What will be the next step after first seeing a fertility dr? I'm 40.

Fertility workup >40. The most likely step would be analysis of hormones on cycle day 2 or 3 including fsh, lh, e2, tsh, free t3, (liothyronine) free t4, prolactin and amh. The results will give you a good indication of a woman's chance of having a baby.