Q: I have had vasectomy done ten years back and had it reversed [microsurgery] about one year back without any success. The vas deferens seems to be blocked and the sperms are not coming out. What are our options to have a baby? I am 48 years old and my wife is 39 years old. Please be kind enough to give the options, the best hospitals/doctors who can perform such procedures.

A:The best option for you is to get Percutaneous Epididymal Sperm Aspiration (PESA) or Testicular Epididymal Sperm Aspiration (TESA) followed by Intracytoplasmic Sperm Injection (ICSI) and In-vitro fertilisation (IVF). This is a highly advanced technology and is actually a test tube baby where your sperms will be aspirated by needle from your epididymis or testis, your wife's eggs retrieved from her ovaries and the sperm injected in 7-8 eggs. Once fertilization occurs, the egg will be put back in the womb. It can be done at Sir Ganga Ram Hospital, Delhi, in Bombay and many other places now. You have to tell me your place of living, so that I can suggest the hospital. The cost is upto 1 lac. The success is 35-40% and in your case it may be still low due to age. The other option is to adopt because at your age the chances of developmental anomalies are high and it is better to have a healthy and normal baby.