Multiple Bilateral Varicoceles

KristoKekerooni

Hey all- I normally play over in TTGP/lurk, but we finally got our ultrasound results back. My DH apparently has several small varicoceles in both testicles. The reproductive urologist was pushing surgical correction, which is understandable, but then saying it only helps 30% of couples achieve pregnancy! Is the surgery worth it? It's 8K out of pocket! Is anyone here dealing with MFI/varicoceles? What's your thought process on correction? I'm leaning toward skipping it and going for IVF, since that's where we will be if it fails to increase his counts. I also can't get a straight answer about how much the surgery costs. Since we are out of pocket, this matters a lot to me. Anyone know? 
Is there a difference in outcome if it's a single testicle effected vs bilateral? So many questions!!!

I'm just trying to think logically, but that's so hard since we are on cycle 23 of TTC-I'm too emotional. 

capps42613

@KristoB sorry you find yourself here. My DH dealt with severe MFI but was not diagnosed with varicoceles. Do you know the name of the procedure? He did had to have a surgical procedure done called Micro TESE though.. Does that sound familiar?

KristoKekerooni

No, they are just trying to tie the varicoceles off/remove them. It's just a varicocelectomy. He had two options, an open surgery, or a radiologic approach to just cauterize them. 

capps42613

Sorry I can't help, Best of luck to you both!

Maydar

I did a lot of reading up on it to try to figure out if it's worth it - sometimes even when studies show that it increases count or quality, it doesn't increase pregnancies! The literature is just a mess. I don't remember if there was a difference if it was unilateral or bilateral; my husband only had one on one side. Common sense (which doesn't always match the research) tells me maybe bilateral would be MORE likely to help, because in the case of unilateral varicocele there must be some other underlying problem with the unaffected testicle, but if it's bilateral that might be the only problem.

If we had to pay out of pocket I think it's safe to say we definitely would not have done it. It was about 1/3 of the cost of a round of IVF! 

We lucked out - our insurance covered it as long as the word "fertility" did not appear anywhere on the paperwork (we watched the urologist freak out when he saw MFI on one form!). It was coded as if it were causing him pain, which it might have at some point, we don't really know. We ended up paying under $500 altogether. They don't do a SA until October (the surgery was at the beginning of May - I think they're waiting longer than some doctors do) so we have no idea if it helped, but we're hoping it could get us to a point where IUI is feasible.

I don't know what the best choice would be for you, but I wish you lots of luck and decision-making strength!

hibiscus118

If you have to pay out of pocket, I say it's not worth it!   My husband just had surgery as well, but insurance covered all but around $300.  Like PP, we have to wait 4-6 months to find out if it even worked as sperm takes that long to regenerate themselves.  He's also on HCG injections to boost testosterone. 

My doctor told us a lot of people skip it and go straight to IVF.  We chose to get it done because he was in the "emergency zone" for having to need his sperm aspirated by the urologist on the day of retrieval.  We are just hoping to get his numbers high enough to make things a little easier later down the line.  

Brewerbrian

I had a bilateral varicocele (grade 3 on one side and 2 on the other). My SA results were right at the baseline for "average", but still considered low by my urologist. He gave me a paper that discussed the different procedures that were possible with statistical results. We decided to do the subinguinal varicocelectomy. Two weeks after the first surgery was the optimal time to try and ultimately from that attempt we got our first positive test ever. The 3 month follow up SA didn't show too much increase in Motility or Morphology, but did see my count go from 25mil to 175mil.

For us, insurance covered all but $1300. I did calculate what the bill would have been for the surgery without insurance and "provider discounts" and it would have totalled over $22K. The surgery center and doctors gave my insurance a discount which knocked everything down to $5K before I had to start paying my deductible plus 20%. If you have to pay out of pocket, you may have to negotiate your own discounts.

Here's my whole post about the experience, recovery and costs: https://forums.thebump.com/discussion/12693422/my-varicocele-story-details-about-cost-surgery-recovery-and-success