.

Good luck!!

Yes, I have coverage for testing to get a diagnosis and up to 3 IUIs. No IVF coverage.

I guess I feel like an RE is going to find it strange that I have an IUD and obviously haven’t been trying (though I’ve never used BC until now and have endo and history of ovarian cysts). Will they think I’m neurotic if I want any testing they can do sooner rather than waiting? My health system is all connected so they’ll see I had an IUD put in and when.

One thing I've learned about being around here is that REs will react in a variety of ways, so you don't know. I don't think my RE would be shocked to see someone come in with a history of endo and AMA and ask for next steps, but I'm sure some would.

It's overwhelming. If you don't feel ready for the RE, at least talk to your gyn or do a phone consult with a RE and ask what they would recommend. Again, you don't have to take any steps, but I would definitely think you'd want all the information possible and to know what you're dealing with and what options you have, rather than dick around for 6-12 months (no pun intended lol).