Recently, Dr. Steven Shu innovatively improved his surgical techniques on vasectomy reversal by using the same principles and instruments as the no-scalpel vasectomy. One Stop Medical Center now offers No-Scalpel Reversal Procedure in its Edina surgical center.

A vasectomy reversal (vasovasostomy) is a microsurgical procedure that reconnects the vas deferens where it was interrupted by a vasectomy. A traditional approach to vasectomy reversal is to make two incisions in each side of scrotum. Over the past decade, more surgeons adopted a single incision in the middle of the scrotum. In order to further reduce the trauma, the recovery time, the operative time, and the postoperative complications, the mini incision vasectomy reversal approach is proposed. Similar to no-scalpel vasectomy, the initial mini-incision is created using a sharp penetrating forceps that spreads the tissue apart instead of cutting it with a sharp scalpel.

“We constantly improve our surgical techniques and the whole service system on vasectomy and vasectomy reversal procedures,” says Dr. Steven Shu, medical director of OSMC. “I was thinking, no scalpel vasectomy has many proven advantages over conventional vasectomy, why couldn’t we use the same principle and instruments to do vasectomy reversal?”

One Stop Medical Center in the Twin Cities has developed an affordable, minimally invasive and convenient vasectomy reversal care system. This approach eliminates these three road blocks in the men’s mind: fear of pain, cost, and time.

One Stop Medical Center also has a powerful website with a plethora of information on vasectomy reversal. All patients are required to review important vasectomy reversal information before scheduling a procedure. Dr. Shu will finalize the consultation on the same day of the surgery, so the patients do not need another trip for the consultation.

We got a question from a patient on anti-sperm antibodies last week: the patient wanted to know the level of anti-sperm antibodies in his blood because he is concerned that they will influence the success rate of a vasectomy reversal. This blog post will specifically address this issue.

What is an Antibody?

An antibody is a blood protein produced by your body’s immune system in response to the stimulation of a specific antigen. Common antigens include multiple antigens in bacteria, viruses, cancer cells and foreign substances in the blood. The antibodies combine chemically with antigens and serve to help the body target and fight-off theses “dangerous” or “unwanted” cells or substances.

What are Anti–sperm Antibodies?

Normally, sperm antigens in sperm are not exposed to the immune system because of the blood-testis barrier and other epithelial barriers along the reproductive tract. When the blood-testis barrier is compromised under certain circumstances, such as trauma/surgery, infection, cancer and congenital defect, sperm could be exposed to blood and trigger the immune responses, which leads to antibody development. Development of anti-sperm antibodies after vasectomy is thought to be related to the breakdown of the blood-testis barrier and leakage of sperm antigens from the epididymis.

Antisperm antibodies are found in between 8% and 21% of men in the general population, 9% and 36% of infertile patients, and 70-100% of men after vasectomy.

What is the Relationship of Anti-sperm Antibodies with Vasectomy and Vasectomy Reversal Procedures?

How Anti-sperm antibodies affect fertility following vasectomy reversal is not clear. The practice guidelines of the American Society for Reproductive Medicine and the Society for Male Reproduction and Urology stated:

“Overall postoperative conception rate (following vasectomy reversal) is relatively high (50% to 70%) and the presence of antisperm antibodies does not correlate closely with postoperative fecundability. Consequently, the value of preoperative antisperm antibody testing remains controversial and unproven.”

Here is a summary of research evidence:
1) Despite almost all men having detectable antibodies following a vasectomy, two thirds of vasectomy reversals are successful in achieving a pregnancy.

2) The presence and levels of antibodies following vasectomy reversal inconsistently predicts what couples will be successful in achieving a pregnancy.

3) The subjects of most research were infertile men. Research data from fertile men is lacking.

4) Testing for sperm antibodies is not well standardized. There are different types of antibodies and different locations in the sperm. The influences from each antibody are unclear.

What is the Long Term Medical Consequence of Existing Anti-sperm Antibodies?

Studies have provided convincing evidence that a vasectomy does not lead to development of autoantibodies in men other than anti-sperm antibodies, and there is no evidence of any immunologic or other diseases related to development of anti-sperm antibodies following vasectomy.