A quick note re vasectomy reversal.  My husband had a vasectomy 24 years prior to us deciding we would like to reverse it.  We were advised by a urologist, not to bother and instead to have IVF/ICSI.  I was in my mid 30's then and it was suggested to us that after a reversal I would be "too old" to conceive naturally because it would take so much time after the reversal before the sperm would really be capable of doing anything.  Unfortunately, we took this advice rather than seeking another opinion. 

If you don’t have a vasectomy reversal, the sperm is accessed via a biopsy or sperm aspiration.  However, when we accessed the sperm this way they were not fully mature, and barely moving.  Finally (and about 4 years later) we went ahead with the vasectomy reversal, with Dr David Sofield.  The reversal was extremely successful and there were no antibodies. 

However, we do still require ICSI for fertilisation because the sperm count is still lower than we would like.  The motility changes from month to month.  Sometimes it’s A/B grade and sometimes lower.  The good news though is that it is far less painful for hubby to produce the sperm and we now have fully matured sperm which are more then capable of fertilizing the eggs.

I feel if we had gone ahead with the vasectomy reversal many years ago, as we had initially wanted, we may have had a chance to conceive prior to me getting sick and then developing immune issues which are now causing implantation issues.  I'm sure it would have been better to have fully mature sperm to work with when I was 37, not 44.  So I recommend getting a few opinions in terms of vasectomy reversal, before making your decision.  If I had my time again, I would definitely not have jumped straight into IVF.