ICSI or Vasovasectomy?

[MaisieM]

Good morning Ladies, I'm new to this forum (and all this!) so your advice would be much appreciated!

I am 41 (no children), my OH is 37. He had a vasectomy in 2001 after fathering two children. My AMH is 20 which is apparently quite good for my age and my periods, whilst on a long cycle are fairly regular). We had been considering a reversal then TTC naturally. However, I work at my local hospital and have been fortunate to have had a couple of informal consultations with the Consultant and Sister in the fertility suite. They have advised us not to bother with the reversal and to opt for ICSI instead (with optional storage of sperm from extraction).

Cost wise (which is a consideration for us) there appears to be only about £1000 between the two options but obviously the ICSI route will only give us one shot.

I asked the Sister, cards on the table, if there was really any point going for the reversal and just seeing what happened but she said that there wasn't much point because of my age. I feel very torn as I hadn't really wanted to persue the IVF route at all.

I'm absolutely useless at decisions like this and my OH is totally happy to go down either route (bless him).

Any words of wisdom would be welcome!

 

[JaniceT]

They have very valid points. Your OH's vasectomy was 10 years ago. A reversal now would have a lower chance of success. Also with reversals, even if it did work for awhile for sperm to swim through, blockage from scarring could occur not long after reversal due to the microscopic diameter of the vas.

Let's say if he did have a reversal and the tubes are properly connected. Since it's been a decade since, he would have to wait from 6 months to a couple of years for sperm to flush out dead sperm and to make the pipes pump fresh sperm. Your own fertility drops every year so time isn't on your side.

My OH had a vasectomy reversal, initially showing a handful of sperm swimming through the vas. Not long after, his tubes blocked. He still had to go for Mesa/Tesa to retrieve sperm.

I would propose the ICSI route as his sperm may be weak after sp many years, and need the assistance of the lab to fertilise your eggs. Time's crucial hen it comes to fertility. I wish we had skipped all that reversal, cools have saved us so much time.