IVF or varicocele repair?

Question

Me and my husband have been trying to conceive for 15 months with no luck. My husband had a sperm analysis done showing low motility (4%) even after vitamins and lifestyle changes we did a repeat SA in 3 months and motility was still low. 
His urologist says he has a medium size varicocele and that repairing MAY help him or may not. The repair will cost us $10000. And will take 6 months to show improvement (we are both 30 so we have time on our side)
We had a consult with a RE and she insist we would need IVF w/ ICSI which is around $20000 with a 50% success rate.
I ovulate regularly and get periods every month but now am getting a work up to see if I have issues too. 
Anybody in a similar situation that can offer advice? We arent sure which way to go. IVF with ICSI seems appropriate but I’m not sure if we should do the varicocele repair??

Answer

My husband had five large varicoceles removed this past nov. We started trying oct 2016. Semen analysis showed only 24 million total count, 11% motility only 1% being progressive and zero morph! I was a wreck. Immediately I thought wow we are going to need icsi just like that. Total shocker. We waited three months to finally see a fertility urologist. He was so busy we had no choice. Did a full hormone and blood panel. Physical check he saw the veins right away. All hormones were fine just borderline low testosterone. Fast forward to first semen analysis in jan and wow! We are at 31 million total count, 71% motility (48 % of that being progressive) and 12% morph. I kept saying, are you sure that is his???? We did a little high five in the exam room. The fertility urologist told us to go forth and procreate. This is month two of trying with good Sperm and a actual fair shot at natural conception. He is also on 25mg of clomid a day, men's multi, Extra vit c and coq10! His doc said coq10 is shown to improve morph! Also his insurance did cover it , we just had to pay deductible which was 2500. My husbands five veins were all left sided and also caused his left testicle to be a tad smaller and softer. I'm so so glad we did see the fertility urologist first before any RE. As I'm sure they would of said ivf. Thankful we have been given this opportunity to show surgery can work and to try it!! I'm praying for a blessing now in 2018.

Answer

If you’re considering having more than one child in the future, the repair seems like the most cost effective way to go. If you want a child sooner, and can afford it, IVF seems like the answer. Write down the pros and cons of each path and prioritize based on money, time, and your needs/wants!

Answer

Did he have blood work done as well to rule out low testosterone, which can cause low counts? Because then they could try chlomid first to boost counts. Or low thyroid? Or an internal infection somewhere could temporarily reduce counts & they could put him on a strong antibiotic? Or did they just discuss the varicocele? I would maybe get a second opinion & another semen analysis in a few weeks to make sure he wasn’t just having an ‘off’ day, before you make a decision. Best wishes!

IVF or varicocele repair?

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