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    I have had a tubiligation, had it surgically corrected and I am 45 years old.
    baylee67 posted:
    I have had a tubiligation, had it surgically corrected and I am 45 years old.
    My husband is 11 years younger than I am and has never fathered a child. We have not diligently tried to conceive as he has been gone for 6 months in the Army and left shortly after I had the surgery.
    What are some good recommendations in this type of situation? I do not look or feel my numeric age. I am a healthy, active woman who is far from over weight. Further more, prior to my tubiligation (18 years ago) I was more fertile than most women. I would go as far to say, I had a harder time NOT becoming pregnant than I did becoming pregnant.
    David K Walmer, MD, PhD responded:
    Dear Baylee67, A good starting point may be to assess your ovarian reserve by getting a serum FSH and estradiol level between cycle days 2-4 and checking a serum AMH level. All women have a natural age-related decline in fertility that usually has little to do with how healthy they look or feel. Most women with unexplained infertility or an age-related decline believe in their heart that nothing is wrong until they have trouble conceiving. Your fertility at the age of 45 might be more like women that are younger but it is possible that you may not get pregnant with your own oocytes as well. Time is of the essence if you want to have a child. At the age of 45, the chances that a pregnancy will have trisomy 21 (Down's syndrome) has increased from about 1/300 at the age of 35 to 1/30 at the age of 45. If you don't conceive right away, you may want to do some soul searching about whether you are willing to consider donor oocytes or adoption to have a child together as a back up plan. Knowing what is an option or completely off of the table will help you in your discussions and a critical transition points. Good luck!

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