low SA and blocked tubes-- laproscopy?

[avocada]

Initial workups with RE show (1) DH's morphology very low (4%- doc wants 10-15%) AND (2) my HSG sez that both tubes are blocked at the ends! After yesterday's HSG (a 3-hr drive away so a day trip w/ DH), I was SOOOO glad that we had already talked about fostering/adoption, AND that we have both realized we'd be fine and great without kids, but WITH each other, going forward. (TTC 2+ yrs, using only acup/herbs til now, and I feel I've wasted time and oh no we're sorta OLD [me 38, DH 49-- plz don't be offended anyone else-- it's a personal feeling only].)

What would you do? AFter the SA but before the HSG, I was feeling fine about IUI, but if the required procedures start piling up, I may not want them. ($$$ [self-pay, no-IF insurance] vs. odds of success vs. time to do all this... etc.) The doc and I haven't had the official, week-after-HSG discussion, but in the HSG room she said the typical fix is a laproscopy. How extensive is that? How expensive is that? DH did the initial laproscopy research yesterday when we got home and reports that it may have a low success rate because the unblocking procedure itself is rough and will create scar tissue. (Doc had said my tube-end-blockage could be due to scar tissue from past infection.)

Any supplements or meds anyone knows about for improving sperm morphology?

What a giant ball of confusion.


(My MDC search tool isn't there, so my apologies if this is a repeat discussion. )

[cincynana]

I'm not sure what I would do...but maybe this will give you some more info in making your decision.

I had a lap June 2007. For me, it wasn't a bad experience. You are put under for the procedure. I had mine done on a Friday and was fine by Monday. After the surgery, I had minimal discomfort from the incisions. The worse pain was my throat (a breathing tube is inserted) and the gas pains in my chest and shoulder (from where they pump in gas to expand your stomach). My insurance covered most of it and we had to pay a certain percent (I can't remember the exact percent, but we did pay a couple hundred out of pocket) I'm glad I had it done (even though I'm still not pg but it did atleast answer some questions since I had both tubes blocked by endo and scarring) ETA: I found our cost for the lap. The total cost was $7580.15 plus $96.46 seperate anesthesia charge. Our co-insurance charge (what ins didn't cover) was $726.20 plus we paid the anesthesia. I know our RE offered a discount for anyone who didn't have insurance and paid upfront.

As for morph, try a supplement called pycenogenol. If you google it, you can find a lot of info on it. dh has low morph too (0%morph, 100% head defects) He is going to have an embolization in 11 days to fix a variocele that is probably to blame for his plummeting numbers. Once he has the surgery, I am going to make sure he takes it everday. Our urologist also suggested a really good multi vit and 500mg of Vit C once a day.

Hope some of this is somewhat helpful to you. Best wishes in whatever you decide to do next.

[avocada]

Thanks. It IS helpful. My first response to surgery was very hesitant, but after the "week-after" doc visit yesterday I'm more comfortable, and you're the second one who's told me their lap was no big deal. My RE is going to make it work for my insurance, too, so even though I have a high deductible ($2500) that we'll have to pay, that's much less than the 7 G's you told me the real cost was. My doc also said, though, that the HSG doesn't show the condition of the tubes, and that if, when she's in there, she determines that they are so scarred that an ectopic is probable, that she'll REMOVE THEM. REMOVE THE TUBES. Says she does this because the next step (to avoid fert that would stick in the tube) would be IVF, and that if there are damaged tubes for some reason the embryo may still go up there and make an ectopic... (?) (But it's implanted in the uterus, right?) Anyway, I already know we'd go with adoption vs IVF (primarily due to expense vs. chance of success), so I think if we go with the lap, I'll tell her to leave my tubes no matter what she sees. She'll probably fight me, saying she wants to save me some heartache, but I feel like I want to keep all of my stuff. I'm hopeful that they're nice and clean :, because my view of the HSG (yes I know I've only ever seen one) is that the dye moved through very well up to the end of them.
Good luck with DH's procedure. I did order some pycnogenol and my DH will start when it gets here.

[ChelseaW]

My experience was very similar to cincynana's. I had a laparoscopy in June 2004 - my HSG showed the possibility of a partially blocked tube and I had symptoms of endometriosis. My DH also has really bad sperm (morph, motility and count are all very low.) The lap itself was no big deal, and our insurance did cover it completely since they found endometriosis and that's not just a fertility issue. I was sore for a few days after and had some cramping (they also did a D&C to remove some polyps while I was out, I think that's what caused the cramps); most of the discomfort post-op comes from the gas they use to distend your belly during the surgery. But it was nothing that some good painkillers couldn't handle. I was feeling back to normal just 3 or 4 days postop. We ended up going on to IVF, and got our DS on the first try. Best of luck to you! Let us know what you end up deciding to do.