TTC at 40 - what would next steps be if we have difficulty?

[anney]

Hi Fiona,
My advice is don't wait too long, so 6 months is probably about right. But also count any other time you have not been on contraception as well. I had my first baby at 40 and like you thought it would happen again, even though I was well educated on the statistics of declining fertility I was sure we would be one of the lucky ones.
Anyway, short story, we tried for 18 months ourselves (but I was breastfeeding) then weaned to give ourselves a good chance. At about 14 months of trying I went to the "family planning centre" in box hill. they were fantastic and sent me off to have the 21 day test you have to check that you are still ovulating. I was so we just kept trying ourselves. I have a few early miscarriages. We eventually got to IVF when I was 44 and I got pregnant but lost the baby at 10 weeks. I am absolutely certain if we had done IVF 2 years earlier, we would have had a baby to take home.
But I have no regrets and am happy with our perfect one child family
Don't go just to an Ob, go to a fertility specialist or at least an Ob that does a balance of both fertility and births. they will do a 21 day blood test to see if you are ovulating and a blood test at CD2-3 to see if there are any signs your ovarian reserve is diminishing. If they come back fine, they may do more invasive tests for both you and DH.
I am jumping the gun a bit but don't be scared of IVF, it cuts out so much of the stress of TTC every month and ensures that you get the best possible chance. I would always recommend going to see someone to discuss IVF sooner rather than later for anyone at 40.