I'm a 39-year-old woman with 4 children. My husband and I are thinking about having another baby and -- because I had my tubes tied -- we're considering in vitro fertilization (IVF). Since our insurance won't cover the procedure, we can probably only afford one round of treatment. What are the odds that one IVF will prove successful for a woman of my age?

--AD

When it comes to the likelihood of successful tubal reversal and in vitro fertilization, the odds are against women your age and older. Fertility drops dramatically after age 38, and delivery rates per IVF cycle started are approximately 15%. This rate is similar to the live birth rate following tubal reversal for a woman of your age.

Before undergoing any treatment for infertility, you should consider a couple of tests to measure your fertility potential. One is called a clomiphene challenge test; the other is a day 3 FSH blood level test. If these test results come back abnormal, the likelihood of successful fertility treatment with your own eggs is even less than noted above.