What treatment to choose, need advice pls

[ElleElleElle]

Hi Girls,

I really need your advice as read tones of information and still not sure what treatment we would need.

My husband had a vasectomy 18 years ago. We want to have a baby now but were not sure either have vasectomy reversal or just have sperm extraction.

DH undergone for the sperm volume extraction to test his sperm and results came back that his sperm is normal.

Which treatments should we have next to have a baby?

Some sites say IFV, some ICSI, some something else.

Does anybody know?

Thx in advance.

Hi Elle,

I'm not sure about vasectomy reversal, but I believe they have to use ICSI for surgically retrieved sperm.

Just out of interest, what are success rates like after vasectomy reversal? This is something I know nothing about...

I believe the clinics use TESE or TESA. Both are very similar. good luck with your quest to become parents together.

Maybe depend on your age.

Does that mean they might be able to successfully reverse.
18 years is a long time.
I would probably incestigate/ persue both as ivf isnt always successful so you get much more chances trying naturally even if its just between ivf cycles.

Thank you for all your kind wishes.

Read more info and more confused now. My husband did a test to find our the quality of sperm and it came back as a good sperm (was taken from his balls) but I understand it will not still classify as a "good" sperm to get pregnant.

Ideally we want to avoid vasectomy reversal and have his sperm instructed and injected into me. But not sure if it is possible and then how.

Had a chat on the phone with one clinic, they said only IVF possible or vasectomy reversal and then can try naturally or monitor my cycle or whatever.

Does anybody knows anything about what I am talking about and why can't they just take his sperm from testiculars and inject into me at the best time of the ovulation?

Elle, I don't think just injecting a single sperm into you will be successful, in a 'normal' (non-ivf) cycle, millions upon millions of sperms are ejaculated into the female, and even then there is only about a 20% chance of success.

If you do go down the surgically recovered sperm route, you will basically follow the same route as ICSI candidates.

Depending on protocol, you will possibly have to down regulate your ovaries, then have a period of ovarian stimulation and then egg collection (surgical procedure under sedation or GA).

The individual sperm will then be injected into the eggs that are recovered from you and any resulting embryos will be transferred back into your uterus 2-6 days after your egg collection.

The only other option would be vasectomy reversal, the success of which will diminish according to age and time since original procedure.

I wish you every success in your journey. If it makes you feel any better, we are having ICSI, it's not the end of the world

Do you mind if I ask how old you are? Do you have any known fertility issues yourself?

In your situation, if I were under 30 or so, I might give the vasectomy reversal a shot and see how we got on.

Over 30, I would probably go straight for ICSI.

We are all different though, how do you feel about it?

BatteryPoweredHen, I am 34 in very good health, weight, etc. No fertility issues what I know of.

I want to try something as less invasive as possible but I am not if my husband sperm will be mature enough when extracted to get me pregnant.

If I can avoid the route when they give me lots of medicine or take an egg from me that would be great but as for now I am not sure if other routes will be good success because we want to have a child sooner rather then later. That;s why I am asking more experience people as it is all very new for me and the more I read about it the more I am confused and seeing a doctor who said only IVF if possible did not help either :(( Now I am questioning why.

Slightly confused.
Why would only a single sperm be injected. i understand that my husband following the vasectomy had his vas deferens cut which now represent blocked vassal tubes. They now offer a few different procedures to pesa mesa tesa and they collect many sperm cells. He recently had a test and they collected 1.2ml which contained a count of 21 million. Is it not possible to inject all these sperm cells directly into the uterus.

The doctor said that IVF (with ICSI) was your best chance because that is the truth.

You have 2 options to have a biological child with your DH:-

1. IVF + ICSI using surgically retrieved sperm - which is pretty invasive (will involve lots of drugs and procedures to retrieve eggs from you/return embryo to you and also a procedure to retrieve the sperm from your DH.)

2. Reversal of vasectomy and take your chances.

At your age, I would definitely go straight for option 1, and the sooner the better as surgically recovered sperm (esp after 17 years) is likely to be of poorer quality than 'fresh' sperm.

The fact that your DH has had a vasectomy doesn't make it impossible for you to have a child together, but it does quite seriously limit your options.

You do have my sympathy, I found getting over the psychological barrier of needing to have such invasive treatment very difficult. Now I am on the other side and in the middle of the treatment, I can see that it really isn't such a big deal after all.

Have you considered taking this over with a counsellor? It might help you come to terms with what are very difficult issues. Also using donor sperm might be an option? This might lead to a slightly less invasive treatment protocol, but has the obvious downside of any child not being biologically your DH's

Well, I suppose you could theoretically, but your chances of success would be very very small, hence you would have a job to find a clinic that would perform this for you.

p.s. I know the clinic I am using will only perform ICSI for surgically retrieved sperm, I can't speak for them all.

Gosh that is a lot collected. :)
Looking though it says you need 20mil for iui (uterus)
Though often several goes at this are needed.
So that would be the lot.
But as battery said quality may not be as good.
I think i read there could be antibodies as well because of a vasectomy.
How much did the retrieval cost.?
How painful was it?
As for ivf you would already have enough.
Also i presume it is and would be frozen which i dont think does as well as fresh.