I can't say what the cause of this distress is and would recommend an exam to determine if there might be an ovarian cyst or other abdominal problem since there are so many organs in the abdomen - bowel, bladder, ovaries, uterus, gall bladder, appendix, etc. There are many possibilities for cause of pain.
As for the pregnancy attempt there is the age concern. Fertility is greatly reduced after age 40-45 so your biological clock is ticking. If you had a tubal reversal (also expensive I'm sure) and then tried for a while, you could find you are having trouble conceiving and each month you get closer to menopause so you don't really have time on your side. It can take a while to get pregnant even if you had a completely successful reversal. Ovaries start to slow down. For this reason I think your chances for having a natural child would be best with IVF. It's true there's no guarantee, but that's the case with all your options right now. If you don't mind trying for pregnancy, while being prepared for the possibility it may never happen on its own, especially considering sperm motility concerns, go for it. But, it can be hugely disappointing to get your hopes up when perhaps it is not realistic.
Many older women successfully carry babies to term but those you see (superstars, etc.) often have used IVF, usually with donor eggs, in order to achieve this goal. There is a lot going on backstage that we don't hear about in the media. Thankfully some things are still private.
Most of the time, several eggs are harvested and conception is attempted. If you fail in your effort, the second time usually is not as costly due to the fact the eggs are already harvested. If cost is prohibitive, I understand you can sometimes travel to other countries (even some Soviet countries) and get the procedure which, including travel and lodging, still saves thousands of dollars over U.S. prices. Just something to consider and investigate on the internet perhaps.
Best of luck to you.
The answers in online forums are for information only and are not intended to substitute for medical advice and care. Please see your personal health care provider for further evaluation of your individual case.
Debbie Miller, RN