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When to give up the hope of TTC naturally?
MollieB5 posted:
My Husband had a vasectomy reversal 18 months ago. We have been TTC for 16 months now with one miscarriage (5 weeks) 8 months into TTC. He has very low morphology 1%. We are not financially ready for IVF, how long should we keep trying before we bite the bullet and go to a fertility specialist?

My husband thinks we need to give it more time, I think we are just wasting time, but I know we don't exactly have the funds.

My husband takes a large cocktail of sperm healthy supplements.

P.S. my husband is a smoker, he tried to quit once (it was a miserable experience for both of us) and failed.
FCL responded:
Generally speaking, they recommend you to seek help when you've been TTCing for 12 months. How old are you both?
MollieB5 replied to FCL's response:
I am 28 and my husband is 38, I know that they say after a year, but I dont know if I should give it a little longer due to his Vasectomy Reversal
nicram8683 responded:
Going to see an RE doesn't mean you have to do IVF. There are other more affordable options available before you get to that point. We also suffer from MFIF only and our RE has 3 steps. 1st is where they give me meds to ovulate more then 1 egg to increase chances, 2nd is IUI (which is pretty successful for MFIF) and then 3rd is IVF. You should get a referral for an RE just to have all necessary testing and see what options you have.
MollieB5 replied to nicram8683's response:
Thank you for your suggestion. We set a date for November that we will go and talk to an RE and see what they have to say. I'm nervous.
AmyAALC responded:
Great questions and I talk with couples on this topic daily.

Is your husband's sperm count and motility in normal range, 20 mil/ml or higher and 50% or higher? If not addressing the slightly low numbers would be the first step.

After a reversal (VR) it is possible to have restriction at the surgery site and this can be managed with anti-inflammatory medications. Another great option would be Clomid for him. Clomid will boost sperm production and sperm quality.

As hard as it is to have a miscarriage it is a positive sign that he has fertility and his sperm can get the job done. Why the pregnancy didn't stick is hard to say in terms of male or female caused.

I would recommend checking everything on the female side just to make sure hormones are in check, ultrasounds look good in terms or ovarian function and the uterus and fallopian tubes have no blockage. Sometimes going through some of those workups does the trick and couples will end up pregnant on their own.

Amy Perkins, MS, TS
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal
AmyAALC responded:
The smoking could also be the cause... I know you've told him a number of time.

I've published research looking a smoking patients after a reversal compared to those that did not smoke and no difference was seen for the return of fertility based on semen analysis results but we did see a significantly lowered pregnancy rate for the men who smoke.

Studies also show that smoking causes DNA damage to sperm cells and that DNA is very important to creating a pregnancy and a healthy baby.

MollieB5 replied to AmyAALC's response:
His volume is 3.8 ml, 66% motility and total motile sperm is 38. I believe his smoking is a huge factor in our issues, but he still can't kick the habit. Do you think it would be a waist of time and money to see a fertility specialist if he is still smoking? Thanks for taking the time to respond.
AmyAALC replied to MollieB5's response:
His volume, count and motility are normal so looks like the smoking could be the biggest problem. A fertility specialist will discuss IVF which on average runs $12,000 per cycle with 2 cycle average for a successful pregnancy and live birth. I think kicking the smoking habit is a lot cheaper compared to the IVF.

You should look into starting him on a antioxidant rich diet and adding in vitamins to try to help improve his sperm quality or at least try to lessen the impact of the toxic chemicals from smoking.


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