# Should we go for vasectomy reversal



## gilin sneachta (May 3, 2015)

This is my first post, so I am a little nervous and apologise in advance if this is already covered in threads elsewhere.

My DH and I have met late in life,  I am 43 he is 56.  I have always wanted a family and know I have probably left it too late.  I have not tried (not the right partner etc.) But I thought I would share our details and ask what experiences others with similar situations may have had.  Individuals with neither time nor money on their side.

Recently we went to see Dr. Gorgy to understand my fertility.  Apparently, I am probably below the average 43 year old with an AMH of 6.8 and follicle count of 3.  I only have one ovary as I lost the other when I was 32 due to a cyst, which makes IVF even more difficult.  We found the whole experience with Dr. Gorgy quite mercenary but maybe that is because we are new to this.  But we were quoted fees on the phone and after the consultation given a bill for double that and told that since we didn't pay in advance over the phone, the price was now double.  As you can expect, we were never told that when we booked the consultation so let it be a warning for others about to book.  We also found that Dr. Gorgy wasn't forthcoming with information,  only if you asked a direct question did you get a realistic answer.  On balance, with the statistics not on our side, we are probably going to rule out IVF etc.  as we were told our best option was donor eggs from Greece.  But when we thought about this and the website with donors on it - it just didn't feel right for us.

But we did think that we might take our chances naturally and what will be will be.  But that means that my DH would have to have a vasectomy reversal which took place 15 years ago.  We know that our chances are few and far between but we thought at least we might have tried and if we fail then at least we are not bankrupt.  We have researched a place in Hartlepool that performs these and seems to have good reports - but how do you find out about the bad ones?  I don't want to place DH in any risk especially since our chances are slim and it might all be for nothing.

I guess my question is whether my fertility chances are so poor that I should acknowledge this and not put my DH through an unnecessary procedure.  Or is there anyone out there that conceived with similar stats without IVF.  I have been given a prescription for DHEA but don't know whether to take it or not.

Would welcome your thoughts and experiences - Thanks in advance


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## MrsGorilla (Dec 12, 2013)

Hi there,

apologies for a short reply but I am full of cold and off to bed as soon as possible!

My DH had a vasectomy reversal in 2011 which was successful. We researched for a very long time and finally chose a surgeon at the BMI Hospital in Nottingham. Although I can't remember his name now, he was very good, and his reviews were excellent - we were, and still are, happy with our choice. Unfortunately, by the end of 2012 (if not before) scar tissue had grown over, and no sperm were present in any samples. The scar tissue had undone all the surgeon's hard work. We were told this was a possibility but didn't really think anything of it because we were so sure we would get pregnant fairly quickly, as my age was on our side. We later found out that although I am young my reproductive parts aren't, meaning it would have been a near-on miracle if we'd become pregnant. We regret now not getting me tested out before paying for the operation, and making DH go through it. That said though, his recovery from the operation was fairly quick, and much faster than his recovery from his Surgical Sperm Retrieval (SSR) which was performed last year for our IVF.

Your AMH is much higher than mine, but I am not sure what the chances of success are with a follicle count of 3. I can't advise you whether to take DHEA or not. You are at an advantage though knowing some of your test results, and that will help you make a decision. I would stress though that a vasectomy reversal will only give you a relatively short space of time to TTC until scar tissue builds up.

Re-reading your post, if I were you, I would go and have a consultation with a couple of other clinics, or attend some open days if possible. It definitely does not hurt to "shop around" before making any big decisions or parting with any money, especially since Dr Gorgy wasn't particularly helpful in your case. There are many other clinics worth approaching for donor egg treatment.

(I have just shown your post and this message to my DH - he recommends that if your DH does have a vasectomy reversal and it works, it's definitely worth thinking about freezing a few samples afterwards in case scar tissue does build and blocks the tubes up or you decide to go for IVF in future. Avoids another painful procedure!!)

It's not easy making any sort of decision regarding treatment, and the best advice I can offer is to research as much as you can before hand (patient reviews are great, and this website too). You won't know how far you are willing to go on your journey to have a family until you start, so don't totally rule out IVF treatment just yet. 

And finally, the best piece of advice I've ever been given, is to choose the path with the least regret. Don't expect to ever be 100% sure or comfortable with any decision you make, but after weighing up all available options, try and choose the decision which will lead to the least regret if things don't go how you plan.

Not a super-positive post, but I hope it helps in some way.

Wishing you lots of luck in whatever you decide to do


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## DippyGirl (Mar 10, 2005)

Hi Gilin

I'm coming to the end of my own IVF journey now, we've still got a few embryos and are working slowly through them anyway, I don't usually post on ff anymore but after yet another BFN today I popped on for some sanity and your post caught my eye.  My husband is older than I am and had a vasectomy when I met and married him.  

I don't care for Dr G, have to be careful what we say on the internet but I think you have him to a tee.

We decided (long story) against reversal and opted for PESA ICSI instead.  That is our regret that we didn't go for the reversal and opted for a 'more simple' PESA procedure instead.  

My reasons
There are risks that a vasectomy reversal will not work and then you are left with the only option of ICSI, however if the reversal does work you can try naturally or explore less expensive, less invasive forms of assisted conception (IUI for example)
PESA involves removal of gametes from the testes, some clinics do it 'rough' with a needle aspiration, others do a surgical incision and remove the testicle then access the more mature gametes, I can't remember why but I think that the latter one results in a better sample.  The surgical PESA procedure I described is probably as invasive as the reversal
Once you have a sample at a particular clinic you are tied to that one clinic - other clinics will under protest use the semen sample but will not store it (infection risk)
It is almost impossible to ship semen sample to another country if you choose to cycle overseas
Once that sample is taken that is it, you won't know how good or bad it is until after the procedure and then you are stuck with whatever the quality was on that day.  My own thinking is that lifestyle (e.g. foresight) can contribute to egg and sperm quality and if you have the option of a fresh sample (successful reversal) you have a chance to make these changes in your lifestyle and see the benefits.
I regret that we never got to ttc naturally, instead we survived 6 full ICSI cycles and I have lost count how many frozen embryo transfers.  

So my advice
If you choose the reversal route, do your homework and find the best possible surgeon to do the surgery, microsurgery and someone who does it a lot.
Go to the best of clinics - Lister would be on my list in the UK but also Geeta Nargund (Create) who does a low dose IVF and fertility support thought to be more gentle for us over 40's, she might also be able to advise what your best options are.
Look into lifestyle changes, my own fertility is probably better in my forties than it was in my 30s, work I did with a nutritionalist found several deficiencies and very high lead.
I would give my own eggs a proper chance first, with well timed intercourse 46 is the cut off for having a healthy baby with your own eggs so you do have time but not time to waste.


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## r4chy74 (Mar 6, 2015)

Hi Gilin

This is a really difficult choice that only you can decide   

I have been married twice and both of my husbands had vasectomies (I must be daft  ).  We had one reversal with my first husband which was unsuccessful and then two reversals with my second husband (one side and then the other), again both unsuccessful.  The surgeon that did my second husband's (ironically) said to me the success of a reversal is largely due to the surgeon! So if you do chose to have a reversal I would research a good one. We were unlucky, but there are plenty of people out there who have been successful  

You do have to take a few things into consideration.  My situation was very similar to you with an older husband (he was 50 at the time) who had a vasectomy 18 years previously. We had a reversal but we also had a sperm retrieval at the same time. We went on to do 4 cycles of IVF, all of which were unsuccessful. 

I donated eggs as part of a cycle and the couple went on to have a baby girl and so I always believe (rightly or wrongly) that it was the quality of the sperm that was the problem. Interestingly enough we were never offered tests to check for sperm quality or any additional problems with me, even though I asked in a consultation if there was anything we could do to improve our chances. Maybe if I'd found ff I would have asked for more tests.

Anyway there are many things that can effect the quality of sperm, but age and the length of time since a vasectomy are quite big factors.

Have you considered using donor sperm? My first husband wouldn't entertain the idea - he was worried he wouldn't look on the child as his own. In hindsight I think he used that excuse as he didn't really want another child (he already has 3 from a previous relationship). On the other hand my husband now isn't bothered by that at all and so we have decided to do double donor to increase our chances.

Sorry if I have put a bit of a dampener on things   

Whatever you decide I am sending you lots of   and   Xxx


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## Molly99 (Apr 16, 2012)

Good luck with your decision, it's a hard one but the others have given you some good advice and your amh is pretty good still.

For me, we are (hopefully) one of the success stories.  Our background is different (my amh is lower, I'm 41 and dh is 40 and it was about 6 years for him).  We had a bargain basement reversal done privately but with the Nhs, it was with a Dr who was weeks from retirement and cost £500.  We weren't expecting much when he only did one tube and said there was no point doing the other because it will either work or not  

There were sperm present afterwards but we were told that there was no hope for a natural pregnancy. We had 3 ICSI cycles and they all failed.  With maybe time and lots of supplements his sperm improved hugely though never great.

Fast forward giving up and trying to move on... one year later and we naturally conceived a complete miracle and I'll be 5 months tomorrow  

It can happen.  Obviously age, time since the vasectomy and a whole host of other factors play a huge part and make it quite a gamble.  For us though it paid off and my DH's sperm improved over time and he didn't suffer from scarring.

It's such a personal choice.  Again for me, it was a big thing to reverse something done in his previous relationship (she 'pushed' him into it and then made him leave) but it was also about having that chance every month.

I was supposed to have been moving on but I couldn't really, so I started taking dhea too.  I know that some ladies really struggle on it but I absolutely loved it and had no side effects other than feeling great.  Who knows whether it woke up my oldie eggs but here we are pregnant!

It's all a guessing game with a huge amount of uncertainty.  You just have to go with what your heart tells you in the end xx


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## gilin sneachta (May 3, 2015)

Dear all,

Just wanted to say a big thank you for your helpful kind words.  It was really heart wrenching and warming to hear your individual stories.  We went to see the GP last week to get some extra advice and hopefully will hear from her soon,  she was going to talk to a consultant and get back to us.  We think we will go ahead with the Vasectomy reversal and hope for the best.  Part of me thinks that if its not meant to be then trying at least helps with that acceptance process and having no regrets later in life.    Hopefully, news from the GP in helping us understand my individual situation will help with the decision.

Thank you again for taking the time to share with me,  I really appreciate it and wish you all the best with your own choices.


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## MissBopeep (Aug 18, 2014)

just thought I'd give you a quick reply.
My dh had a VR 18 months ago (BMI nottingham Mr Harris - absolutely brilliant - only 30 minute procedure and let him out the same day. ultra optimistic and very professional)
Haven't had the post semen analysis but have scoped samples at home which got better and better as time passed. Still no bfp  but have actually had a few bfps since the vr which didnt stick. 

I was 43 at time of VR, DH was 46 (15 years since V). I'm now nearly 45 and feeling a bit desperate but still hoping for that little miracle.

My main point is the VR is relatively cheap and simple and doesn't take away your other options, in fact it gives you the potential for a natural bfp and the added opportunity to do conventional ivf afterwards. 

Good luck to you x


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