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

[fionas]

I'm reasonably optimistic about our chances based on getting pregnant fairly easily in the recent past. Pregnant when we weren't trying when I was 36 (miscarriage), pregnant first time at 37 (with DD who was born when I was 38) and pregnant (again not 'really' trying in terms of timing things right) earlier this year when I was 39 (ended in miscarriage).

As silly as this sounds though, this is the first time in my life that I've been 'trying' to have a baby and it's a bit bloody nerve-wracking. I'm temping and trying to time things right and have done so for the last two months. Yes, I know that's not very long in the whole scheme of things but as everything arounds me keeps reiterating, time is getting short at my age.

I guess my question is, given my age how long should we give it and what would be the next steps that an ob would take if we do have difficulty? Obviously I don't want to rock in there when I'm 41 and say that we've been trying for the last 12 months.

[Trevo]

I think the general rule of thumb is 6months ttc when you are 40plus with no known fertility problems. Because time is of the essence they say 6months is long enough before an obstetrician will look into why conception hasn't happened. Good luck. Hope it happens soon.

[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.

[mildlymadmom]

Hi. Also 40 and now 6 weeks pregnant. It happened when we went out for dinner, had too much nice wine. etc.... So it certainly helps if you don't get too obsessive about it. (I had my Norplant removed on July 12). Didn't think it'd happen for at least 6 months. So, sit back and enjoy the next six months and if nothing happens you know to contact you ob/gyn. Until then don't count too many days, temps, and all the rest. Just enjoy hubby.

[Matthew's Mum]

Hi good luck with it all,i'm 39 and fertility specialist put me on clomid after 3 cycles of unsuccessful ttc as blood tests and longer cycles indicated menopause looming,so far have not had success with clomid,there is no harm in going and talking to a specialist to discuss options.

[juniper76]

The rule of thumb seems to be that you can seek medical assistance after 6 months if you're 35 or over. However, I'd add that if your BBT charts showed any irregularities or hinted at any problems (eg annov cycles, short LP, etc) that you could probably ask for assistance earlier.

[blackduckies]

Hi, we decided when I was 38-39 that we wanted 1 more baby.. Up until that point we had had no trouble concieving (1-2 cycles) and thought that we would'nt have an issue again??? well it time took 18 months, and 3 early MC's.
After the first MC we went to see my OB by the time I got to see him I was BFP but with low HCG numbers and it was only a matter of time before we lost bubs, he referred us to a FS (highly recommended) where we had lots of testing done showing no real problems then it was on to insemination, after a few attempts and no success, with good follie numbers etc, I was very concious that I was depleting my egg supply at an alarming rate so it was decided that we would move to IVF in an attempt to a least collect the eggs!!!
Resulst were devestating it seemed even on higher doses my body did'nt respond well with only 1 mature follie and 1 immature one, cycle was cancelled. Basically I gave up hope.. my next cycle was booked for early the next year, DH and I had come to the conclusion that even with help the job was'nt getting done, so we had little hope ourselves, sex had become abit of a chore, so we did'nt really worry about it too uch decided the break would be good in readiness for the following year, all it took was one time, one good eggie and we were BFP ourselves when we went back to see the FS in Jan. A healthy baby girl was born when I was 41, it was stressful a bit of a tricky pregnancy , and we had put so much effort into the trying that we had'nt thought to much about the other things eg: risk factors for downs etc, in the end it alll turned out well with lots of worry for no real reason.
Our family was complete DH was booked for a vas, we had a vas sex celebration one time only and GUESS what baby no 5 is on her way!!! So I think the best advice is when you are'tn really trying seems to be when these bubs make there way to existence, but not much help when you need/want to try!!! Try and keep it as relaxed as possible, take some time away or mini celebrations, dinner ,movies and enjoy DTD.
Good luck.

[onthefly]

Yeah, I would say 6 months, but don't wait that long if you suspect anything is not as it should be - ie, irregular cycles or whatever. I hope very much it doesn't come to it, but going down the ac route is very time consuming. Before you get to start IVF there's generally months of testing and procedures. then it usually takes at least a couple of cycles just to get the right mix of meds...

Good luck!