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I don't have much experience but bumping for you as some ladies on here know a ton.

We tried over a year for LO2, and after 6 months of serious trying with OPKs and everything (and another 6+ months of not so serious timing) my OBGYN did an ultrasound and blood test. I guess at least for her practice that's the way to start. Nothing came up, just two different TTC experiences.

My long-time Kaiser-using family say that it's good so long as you advocate for yourself and are proactive. Good luck with everything!

@mrs. k sorry you are going through this! Getting dh a sperm analysis is absolutely the first step since that's the easiest thing to diagnose. That's how we found out ivf was our only option. Regardless you'll still probably go through a series of tests too. This is what I did through a fertility clinic, not sure how kaiser would differ: first day 3 blood work to check hormone levels, then blood work later in cycle and ultrasound to see if you ovulated. Finally a hysteroscopy which uses colored dye and xray to see how fluid moves through your tubes to check for blockages. I think that's it but maybe others can chime in. Good luck and feel free to follow up with questions here or on my wall. There's a ton of knowledge on the ivf #4 thread too even if you don't go all the way through ivf. Also wanted to provide some hope by letting you know I'm currently 15 weeks with my second ivf baby. DD is 2 and so worth all the struggle and wait for ttc!!

@Mrs. K: I'm also almost 34. When I mentioned how long we'd been trying to the nurse practitioner at my well check, she said that she thinks the one year recommendation is fine for people in their 20s but that she personally would recommend checking things out closer to the six-month mark for those in their mid-30s, especially for those that are hoping for another little one in the future. I've also seen this recommendation in a few books. On the one hand I don't want to rush it, but on the other hand I also really feel the clock ticking, plus, I think more information would provide greater peace of mind...

@Mrs. K: I feel the same way on all of this. I'd rather have an unnecessary blood test and ultrasound than find out later that I'd spent over a year trying with no chance of getting KU, all the while with the clock ticking. It hasn't even been that long, but with each BFN the family I'd hoped for feels a little bit less likely - even if the diagnosis is really bad, I'd prefer just to know. I also have managed care so have to get a referral for everything. I'm glad at least that the testing (at least the basic stuff) will be partially covered.

@Mrs. K: Yeah, I tend to assume the worst. I know it's not good - most likely we will eventually have a family and I'm wasting valuable energy feeling like we won't - and I should just take things one month at a time. But it's hard when all you see are BFNs to imagine that next cycle could be different. Sorry about all the just relax's - that would drive me crazy. I haven't told my mom we're TTC, but for the opposite reason - she is a mega worrier and I'm trying to avoid being sucked even further down the worry rabbit hole.

@Mrs. K: The post-it notes are a cool idea, thanks for sharing!

The Kaiser system where I live (Colorado) doesn't do infertility testing or treatments. They refer out to a local fertility clinic and either 0% or 50% is covered, depending on your specific plan. Our plan didn't cover any infertility related expenses so I ended up choosing a clinic I liked and payed for everything out of pocket. My Kaiser on/gyn did check my thyroid function which is a good place to start if you are having trouble getting pregnant. I know Kaiser does vary from state to state and maybe your ob/gyn will be more willing to run more tests. Good luck!

@Mrs. K: have you been using OPKs and/or charting while you've been ttc?? I didn't see a mention of that above? It took 9-10 months to get a with my first, didn't start using OPKs until the 5 month mark and realized I ovulated way later than I thought.... anyway, since you're 34 and not yet 'AMA' they may tell you you have to wait until after a year of trying... but that could depend on the Doctor/practice. I brought this up with my doc the first time (I was 32) and she told me to wait longer before they did everything... anyway, good luck!! Hope you get a soon

@Mrs. K: I would really encourage you to start charting. It will give you so much more information about how/if your body is working. It took us 11 months to conceive our first. I started charting and realized two things. One, I produced low cervical mucus, and two I ovulated later than I thought I did. We got pregnant my second month charting. When it came time for #2, we were able to conceive right away. Check out the book "Taking Charge of your Fertility."

@Mrs. K: TCOYF talked about being able to monitor their CM by checking the toilet paper, but I never really got any on the toilet paper. It's kind of TMI, but I could only check my CM by sticking my fingers all the way up and almost milking my cervix. I started drinking two cups of green tea from cycle day 1 to ovulation and noticed a huge difference. I was really resistant to temping and charting too, but after 9 months it seemed like a logical next step.

Not in your position but I wanted to chime in and say that I used ground flax during the first part of my cycle when I was ttc (up until day 14 or until you've ovulated if you are temping). It mimicks estrogen in the body and helps with cm. I had soooo much ewcm when I started adding that. You can sprinkle a bit on your cereal, add it to scrambled eggs or put it in a smoothie!

Just a tablespoon every day.

When I was ttc I was on a mirad of vitamins. Mostly because my cycle was very irregular but also because I was lacking in some of them. I took vit D, magnesium citrate (supposedly building up a supply of this before pregnancy can help prevent morning sickness/nausea), a prenatal, iron and vitex. Apparently most of us are vit d deficient these days since most of our days are spent indoors and we use sunscreen all the time, so it can't hurt to add more! If anything it may give you more energy!

@Mrs. K: I started taking vit D for TTC a few months ago, as I've been deficient in the past and being deficient can cause infertility. I can't remember exactly how much off the top of my head. When I got super deficient a few years ago, my doctor prescribed a prescription strength one to get things back to normal.

@Mrs. K: it's new research, or newish research. Plus I think so many people being deficient is also new, we tend to drink less milk and get less Sun exposure. At least there is a reasonable sized vitamin for it.

RE cervical mucous, I do a charting method that relies solely on that (since it's often a natural biomarker of unbalanced hormones)

Before I started this method, I thought I barely had any mucous. Once I did it for a while and was fully compliant (wiping BEFORE and after using the bathroom), I learned I actually had more to "read" than I imagined! (still not much egg white/super fertile mucous though)

My doctor has me on extended release B6 (I take P-5-P because I have MTHFR) to produce more mucous, and I take Mucinex from a couple days before expected peak until it's confirmed to thin the mucous that is there.

@Mrs. K: I have Kaiser and I just emailed my OB about getting some initial fertility testing done since we are now on our 10th month of trying. I'll let you know what my experience is. I asked her some questions about whether she can do the testing or if we need to be referred.