Ah, I understand now. Yes, you're in a sensitive situation. Don't be alarmed that you haven't conceived in 3 years--especially when you weren't trying. It's not all that uncommon. If you and your partner had been actively trying for 3 years, you might want to consult a fertility specialist.
If I go on BCP (or IUD), I'll let you know. I'm pretty sure, though, that I want to avoid anythig with hormones, so if it's not a tubal ligation it will probably be an IUD. At your age, though, I did the hormone thing (depo), and didn't have any problems with blood clots. But see, I smoked when I was your age, so BCP were out of the question. They also become more out of the question, the older you get.
Erin, it sounds like you need a real heart-to-heart with your sweetie about children. One option that is available to both of you is adoption, granted not an option for everyone. Adoption has always been an attractive option for me (providing a home to a child that doesn't have one), and foreign adoptions are very popular. The prospect of adopting if I get my tubes tied makes the tubal ligation decision much easier. I KNOW that I don't want to be pregnant again (had first major flare while pregnant--that's how I know I don't have RA because you're supposed to go into remission while pregnant), but I may want another child, especially if I can provide a life to a baby that was "thrown" away in a 3rd world country. Just something to chew on...
Your sweetie is not too old to conceive, and you certainly have plenty of time left. Go on mtx, if you need to. You will have time to work on conception later. I know my clock started ticking at around 32, but jeez, these days women are having their first children in their early 40's!
Have you ever thought of pregancy to induce remission?
Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Aciphex, Ultracet, Zyrtec, Allavert-D, Zantac, Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan