When you take vitamins, avoid Folic Acid. Take Folate. Up to 50% of women do not process Folic Acid well.

get day 3 bloodwork to have a base line. This can be a part of your well woman exam, just ask your ob/gyn or PCP, whoever does your annual PAP (speaking of which, your PAP and Mammogram need to be up to date, you can't start infertility treatment if either is older than 1 year).

Start a pre-natal vitamin now, and look into other supplements. If your insurance moves slow you might have a couple of months to take them before the fertility testing and treatmetn.

Do work outs several times a week. If you're overweight (over BMI of 25) - try to drop some weight. Eat a high protein diet with plenty of omega 3s. Research healthy proteins and include at least one in every meal (yoghurt, nuts, lentils, beans, lean meat, NOT protein bars). If you have any suspicions of thyroid or insulin resistance issues - get tested by an endocrinologist or PCP, it doesn't have to be through a fertility clinic.

keep very good track of your labs (electronically), request copies of results. Write down things you read up on, it will help to talk to RE.

Sorry, but at 39 you don't have the time to think about things. You need to go to an RE and start IVF. There are procedures/tests that they will make you do before you can even start -- your insurance will cover these tests (like HSG, etc.). You are not eligible for SG shared risk, you may want to consider Cornell or someplace like that. I think your RE will probably tell you not to waste your time with IUIs. Good luck.

So much great advice here.

For online support I really loved www.fertilethoughts.com

Found a great community of people going through exactly what I was doing, at the same time. Tremendously helpful to me.

Good luck OP!

Anonymous wrote:Use the SART website to compare statistics between different clinics.

Definitely. Wish I'd known this was important fro the start. But use this website, which allows you to compare more easily. http://fertilitysuccessrates.com

And make sure you look by age. Some of the clinics with great success for under 35 are not good for older patients.

Use the SART website to compare statistics between different clinics.

Some tips and tricks

http://www.dcurbanmom.com/jforum/posts/list/483405.page#7223298

Get a Pap and Mammogram done ASAP. They have to be up to date before you can do some procedures.

If you have Male Issues, skip the IUI. Maybe do one, but don't waste your time otherwise.

I wish I had gone to a Registered Dietitian before I did all the Traditional Chinese Medicine and Acupuncture. Nicole at Pulling Down the Moon in Rockville is great. You can also reach her at http://www.wholehealthrd.com

Don't expect unconventional things to create miracles. Using things like TCM herbs and acupuncture is a great supplement. But I wasted too much time hoping these things would work.

Find a support network, Either online or IRL, to help you with the emotional stuff. The most difficult part is the emotional stuff.

That being said, don't tell too many people IRL that you are doing ART. Nothing worse than having to tell your 20 co-workers that another cycle failed.

The resolve forums are awesome!

Shady Grove's website has a lot of information about the processes involved, for starters. If you have specific questions, ask here or on the Resolve forums.
Speaking from my experience, at 39 you do not want to delay. My OB literally pushed me to the RE.
At the minimum, get the day 3 bloodwork done for you and a sperm analysis for your partner unless this has been done already. Your ob-gyn will be able to order these. These results will inform your next steps.Also if you have an option, switching to another health plan with more coverage may be something to think about during open season.
Wish you good luck!

At 39, you can't really waste your time with stuff that doesn't work. (says 42-year-old who started at 39 and did waste her time with stuff that didn't work, and now finds it might all have been a waste of time.)

Obviously everyone is different, but if I could do it all over again, I would:

*make sure your thyroid levels are ok going into things. And check to see if you're immune to chicken pox. That held me up two months, because I had to get the shot! OB-GYN and GP can do those tests, and they should be covered under well woman visits, so you shouldn't have to pay for
*look at the clinics with the best stats for women in your age group. (Happily, many are in NJ or New York.)
*get a consult and all the testing at one of those clinics, and be on top of keeping all the records, because you might need to switch clinics if things aren't working for you ad they can move more quickly if you've got it all in hand. The consult itself and the diagnostic testing should be covered...and are not that expensive in the greater scheme of things.
them.
*Get an HSG, stat. It might be as simple as blocked fallopian tubes. Some insurers cover this procedure, some don't. IF you do need surgery, make sure it is coded as a necessary gyno procedure, not as for infertility -- that way it's covered.
*max out how much money you put in your HSA for next year so you have money for procedures next year.
*start saving money for OOP stuff. My insurance covers IVF, but the drugs have high copays -- one cycle was $4000 in meds before we hit our OOP max for the year. Even if you do get pregnant without ART, how nice will it be to have that money for the baby or a head start on a college fund?
*pick a progressive clinic that does CCS testing on embryos and that does six-day transfers, which help older women because their embryos develop more slowly.
*Unless your insurance insists on it, do no more than one IUI before moving on.

39, off BCP for a year, no previous kids, 6 months trying using OPKs to time things (and a very regular cycle) and nothing, so it seems time to talk to my doctor. As I get that ball rolling (knowing my providers, it will not be speedy) are there any websites or anything that people read as they were thinking about potential fertility challenges that you found useful? Either to get an idea of the things that could be going on or what next steps might be? I have an HMO that will cover testing but no treatment so kind of want to think through ahead of time what next steps and issues might be.