Monthly Archives: September 2018

Shake Off Your Concerns About Vasectomy-Related Birth Defects | Minneapolis & St. Paul

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A question that occasionally comes up regarding vasectomy reversals is whether or not the reversal increases the chance of future birth defects. Considering the lack of studies on this topic, it’s a completely warranted concern for couples who are planning their futures and who might find the potential risk unsettling.

While there have indeed been studies suggesting that men who previously underwent a vasectomy may experience higher rates of sperm abnormalities, follow-up studies have NOT been conducted to successfully link birth defects to vasectomy reversals. Furthermore, studies have suggested that the rate of birth defects may actually be higher among babies conceived through in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI). At the Scott Department of Urology at Baylor College of Medicine, researchers found that the rate of birth defects in conventional IVF was nine percent, while that of ICSI was roughly the same at 8.6 percent.

In a landmark study from the Vasovasostomy Study Group (VVSG) published in 1991, Dr. Arnold Belker and four other expert microsurgeons examined various facets of vasectomy reversal, including the risk of birth defects. Their trial, which followed 291 children born post-vasectomy reversal, found that only three of the 291 subjects displayed birth defects. That’s a one percent birth defect rate.

Compare this number to the overall birth defect rate in the entire U.S. population, and you’ll find that it compares quite favorably. According to the Physicians Committee for Responsible Medicine (PCRM), approximately three percent of children born in the US are born with major birth defects. After accounting for birth-related developmental abnormalities by the age of one, this number rises to about six or seven percent.

All in all, the risk of post-vasectomy reversal birth defects shouldn’t stop you from planning your future, as the odds don’t vary too much from that of the general population.

For more information on One Stop Medical Center’s no-scalpel vasectomy reversal procedure, please contact us for a consultation.

 

The Curious Case of Vasectomy Late Failure | Minneapolis & St. Paul

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After undergoing a vasectomy procedure, patients typically aren’t declared sterile until a post-surgery semen examination comes back negative. While early failure of a vasectomy—where semen is detected in the ejaculate soon after the procedure—has been recorded and recognized as a possibility for nearly 50 years, late failure of a vasectomy wasn’t considered until years later.

Late failure of a vasectomy occurs when semen reappears in the ejaculate even after two previous negative specimens. In an eight-year span between 1984 and 1992, six spontaneous late failure cases were recorded. All six cases resulted in DNA-proven fatherhood despite previously consistent negative semen analyses that confirmed patients could forego secondary contraception.

In one case, a patient who underwent a vasectomy in March ’84 recorded one positive semen analysis before recording two consecutive negative analyses later that year. Despite his negative semen results, he conceived a child in November ’85 while still showing a negative sperm count post-conception.

How does late failure of a vasectomy even happen? Based on study results from Churchill Hospital in the UK, it’s assumed that patients must have intermittently produced small amounts of viable semen either in between semen analyses or after the final analysis. Furthermore, results showed that even when post-conception semen analyses came back negative, paternity was still possible and, in these cases, actually confirmed via DNA.

All in all, a vasectomy is still the most reliable method of permanent male contraception. However, it’s important for all patients to note that late failure and/or pregnancy after a vasectomy, while rare, is still a possibility.

 

Study Finds Limited Use of Post-Vasectomy Secondary Contraception | Minneapolis & St. Paul

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Last month, we published a post emphasizing the importance of using contraception even after a vasectomy, as patients are NOT completely sterile immediately following the procedure. Because “a series of follow-up tests is required to first confirm that sperm are no longer present in the patient’s semen,” using some form of birth control in the first few months post-surgery is strongly advised.

However, a study conducted within the Pregnancy Risk Assessment Monitoring System (PRAMS) found that over half of the study’s couples (57.8%) did NOT use secondary contraception after undergoing a vasectomy postpartum. All couples had recently given birth and had reported a partner vasectomy four months following the live birth. Conducted in 15 states and New York City, the study assessed both the election of post-vasectomy birth control and the method of birth control used.

Essentially, this means that the 57.8% of couples who chose not to use secondary contraception relied solely on the vasectomy itself as their birth control method. Of the remaining 42.4% who opted for secondary contraception, 50% used condoms, 26.5% used oral contraceptive pills, and 9.5% chose the withdrawal method.

Based on these results, it seems that doctors and clinics need to better communicate to patients the necessity of secondary contraception in the months immediately following a vasectomy. In order to reduce the chance of unintended pregnancy, it is also important to understand the complexities surrounding why some couples choose not to use secondary contraception, despite being advised to.

For more info on our vasectomy procedures, please refer to our FAQ page or schedule an Easy VasectomyⓇ consultation.

 

Can Sperm Antibodies Affect Vasectomy Reversal Results? | Minneapolis & St. Paul

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You may be familiar with the term “antibodies” as “something that helps the body ward off disease,” but the notion of sperm antibodies might seem counterintuitive. After all, why would the body want to destroy perfectly good sperm?

Antibodies, small molecules that the body naturally produces to fight off infections, essentially stick to and kill off invading/unfamiliar cells. Sperm, however, are protected from being targeted by these antibodies via the blood-testis barrier, which physically prevents sperm from interacting with the blood stream. The body normally isn’t even aware of the presence of sperm.

However, when the blood-testis barrier is compromised due to surgery, trauma to the area, or abnormal development of the testis, sperm may be detected and targeted by antibodies. In the case of a vasectomy, the vas deferen is cut and may leak sperm, potentially allowing the body to “see” and detect sperm for the first time. As a result, the body naturally produces antibodies to fight the sperm, which can affect sperm function and overall motility. Research suggests that at least 70 percent of men have detectable antibodies following a vasectomy, with 50–80 percent of cases occurring in the first year after the procedure. A small percentage of patients who do not develop antibodies in the first year develop them in the second or third year.

While antibodies can cause problems for some patients, they aren’t usually responsible for post-vasectomy reversal infertility. A recent study published in Urology concluded that patients who experienced poor sperm quality actually had partially blocked vas deferens following a reversal. The patients’ initial post-reversal low motility wasn’t a result of sperm antibodies. After correcting the blockage issue, most patients were able to successfully conceive.

Furthermore, despite some research suggesting that antibodies may decrease the chance of pregnancy after a reversal, the high overall post-operative conception rate (50-70 percent) and the uncertain correlation between antibody testing and post-operative pregnancy rates make antibody presence a controversial predictor of fertility.