No Scalpel and No Needle: Minimal Invasive Techniques in Easy Vasectomy ReversalⓇ | Minnesota

The patients always wonder how the Easy Vasectomy Reversal is performed without a scalpel and no initial skin injection. This blog explains it.

Conventional needle anesthesia in vasectomy Reversal involves the use of a 27 gauge needle to raise a wheal at the skin of scrotum; it is then advanced its full length along the vas on each side and the deep tissue where further anesthetic solution is deposited. Dr. Shu uses the modern minimal invasive technique, exposing each vas in turn through a tiny opening in the front scrotal wall under local anesthesia. The initial local anesthesia is applied without the use of needles. A spray applicator (MadaJet®) delivers a stream of anesthetic so fine that it penetrates the skin and diffuses to a depth of about 3/16 of an inch, enough to surround and anesthetize each vas tube in turn as it is lifted into position beneath the skin. The initial numbing medication is usually enough for skin incision and vas lifting. Once the vas is identified and lifted, additional anesthetic is given to reach 100% painless effect during the whole procedure.

MadaJetSprayApplicatorMadaJet

No-scalpel vasectomy instruments were originally developed by Dr. Shungiang Li, in China in the mid-70’s and introduced into the United States in 1989. Many years ago, Dr. Steven Shu innovatively improved his surgical techniques on vasectomy reversal procedure (vasovasostomy) by using the same principles and no-scalpel instruments.

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 big 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 was 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.

hemostat_2

ring clamp_2

Dr. Shu uses two important no-scalpel instruments to perform the vasectomy reversal procedure. They are simply a very pointy hemostat, used initially to make a tiny opening into anesthetized skin of the scrotal wall, and a ring clamp, used initially to secure each vas tube in turn beneath this opening.

The refined techniques of no-scalpel Easy vasectomy reversalⓇ minimize trauma, pain and complications. The introduction of no-scalpel Easy vasectomy reversalⓇ has successfully allayed many men’s fears with regard to the scalpel.

Robot-Assisted Vasectomy Reversals: Are They Reliable? | Minneapolis & St. Paul

From self-order kiosks to robot vacuum cleaners and robot cafes, the rise of robot-assisted experiences in recent years has been undeniable. But would you ever consider participating in a robot-assisted surgical procedure?

In a previous blog post, we detailed the pros and cons of electing a robotic vasectomy reversal over a traditional vasectomy reversal performed by a surgeon. While a robot would provide more precise cuts and deliver a more efficient process overall, actual results seemed to show that patient outcomes were simply comparable to, rather than improved from, those of traditional reversals. And since robot machines are quite expensive, most surgical centers are sticking to traditional reversals for the time being.
 
However, costs aside, it’s still noteworthy to highlight the reliability and effectiveness of robot-assisted vasectomy reversals. A 2014 study conducted by urologist Parviz K. Kavoussi concluded that “transitioning from MVR (microsurgical vasectomy reversal) to RAVR (robot-assisted vasectomy reversal) is feasible with comparable outcomes.”
 
Comparing 27 men who elected MVR and 25 men who elected RAVR, Kavoussi found that there was “no statistically significant difference” between the two groups in “overall patency rates (89 percent vs 92 percent), six weeks post-VR mean sperm concentrations (28 million ml−1 vs 26 million ml−1), total motile counts (29 million vs 30 million) or mean operative times (141 min vs 150 min).”

Interestingly, the study also found that for men who were in the 0–8 years obstructed interval, RAVR had a 100 percent patency rate compared to an 89 percent patency rate for MVR. This particular finding could be a game changer in the development of robotic vasectomy reversals and significantly influence some patients’ preferred techniques.

As more research on robot-assisted procedures surfaces in the coming years, we may see shifts in how doctors and patients perceive such methods. One thing’s for certain, though—the use of robots in everyday life will surely become more common than ever.

 

The Dos and Don’ts of Preparing for a Vasectomy | Minneapolis & St. Paul

So you’ve finally made the decision to go for that vasectomy procedure—congrats! Knowing what’s best for your body and future is the first step, and now it’s time to make sure you’re well-versed in preparing for the surgery. The outcome and success of your vasectomy can depend on how well you prepare yourself pre-surgery, so we’ve compiled a list of essential pre-operation dos and don’ts.
 

DO

Do let your doctor know if you’ve undergone previous scrotal surgery.

Do inform your doctor about any other medications you may be taking.

Do follow a diet that’s high in antioxidants (fruits and vegetables, whole grains, green tea).

Do eat a normal breakfast/lunch on the day of your procedure to avoid becoming lightheaded later on.

Do fully shower and clean the area around the scrotum on the day of your procedure.

Do shave your genital area if your doctor instructs you to.

Do arrange for a friend or family member to help drive you home after the surgery. Driving yourself may put pressure on the surgical area.
 

DON’T

Don’t take any aspirin, anticoagulants, or non-steroidal anti-inflammatory drugs such as Ibuprofen, Motrin, Aleve or Advil starting two weeks before your procedure. These medications can thin your blood and cause bleeding afterward.

Don’t drink alcohol starting 2-3 days before your surgery.

Don’t shave the scrotum the day before your surgery, as any nicks and cuts will not be fully healed by the next day.

Don’t apply any lotions, colognes or deodorants prior to surgery.

Don’t wear any jewelry or piercings to the surgery.

Don’t bring a jockstrap or athletic supporter to wear post-surgery. Our office will provide you one.

Don’t forget to sign a consent form before surgery. This is to protect both you and your doctor to ensure that you’re aware of what the operation entails and its potential risks.
 
For more on how to prepare for your vasectomy, check out our earlier post on how to prepare for an Easy Vasectomy®.

 

Clearing Up Vasectomy Reversal Myths | Minneapolis & St. Paul

You may have contemplated whether or not a vasectomy reversal is the right option for you. But even after weighing the pros and cons, you may still be wondering if you have all the facts—after all, there’s a ton of information out there. It’s crucial to know what’s true and false about vasectomy reversals, so let’s break down some of its most common myths below.

Myth: Vasectomy reversals are NOT effective for older men.

It is entirely possible for an older patient to successfully undergo a vasectomy reversal and conceive a child. However, just as women may have more difficulty becoming pregnant as they advance in age, older men can also experience lower quality sperm that affects their overall chance of conceiving.

Myth: After 10 years, a vasectomy reversal will NOT work.

While it’s true that higher success rates are associated with vasectomy reversals performed closer to the original vasectomy date (within five years), the average success rates for ALL reversals—including those performed even 15 years after—are still fairly high. Your chances of a successful reversal increase greatly by finding a highly-skilled doctor to perform the procedure.

Myth: In Vitro Fertilization (IVF) is quicker and easier than having a vasectomy reversal.

Many couples tend to assume that IVF is both easier and more cost-effective, but IVF can be extremely draining and time-consuming. In fact, the cost of IVF is actually more expensive than that of vasovasostomy (the most common type of vasectomy reversal) performed in an office setting. IVF often requires multiple cycles and treatments, potentially becoming much more expensive than initially believed.

Myth: Vasectomy reversals are 100 percent guaranteed to work and lead to fatherhood.

Success rates change depending on individual patient circumstances and do not solely rely on whether or not a reversal procedure was performed. Important factors to consider include the time between the original vasectomy and the vasectomy reversal, the type of vasectomy originally performed, and the surgeon who performs the reversal. Furthermore, what should be considered a “success” is evidence of responsive sperm—not simply the intended result of having a child.

Myth: Couples should not try to conceive right after a vasectomy reversal for fear of a “leftover, defective sperm.”

New sperm are constantly created and reabsorbed by the body, meaning they don’t stick around and “age” and grow defective. Immediately following a reversal, any “older” remaining sperm from pre-reversal that are still being broken down will quickly lose their motility and have little chance of meeting the egg. There is also no evidence to suggest that an early pregnancy following a vasectomy reversal is linked to higher risk of miscarriage, birth defects or health problems in babies.

Myth: Some vasectomies are not reversible due to how they were originally performed.

This is simply false. While there are different ways to perform a vasectomy, it is very rare for one to be irreversible in the hands of a skilled surgeon, regardless of how it was originally performed. However, it’s important to note that if the long segment of a patient’s vas deferens is cut away, or the position of the cut in the vas deferens is either too high or too low, then the reversal procedure and success rate could potentially be affected.

 

What Type of Vasectomy is Most Reversible? | Minnesota

Fundamentally, what a vasectomy does is to prevent the flow of sperm from the testicle to the urethra by cutting and blocking off the ends of the vas deferens, the tube which carries the vasal fluid. There are many ways to block off the vas deferens.

Suture is very common, where a thread is tied around the end of the vas to prevent the flow of sperm.

Cauterization is also a common method, using heat to create scar tissue that will block the flow of sperm.

Another very common method is the use of metal clips, which clip off the ends and are embedded in the scar of the vasectomy site.

It’s not uncommon to have a small portion of the vas removed as well- up to an inch.

Dr. Shu uses 3 steps to insure complete occlusion: he cuts the vas deferens and destroys the lining of the tube on upper end with cautery (scarring it) and places small titanium clips in the vas fascia to separate the opened ends of vas deferens.

No-scalpel vasectomy is performed by making the tiny opening in the middle of scrotum with a pointy hemostat. The vas is then pulled out, severed, and blocked off.

Another method is open-ended vasectomy, where the vas end closer to the testicle is left open instead of being blocked off in order to reduce the post vasectomy. It also save more vas to make a reversal easier.

Vas crimping with VasClip or Pro-Vas was not favorable because of the high failure rate. These still require surgery for a vasectomy reversal, so the idea of crimping rather than severing is a moot point.

Ultimately, none of these ways seem to affect the chances of a reversal being successful. The type of vasectomy, how it was blocked off, how the incision was made, etc, will not actually have an effect on the success rate of the reversal.

What really makes a difference when it comes to success of the reversal is time (years after vasectomy). Time is the single most important factor. Each year after vasectomy patency gets lower.

There are two metrics when looking at success rate: sperm patency and pregnancy rate. Sperm patency has to do with the motility of the sperm, that is, how much sperm is present and how much of the sperm in the semen is moving and healthy. The pregnancy rate is typically lower, since not everyone chooses to have a child after a reversal, and sometimes there can be issues on the woman’s end, or there is simply not enough motile sperm.

Is the Chance of Birth Defects Higher After a Vasectomy Reversal? | Minnesota

Some patients are concerned over the possibility of birth defects being higher after a vasectomy reversal. The decision to continue having kids after a vasectomy can be a big one and it’s natural to want all your bases covered. So, what does the science say about it?

A landmark study known as the Vasovasostomy Study Group (VVSG) trial sought to answer to that question. Published in 1991 by Dr. Arnold Belker, he and four other surgeons conducted the trial accross five different centers. Described by Herrel as a landmark surgical study in “Meta-analysis of the Microsurgical Vasovasostomy literature”, this study holds quite a bit of weight.

The study followed 291 children born after a vasectomy reversal, tracking their development and medical histories to see what effects, if any, vasectomy reversal had. The study found that, out of the 291, 3 had birth defects- or about 1%.

So how does that compare to the prevalence of birth defects across the nation? Well, according to the Annual Summary of Vital Statistics, published in Pediatrics by Hoyert in 2006, the annual birth defect rate is said to be 3%. Other studies fluctuate between 3% and 5%. The defect rate was actually lower for children born post-vasovasostomy.

Now, does vasectomy reversal reduces or increases the risk of birth defects?
Probably not. Based on what we know, vasectomy and vasovasostomy does not affect the genetic quality of the sperm. In actuality, there is almost certainly no difference in the rate of birth defects regardless if you had a vasectomy reversal or not.

Back in 2006, a study conducted at Chulalongkorn University in Bangkok showed that chromosomal abnormalities of sperms were more common in vasectomized men than men with healthy fertility. However, the authors of the study acknowledged that they were unsure whether these findings would support the theory that the risk of birth defects was higher after vasectomy reversal. So far, there have been no follow-up studies to confirm that such a link exists.

Although vasectomy reversal birth defects are among the possible risks discussed during the consultation, most men are pleased to hear that there is no definitive evidence to suggest that the rate of birth defects after vasectomy reversal is significantly higher than that among the general population. In fact, the rate of birth defects may actually be higher among those who achieve pregnancy through in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), which has been indicated in many researches.

Based on the available scientific literature and our own experiences, if you are looking for a vasectomy reversal, you have nothing to worry about as far as having healthy children go.

How do the Sperm Retrieval Techniques Affect the Qualification for Vasectomy Reversal? | Minnesota

It is estimated that about 2 million couples each year face the problem of infertility. While assisted reproductive technologies (ARTs) have helped many couples conceive, vasectomy reversal is the main option for restoring fertility for the vasectomized men. Small percentages of couples who fail in ARTs change their mind and would like to have vasectomy reversal. The common questions they ask are how the sperm retrieval techniques affect their qualification for the vasectomy reversal. This blog specifically answers this question.

ARTs requires the collection of both egg and sperm to increase the likelihood of conception. The sperm-extraction methods vary depending on the men’s fertility, the ability of the surgeon to retrieve sperm and the needs of the couple.

The five main types of sperm retrieval techniques are:

Microsurgical Epididymal Sperm Aspiration (MESA): a small incision in scrotum is made to identify the epididymal tubules, then the sperms in epididymis are aspirated with a small needle.

Percutaneous Epididymal Sperm Aspiration (PESA): no incision is made, and a small needle is used to aspirate sperm percutaneously.

Testicular Sperm Extraction (TeSE): a small incision in the skin of the scrotum is made to explore the testicle. Small pieces of tissue from the testicle are havested and the sperm is extracted from that tissue.

Testicular Sperm Aspiration (TeSA): no incision is made, and a needled is used to percutaneously aspirate small amount of testicular tissue, then sperm is ten retrieved from the tissue.

Testis Perc-Biopsy: a larger gauge needle is used to harvest sperms from the testicles. The process is similar to that of TeSA, but allows for the collection of a greater amount of sperms.

The men with MESA and PESA are not good candidates for vasectomy reversal since both procedures could damage the vas tubules inside epididymis, and the tubules are easily blocked by the scar.

The men with TESE, TESA and Testis Perc-Biopsy are still good candidates for vasectomy reversal since these procedures cause small damage in the testicular tissue, and the vas tubules inside epididymis usually remain intact.

Is a Vasectomy Reversal the Best Option for You? | Minnesota

Vasectomy is a permanent sterilization surgical procedure. But at some point in the future, life circumstances may change:

• Some couples may simply regret it.
• Some couple may have a much different situations in their health or finance now.
• With a 50% divorce rate in the US, a new partner may have a much stronger desire for children than his ex-partner does.

When this happens, you and your partner will need to look at the options available and decide whether a vasectomy reversal is the best option for you. These options include vasectomy reversal, in vitro fertilization, donor sperms, and adoption.

If you’re considering a vasectomy reversal, you need to know several important factors that affect the success rate.

Years after vasectomy
The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between vasectomy and vasectomy reversal. Studies have consistently shown that vasectomy reversal procedures have a higher rate of success when the procedure is performed closer to the date of vasectomy. Theoretically, the sperm recovery rate drops two percent every year after vasectomy. This is because the likelihood of obstruction due to scar formation in the epididymis increases—especially after 7-10 years. Additionally, the anti-sperm antibodies in man’s body may limit or reduce sperm production.

Type of reversal procedure
There are two types of reversal procedures—vasovasostomy (VV) and vasoepididymostomy (VE). The aim of VV is to reconnect the vas where it was severed at the time of vasectomy, whereas during a vasoepididymostomy the surgeon connects the severed end of the vas deferens directly to the epdidymis (the tube attached to the testicle where sperm mature). A VE is more complex and technically demanding than a VV, and it a lower rate of success than vasovasostomy.

Experience matters
The vasectomy reversal procedures are usually conducted by urologists and other surgeons. You need to check surgeons’ credentials. Besides basic medical credentials, the most important questions you need to ask are:

• How many vasectomy reversal does the doctor performs every year?
• How many years has the doctor been performing vasectomy reversal?
• Are the minimal invasive procedure with no scalpel and no needle techniques?
• What are the failure rate and the complication rate?

Cost
Most vasectomy reversal clinics charge expensive facility and anesthesia fees. If you are one of the few for whom vasectomy reversal does not succeed, it will be difficult enough, without a $7000-$10,000 bill!

One Stop Medical Center provides premium reversal services with affordable price by not charging any facility and anesthesia fees.

Reversal tends to be the least expensive choice, but the costs of IVF and other Assistive reproductive technologies (ARTs) could be much higher than that of vasovasostomy, and IVF may require several cycles before conception is achieved and has a lower overall success rate.

ARTs may be a better alternative if vasectomy reversal is not a viable option, or if you don’t want to undergo a second surgery, or your reversal procedure fails.

Age
Although age is not the main factor for considering a vasectomy reversal , but a woman’s fertility begins to decline more sharply after age 35.

Understanding of the Risks, Complications, and Side Effects Related to Vasectomy Reversal Procedures

Similar to Easy Vasectomy, the complications from Easy Vasectomy Reversal are rare because of minimal invasive approach, but any surgery carries some degree of risk. Vasectomy reversal is much longer and more complicated microsurgery than a vasectomy, it has a greater chance of side effects.

Most common vasectomy reversal complications include bleeding and infection following the procedure.

Anesthesia: Dr. Shu performs the vasectomy reversal under local anesthesia which avoids the risks and complications from general anesthesia. If it is performed under the intravenous sedation or general anesthesia, patients must be cleared medically prior to the surgery. Anesthesia-related complications include reaction to the anesthetic medications, breath diffculty, and cardiac problem.

Postoperative pain: The patients usually have mild or moderate pain for a few days after surgery. The pain can be managed with prescription narcotics or over-the-counter pain medications. The patients should avoid anti-inflammatory pain relievers (such as ibuprofen and aspirin) for the first 48 hours after the surgery to reduce the risk of bleeding, but Tylenol is fine to use. A small number of men experience long-term pain (more than three months) in the area of the scrotum or testicles after a reversal.

Hematoma (collection of blood): Bleeding under the skin that may cause scrotum area to look bruised, and bruise shows commonly in a few days after surgery, but pooled blood can be occasionally caused by bleeding in the surgery site inside the scrotum. The patients should report any unusual scrotal swelling and bruise to the surgeon.

Infections: Infection after vasectomy reversal is not common, and it occurs more common when there is a hematoma beneath the skin. Infection occurs in the wound or inside scrotum, can be treated with hematoma evacuation (I&D drainage) and antibiotics.

Hydrocele (Fluid Collection): Fluid can build up inside scrotum and cause swelling. This may resolve on its own, but may sometimes need to be drained with a needle. Check with a doctor if there is any unusual swelling.

Sperm granuloma: If sperms leak into the scrotum, the immune system can react to the sperm. The local tissue gradually forms an inflamed mass. It is much more common with vasectomy than vasectomy reversal. If it happens, it indicates that the vasectomy reversal is probably not successful.

Testicular atrophy: Testicular atrophy occurs when the blood supply of the testicle was injured, which results in permanent damage to that testicle. This can lead to scarring and dysfunction of testicle with diminished sperm and testosterone production. In general, the other testicle produces enough sperm and testosterone to compensate.

Low sperm count: After a vasectomy reversal, the initial sperm count might be lower than that before vasectomy. This may be caused by many factors such as scar tissue blocking the sperm in the connecting sites, or the reaction of the body’s immune system to the presence of sperm, or epididymal dysfuction.

Sexual difficulties: There is no physiological reason that a vasectomy or a vasectomy reversal should affect the patient’s sex drive, or their ability to have sex or an erection, but these procedures can occasionally cause significant psychological and emotional response in some men.

Why Procedure Clinic for Vasectomy and Vasectomy Reversal procedures | Minnesota

1. No-scalpel and no needle technique that only requires one micro incision, which minimizes trauma, pain, and risk of complications, and it allayed many men’s fears with regard to the scalpel and needle

2. Local anesthesia: Not having to use general anesthesia or IV sedation greatly reduces the risks associated with it.

3. High success rate: The success rates of our operations are up there with the best, thanks to the extensive past surgical experience and high volume practice.

4. High quality, personalized medical care: Being in an office allows for a more personal, patient oriented approach. Our team of professional and friendly staff go the extra mile to ensure patient satisfaction.

5. Enjoy an accredited, private surgical center with a premium clinic environment.

6. Affordability: At $690 for a vasectomy and $2590 for a vasectomy reversal, our prices are only a fraction of the cost of the same procedure done in a hospital or public surgical center. We do not charge facility fees or anesthesia fees.

7. Website: Our website is full of information and resources for prospective patients. For those that want to learn more about the procedures, our practice, and our mission, our site is the right place to be!

8. Online Registration: Using online registration makes scheduling appointments convenient and easy!

9. We offer consultations on the same day as the surgery and the phone consultation.

10. One trip system: An initial face-to-face consultation is no longer required. We also developed a mailer system to eliminate another trip for patients. This is especially good for those that live far away or out-of-state.

11. Only 10 Minutes from the Minneaplios-St Paul airport (MSP)

12. Located in the famous high end town of Edina, France Avenue is enriched with hospitals, medical offices, commercial and business centers, as well as hotels.

Second Attempt After Unsuccessful Vasectomy Reversal

Success rate for vasectomy reversal is generally reported in two ways: sperm recovery rate (patency success rate) and pregnancy rate. Patency rate refers to the likelihood of the vas deferens remaining open and providing unobstructed flow of sperm cells. High patency rate means that flow is unobstructed and sperm has a high likelihood of returning to the seminal fluid. Pregnancy rates are always lower than patency rates, as there are multiple factors that affect pregnancy.

The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between vasectomy and vasectomy reversal. Primary failure after a vasectomy reversal means no sperm is seen in the post semen analysis tests. If the sperms showed up in the initial semen analysis after the procedure, but is not seen in the follow up semen analysis, it is called secondary vasovasostomy failure.

If you have been frustrated and disappointed with an unsuccessful vasectomy reversal, you may want to ask a microsurgeon whether another attempt might be worth it.

In general, first-time vasovasostomy failures often occur in patients that are more prone to develop heavier scars, which can narrow at the location of the reversal. In some cases, the tissue in the ends of vas deferens could be dead due to ischemia. Other reasons include an undetected epididymal blockage and epididymal dysfunction. Of course, the surgeon’s experience and techniques matters. This is why it is particularly important to choose your surgeon carefully. The success rates for a second reversal are slightly lower than for first-time procedures.
Second-attempt Vasectomy Reversal Techniques

If the patients showed evidence of healthy sperm in their seminal fluid during the first reversal procedure, or had the positive result in the initial semen analysis, they are probably the good candidates for a repeat vasectomy reversal When the vas deferens appears healthy and doesn’t have a lot of scar tissue from the previous procedure, a surgeon will usually do another vasovasostomy, and the chances of a successful second attempt are fairly good.

If the vas fluid is not favorable and no sperm was seen, if the first reversal left the vas deferens too short, if injury to the vas deferens is more extensive, or if a surgeon believes that the epididymis is scarred or blocked, a vasectomy reversal re-do becomes more complicated. In some cases, the more effective approach is a vasoepididymostomy, which is a more complex procedure than a vasovasostomy. Dr.Shu doesn’t perform vasoepididymostomy, but he will refer you to see a urologist who performs vasoepididymostomy. In other cases, however, there are a number of effective alternatives to vasectomy reversal that are worth investigating, such as In vitro Fertilization (IVF), donor sperms, and adoption.

Still not Pregnant after Vasectomy Reversal? | Minnesota

Few things are more disheartening than months and months of negative pregnancy tests. You talked with your husband, and you both agreed that you wanted children. He got vasectomy reversal for you, but a year later you still aren’t pregnant. It may seem frustrating, but you shouldn’t lose hope without knowing all the facts.

You won’t get pregnant immediately

This cannot be said enough. If there is no sperm in the ejaculate six months following a vasovasostomy, the reversal is said to have failed. Even if there is sperm, that doesn’t guarantee pregnancy. It can take months for a man to return to a normal sperm count. Once sperm has been detected it still takes time for sperm number and motility to reach normal levels, and this time can vary from person to person.

Conception

Getting pregnant takes patience. It is generally known that most men produce millions of new sperm every day. However, you might not know that these new sperm take about 2 ½ – 3 months to fully mature or that when sperm are initially formed they lack the ability to swim forward or fertilize an egg. It can take a couple of these cycles for sperm to regenerate. Even at this point it can take another 6 months for conception to occur. It’s important to remember that getting pregnant within months of a vasectomy reversal is not the norm. We do have a few patients who got pregnant in 2 months after vasovasostomy in the past few years.

To monitor progress, a sperm sample will be taken 6 weeks after the procedure. Follow up tests will occur every two months after the initial test. This way we can see whether sperm has returned and at what level. Once sperm count has reached reasonable or normal levels, pregnancy usually occurs within 6 months of having timed intercourse- that is, having intercourse every other day from four to five days before and after ovulation. If this does not occur, it’s possible the issue may be due to fertility in the other partner.

How is Easy Vasectomy Reversal® (Vasovasostomy) Done without a Needle? | Minnesota

General anesthesia or intravenous sedation is needed in the traditional vasectomy reversal since a traditional approach to vasectomy reversal is to make two big incisions in each side of scrotum. Easy Vasectomy Reversal® with modern no scalpel technique and single mini incision reduces the trauma and pain, therefore, general anesthesia or intravenous sedation is no longer needed in the vasectomy reversal procedure (vasovasostomy).

Conventional needle anesthesia in vasectomy Reversal involves the use of a 27 gauge needle to raise a wheal at the skin of scrotum; it is then advanced to both ends of the vas on each side where further anesthetic solution is deposited. Since the opening is so small in the no-scalpel Easy Vasectomy Reversal®, it is easy to apply anesthesia without the use of needles. A spray applicator (MadaJet®) delivers a stream of anesthetic so fine that it penetrates the skin and diffuses to a depth of about 3/16 of an inch, enough to surround and anesthetize each end of vas tube in turn as it is lifted into position beneath the skin, attaining a close to 100% efficacy rate with no need for supplemental anesthetic in the initial vas grabbing.

The tiny opening in the dime-sized area of numb skin is made with a pointy hemostat: one tip makes a pinpoint opening, then the two tips are used to spread and enlarge the opening to about 1/3 of an inch. Since blood vessels in the skin are spread apart rather than cut, bleeding is less than when a scalpel is used.

MadaJet_2

MadaJetSprayApplicatorMadaJet

Once the vas ends are grabbed and lifted up, the complete local anesthesia is achieved by giving additional anesthetic with a fine needle, usually with no pain at all because of the partial anesthesia achieved with the MadaJet.

Easy Vasectomy Reversal Receives Trademark from U.S. Patent and Trademark Office | Minnesota

Office proceduralist, Dr. Steven Shu, obtains a registered trademark from the United States Patent and Trademark Office, for his Easy Vasectomy ReversalⓇ, a minimal invasive office procedure with no scalpel and no needle techniques.

The introduction of Easy Vasectomy ReversalⓇ has successfully allayed many men’s fears with regard to the scalpel and needle. It is safer, less invasive, and has fewer complications and quick recovery. Under local anesthesia, only a tiny puncture is made at the midline of the scrotum skin, instead of bilateral big incisions done in the traditional vasectomy reversal.

Easy Vasectomy ReversalⓇ Service in One Stop Medical Center (OSMC)
OSMC developed a powerful website, EZvasectomy.com, with rich information on vasectomy reversal. All patients are required to review the important information on vasectomy reversal. Dr. Shu does the same day consultation to finalize the consultation on the day of surgery, so the patients don’t need another trip for the initial consultation if they live far away or out-of-state. Moreover, the patients are able to register their vasectomy reversal procedures by filling out the online registration form in the website.

In order to reduce the financial burden for our vasectomy reversal patients, OSMC offers very affordable price that is only fractional cost of the same procedure done in other medical facilities, and it doesn’t charge facility fee and anesthesia fee since it owns an accredited, private surgical center. This way, more families can afford to have their vasectomy reversed.

OSMC has simplified the vasectomy reversal care system to create a more affordable, friendly and convenient vasectomy reversal service.

Understanding Male Infertility

Infertility, simply put, is the inability to conceive children. There are several causes for male infertility: low sperm count, low sperm motility, and poor sperm morphology. Each of these can make conception difficult. Each of these can be a result of genetics or environment. These days, it seems like the list of things that’ll give you cancer or a disease is increasingly long and confusing, so I’ll try to make it simple.

Low sperm count is simply the lack of sperm of in semen. A lot of this is caused by environmental factors such as excessive alcohol and drug abuse, sexually transmitted disease and infections, exposure to toxins, hazardous chemicals, and radiation. These can be usually be avoided by taking the proper precautions. Not to mention the many other negative side effects that accompanies them. Low sperm count can also be influenced by exposing the testicles to high heat (from a fever), and genetic causes such as Klinefelter’s syndrome, or cystic fibrosis.

Abnormal sperm refers to sperm that is not a normal shape and is thus unable to swim or function normally, preventing conception. This can be caused by testicular inflammation, twisted or swollen veins in the scrotum, exposure to heat, as well as environmental influences such as exposure to toxic chemicals.

Infertility can also be caused by other issues such as premature ejaculation, retrograde ejeculations, erectile dysfunction, and other structural problems related to the male reproductive organs. Although men do not suffer the same loss of fertility that women do with age, men past the age of 70 may exhibit decreasing sperm quality. Many medical conditions such as diabetes, HIV, thyroid diseases, organ failure, heart attack, and anemia can cause infertility as well.

Various drugs can also cause infertility, including: steroids, cimetidine (Tagamet), sulfasalazine (Azulfidine), salazopyrine, colchicine, methadone, methotrexate (Folex), phenytoin (Dilantin), among many others.

Vasectomy is obviously a common reason for male infertility.

The best way to treat male infertility will be different for everyone. Obviously, preventative measures such as moderating drug, tobacco, and alcohol abuse, avoiding working with toxic or radioactive materials, using protection, and limiting sexual partners. Other solutions will depend mostly on the cause- like treating ejaculation issues or a disease that is causing infertility. The vasectomized patients may consider the vasectomy reversal procedures to restore their fertility.

Robotic Vasectomy Reversal- The future of vasectomy reversal? | Minnesota

Vasectomy is the most effective method of male contraception, with an estimated 500,000 vasectomies per year and rising. Naturally, as divorce rates have been steadily increasing, there has been a corresponding increase demand for vasectomy reversals. This poses some challenges- while vasectomies have become increasingly simple, quick, cheap, and noninvasive with techniques such as no-scalpel vasectomy, vasectomy reversal is still a relatively complicated microsurgical procedure that requires time, skill, concentration, and money. To give you an idea, the opening of the vas deferens (the tube which carries sperm to the semen) is 0.1mm wide, about as wide as a human hair. Knowing that, it makes sense why vasectomy reversals are harder than vasectomies; it’s a lot easier to cut it in half than stitch it back together. That’s not to say vasectomy reversal isn’t effective as it is now. Patency rates (moving sperm) have risen from 5-30% to 85-90% today with the advent of microsurgical techniques.

How can it get better?

Of course, vasectomy reversals aren’t always perfect. As time goes on, the chance of pregnancy goes down considerably. Also, the procedure is time-consuming and highly dependant on a physician’s skill. Robotic surgery is an exciting alternative that could theoretically mean a higher patency rate if there are no other complicating factors. Robotic surgery also theoretically has several potential advantages:

Smaller incisions- Little robot arms are a lot smaller than a doctor’s hands. Also means less scarring.
Visualization- Robots mounted with cameras can give detailed magnified images that the eye could not resolve
Pain- Robotic surgery is usually less painful and likely to develop complications
Time- Robotic surgery has the potential to be much faster than hands.

What does the research say though?

There have been vasectomy reversals that have been performed using robotic-assisted vasectomy reversal, but so far it does not offer a lot of advantages. Studies have given different results, but on average, robotic-assisted vasectomy reversals take just as long and are equal in patency rates. With no significant advantages over a regular vasectomy reversal, it’s not worth it for most hospitals and doctors to spend a lot of money on expensive robotic-assisted surgery equipment. However, that doesn’t mean robotic-assisted vasectomy reversals should be discounted. The technology is still in its infancy; who knows where it might be in 20 years down the road. As robots and AI get more advanced, operating time, precision, and effectiveness should increase, and the physical role of the surgeon will go down- not just for vasectomy, but all surgical procedures. It’ll be a while before that happens though. Your best bet right now is the tried-and-true vasectomy reversal, done by your local human doctor.

Effects of Anti-sperm Antibodies in Patients with Vasectomy Reversal | Minnesota

What are Anti–sperm Antibodies?

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. However, it is possible for antibodies to work against the body’s own cells; such is the case in many autoimmune diseases. In cases of vasectomy, especially after long periods of time after the surgery, it is possible for the body to form antisperm antibodies. This is a concern for many patients seeking vasectomy reversal.

This is normally not a problem with sperm cells as they technically not in the body, in the same sense that the inside of our digestive tracts are not considered to be inside the body. Sperm is created in the testes, transported by the vas deferens, mixed with seminal fluid, and exits the body during ejaculation- at no point does sperm ever contact blood, as direct contact is prevented by the testes/blood barrier.

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. For this reason, the body may treat sperm as a foreign pathogen, creating antibodies that correspond to the antigens on the surface of the sperm cell. A vasectomy, especially if a long period of time has passed since the procedure, can result in higher concentrations of anti-sperm antibodies.

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. 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.

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

Antisperm antibodies can affect fertility in the male if they are in high concentrations. Fertility loss can come at varying degrees; the more antibodies one has, the lower fertility will be. B- immune cells create multiple types of sperm antibodies. Some antibodies will cause sperm to stick together, forming large clumps that hinder mobility of the sperm. Other antibodies act as a “flag” for natural killer cells, and others can even bind with the antigens on the surface of the egg in the womb, causing its destruction.

How Anti-sperm antibodies affect fertility following vasectomy reversal is not clear. While 79% of men that are tested after a vasectomy have elevated antisperm antibodies, the levels at which they are present are not significant enough in most men to cause a significant drop in fertility. Most experts, including those from the American Urological Association, agree that there are rarely significant long-term side effects that arise from vasectomy.

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.

Why do Vasectomy Reversals Fail? | Minnesota

First, it’s important to distinguish patency rate and pregnancy rate. Patency rate refers to the likelihood of the vas deferens remaining open and providing unobstructed flow of sperm cells. High patency rate means that flow is unobstructed and sperm has a high likelihood returning to fluid. Pregnancy rate refers to likelihood of pregnancy. Pregnancy rates are lower than patency rates, as there are multiple factors that affect pregnancy.

One reason is abnormal sperm quality. Some men might just have low sperm quality to begin with, which a vasectomy reversal alone would not be able to fix, no matter how unobstructed the vas deferens is. Options for those wanting to have children with this condition include IVF or a trial of steroids and lycopene supplement.

Another common reason for failure is anti-sperm antibodies, which immobilize sperm. These antibodies are typically found in the blood, so it is not common to find it in seminal fluid. Studies suggest 8-21% of men that have not had a vasectomy have anti-sperm antibodies in their fluid. By contrast, studies on vasectomized men show that 50-80% of men develop concentrations of these antibodies after the first year post-vasectomy. It is unclear how much this affects fertility after a reversal, as there have not been many studies done that confirm it, and there is not a surefire method of testing for antibodies in the semen either.

Another possibility is simply scarring, which is not uncommon but possible as a result of vasectomy reversal. It can be treated with anti-inflammatory medication and/or repeat of the procedure. Even if none of these affect you, those who have had vasectomies for a very long time may experience epididymal dysfunction (e.g. the ability for sperm to move through the epididymis), which will either clear up on its own, or may require that you use IVF.

Finally, many times it is the female partner that results in low pregnancy rates. Women over 35 experience a drop in fertility, which may be one reason why there is a discrepancy between patency and pregnancy rates.

Microsurgical Vasovasostomy | Minnesota

Microsurgery involves the use of an operating room microscope or surgical loupes (magnifying glasses) to conduct very small scale operations on the body. Microsurgical reconstruction of tissue is often a complex and very technical procedure. In the early 1900s, Carrel and Guthrie pioneered microsurgery techniques through experimental procedures on animals, replanting and transplanting tissues and organs such as amputated limbs, and kidneys. The first use of optical magnification was recorded in 1921, where a monocular microscope was used for ear surgery by Nylen. It was during this time period microsurgical instruments, operating microscopes, and other advancements in medical technologies paved the way for microsurgery.

Advancements in vasectomy reversal closely mirror those in other procedures in well. The first successful vasovasostomy was in 1919, although its efficacy was questionably. By 1948, 18% of urologists had tried it, and the success rate was only 40%. The first microsurgical vasectomy reversal took place in 1971, by Owen. The next big advancements came in 1977, with the development of 2-layer and modified microsurgical suture techniques. The patency rate has rose to more than 90% with these advancements if vasectomies are done with nine years. Microsurgery continues to see advancements every year. Robots with hands far steadier than any human now have the capacity to perform operations as small as vasectomy reversal.

Ultimately, microsurgery is a powerful contemporary surgical technique with many different applications, not least of which is vasectomy reversal. It is because of microsurgery and its advancements that effective vasectomy reversals are possible, now with minimal pain or downtime at Procedure Clinic. It will be fascinating to see what this procedure could look like many years into the future!

Vasectomy Reversal and Other Alternatives | Minnesota

Traditionally vasectomies were considered to be permanent procedures, but headways in science and medicine have made reversal attainable for the average person. Vasectomy reversal is a procedure that involves the surgical reattachment of the severed vas deferens, with the end goal of restoring fertility in men that have had a vasectomy in the past. There are many reasons why someone would want a vasectomy reversal. Most couples want more children, often following a remarriage, some couples that at one point did not want children change their minds, and a few have unfortunately lost children and desire more.

Other methods of having children besides vasectomy reversal are available as well. IVF, (in-vitro fertilization), known colloquially as having a “test tube baby”, involves taking one of the female’s eggs and retrieving sperm from the male, and manually combining them outside of the body without sexual intercourse. The embryo is then transferred to the uterus. ICSI (intracytoplasmic sperm injection) is a more recent innovation that involves directly injecting a single sperm into an egg, and is very effective for severely infertile men whose semen lacks enough motile (moving) sperm cells.

The average cost of basic IVF in the US is around $12,500, and medications run another $3,000-$5,000. Pre-implantation genetic diagnosis (PGD) step of the process another $3,000 to $6,000. Altogether, conservatively speaking, The cost of basic IVF is about $20,000 … for each attempt to have a healthy child utilizing a procedure that is successful (most optimistically) about 40% of the time, depending upon factors such as maternal age and the specific medical circumstances of the parents.

Adoption or sperm donation are other options as well, but many naturally desire to raise their own biological children. Sperm donation is the cheaper option, and usually costs $400-$1,000. Adoption is considerably more expensive ($5,000-$40,000) and the process can take years to accomplish. The final, and often least desirable option is a child-free lifestyle.

For couples where the child-rearing partner is reproductively healthy, vasectomy reversal seems to be the most cost effective way of having biological children. One Stop Medical Center offers vasovasostomy at $2,490, considerably cheaper than IVF and adoption while still making biological children of both parents attainable, which cannot be said of sperm donation.

Fertility After a Successful Vasectomy Reversal | Minnesota

Many couples are concerned about the attainability of pregnancy after a successful vasectomy reversal- after a year of negative pregnancy tests, any couple may naturally feel discouraged. It is important to stay positive during this time, as pregnancy will not happen immediately. Here are some things couples should know:

First, it takes time for the sperm count to return to normal. For the first couple months, the absence of sperm is not unusual. After a vasovasostomy, sperm should be present in the ejaculate after three months, otherwise the vasovasostomy probably was unsuccessful, although we usually call it failure if no sperm is seen after six months. For an epididymovasostomy, this could take even longer. Keep in mind however, the mere presence of sperm does not guarantee conception. Sperm count must reach an adequate level in order for conception to be possible.

Second, a man renews his sperm reserve every 3-4 months, and it can take a couple turnovers, or about 6-8 months, for sperm count to reach optimal levels. Even after that, it could be up to six months to reach the proper conditions for conception. For some couples, conception could take just a few months, while others may take longer. Everyone’s body is unique- it is important not to lose hope.

The best way to ensure conception is to monitor sperm content and mobility over time. The first lab test is done six weeks after the procedure, and is repeated as required. Once it has been determined that sperm count has reached adequate levels and that the sperm is mobile, conception should occur within six months assuming the couple is having intercourse often and regulaarly and at the most fertile points of the woman’s cycle (a few days before and after ovulation). If there are still issues, and the sperm is fine, the issue may lie with the female partner’s fertility.

Conception can be a long and trying process for many couples. Again, it is important to stay positive and not be discouraged, as it can take quite a long time to meet the conditions required for conception, and there are many factors that affect pregnancy. Patience is often rewarded.

Can Lycopene Increase Fertility in Men? | Minnesota

Lycopene is an organic compound that gives tomatoes their distinctive red color, but recent research has found that taking lycopene may increase fertility in men.

Previous studies, led by Ashok Agarwal, have demonstrated that taking lycopene can boost sperm count by 70%. These studies also showed improvements in swimming speed, and reduced amount of abnormal sperm. Hypothetically, lycopene could protect sperm from DNA damage, increasing the quality of the sperm.

This is the focus of a 2016 study from the University of Sheffield in England. This study involves a 12 week trial that will determine whether or not lycopene can reliably increase fertility in men. The study involves 60 male subjects, ages 18-30, who will be divided into two groups. One group takes a lycopene supplement, and the other takes a placebo. If lycopene does indeed affect fertility, the results should be apparent based on test results on the subject’s sperm and blood.

While the link between lycopene and male fertility is far from concrete, these discoveries may bring new hope and new life to couples trying to have a baby in Minnesota.

Risks & Complications of Vasectomy Reversal (Vasovasostomy) | Minnesota

risk Although an Easy™ vasectomy reversal is one of the safest procedures, there are still chances of minor complications, such as infection, bleeding, prolonged pain or transient bruising, temporary swelling or fluid accumulation. Most patients experience a dull ache in the scrotal region, but this usually resolves with time. We avoid the risks related to general anesthesia or intravenous sedation by using the local anesthesia only, and the risk from local anesthesia is almost zero.

The potential risks and complications:

  • Hematoma(collection of blood) in the scrotum occurs in less than 5% of men. Mild swelling, bruise and pain are expected after such surgery, but excessive scrotal swelling and bruise could be a hematoma, the patients should report immediately if they suspect to have a hematoma. Small hematoma usually resolves by itself, and the patients may take the pain medications and antibiotic for pain management and infection prevention. Large hematoma needs to be drained to facilitate recovery. Very occasionally, the patient needs to be operated in order to stop acute arterial bleeding. We didn’t have any case of large hematoma or arterial bleeding since we offered the vasectomy reversal service.
  • Seroma (collection of fluid) can accumulate in the scrotum after surgical trauma and local anesthesia. It happens rarely. In some cases that prone to develop hematoma or seroma, Dr. Shu preventively put small Penrose rubber tube in the scrotum to drain the blood or fluid over 24 hours.
  • Infection occurs in the wound or inside scrotum, more common if there is a hematoma beneath the skin. The risk of infection in vasectomy reversal procedure is less than 1%. The patients usually take oral antibiotic in the first week of post-op to minimize it. If scrotal infection happens, abscess needs to be drained, and the patients will be given a different oral antibiotic, or in its most serious form, intravenous antibiotics in the clinic or hospital.
  • The patients should watch for the signs of infections in the first week, such as worsening pain, swelling, redness, or purulent drainage, and fever. We didn’t have any case of scrotum infection since we offered the vasectomy reversal service in our clinic.
  • Postoperative acute pain (mild) in the first week or occasional prolonged dull ache (congestion) in the testicles, usually disappears within a few weeks or months.
  • During or after vasectomy reversal, when a small amount of sperms and fluid leaks out of the reconnected site of vas, it may induce an inflammatory reaction termed a granuloma (risk less than 1%) that may be painful, but usually resolves with time. Rarely this will disrupt the reconnection.
  • Epididymitis, when the packed vas tube behind the testicle becomes inflamed and swollen, although very rare, can be treated with heat application and medication.
  • Sexual difficulties for the man due to psychological and emotional responses to a vasectomy reversal.

An Affordable Vasectomy Reversal Service | Minnesota

Summary: The expense of vasectomy reversals is an important factor that discourages couples wanting to have another child. One Stop Medical Center has been offering $2490 for an affordable vasectomy reversal service, helping couples conceive children naturally.

MINNEAPOLIS, MN (SEPTEMBER 17, 2016) – There are approximately half a million men who undergo a vasectomy every year in the U.S. About 7% of them would want a vasectomy reversal. Whereas the cost of vasectomies is usually less than $1000 and are covered by most insurance companies, reversals are not, so couples have to pay for the expensive procedure with cash. If the reversal is performed in a hospital or surgical center, this, in turn, accelerates the cost, further discouraging couples wanting to have another child.

One Stop Medical Center has been offering an Affordable Vasectomy Reversal Service since the creation of the Vasectomy & Reversal Center of Minnesota 4 years ago. It continues to Offer $2490 for a vasovasostomy procedure.

The aim of vasovasostomy is to reconnect the vas where it was severed at the time of vasectomy, making it a true reverse vasectomy, which makes the most sense for men whose intervals are short (less than 10 years vasectomy) . Vasovasostomy (VV) takes about two hours. It is performed under local anesthesia, similar to the anesthesia used for vasectomy but with a longer-acting drug. Continuity of both vas tubes can be restored with micro-surgical techniques through a single small incision with the assistance of magnification.

We are able to lower your costs by not charging any facility fees and anesthesia fees, but never sacrifice our quality of service. The medical director, Dr. Steven Shu, is an expert in office procedures who is dedicated to helping couples conceive children naturally, and he performs about 150 vasectomy reversal procedures every year.

Factors Affecting the Pregnancy in Vasectomy Reversal Procedures | Minnesota

Sperm recovery is the first goal in the success of a vasectomy reversal procedure. We all know the ultimate measure of success in vasectomy reversal procedure is a pregnancy. There are several factors affecting pregnancy in vasectomy reversal procedures, and these factors are outlined here.

1. A pregnancy involves male and female partners. If both of the count and quality of sperm after vasectomy reversal surgery are good, female fertility factors may play an indirect role in pregnancy failure.

A woman’s age affects her fertility. The decline in fertility begins to accelerate after 35. Advanced maternal age is a common reason for vasectomy reversal failure. Therefore, female partners age >35 years old should consider an evaluation to determine if they have adequate fertility before a vasectomy reversal is undertaken.

Age_pregnancy

This evaluation panel of fertility usually includes

  • Follicle-Stimulating Hormone (FSH) and estradiol levels at a menstrual cycle day 3.
  • Anti-Mullerian Hormone (AMH) levels.
  • Assessment of menstrual regularity.
  • Hysterosalpingogram

2. Up to 60% of men with vasectomies develop antisperm antibodies in their body, which may impair fertility. Antisperm antibodies are usually assessed >6-12 months after the vasectomy reversal if no pregnancy has ensued.

3. A man may have abnormal sperm quality even before the vasectomy, especially in men without prior paternity. This could be a reason for pregnancy failure.

4. A number of men fail who have been placed on testosterone replacement before vasectomy reversal procedure, and they continue to use it afterwards. Testosterone is a very effective form of male birth control, effectively stopping sperm production.

5. If an epididymal blowout has occurred in both sides of vas deferens before the vasovasostomy procedure, the vasectomy reversal will likely fail. In this case, an epididymovasostomy would need to be performed.

6. Not only is epididymis a “storage site” or, but also is where sperm mature. In certain patients, their epididymis is adversely affected after the vas deferens has been blocked for a long time. In these patients, sperm counts may be normal, but sperm functions (movement and penetration ability) may be poor after vasectomy reversal. Most patients will gradually recover from epididymal dysfunction.

7. Sometimes, scar tissue develops at the site of anastomosis, causing a blockage and late failure. It may be treated with anti-inflammatory medication or could consider repeating vasectomy reversal procedure.

Factors Affecting the Sperm Recovery Rate of Vasovasostomy

The microsurgical vasovasostomy is a treatment of choice in restoring sperm to the ejaculate and in establishing pregnancy for men wishing to resume paternity after vasectomy. The success of the reversal is dependent upon the length of time since the vasectomy, vasectomy techniques, the experience of the surgeon, and many other factors.

Success rate for vasectomy reversal is generally reported in two ways: sperm recovery rate (patency success rate) and pregnancy rate. This blog will talk about sperm recovery rate after vasovasectomy. The relationship of pregnancy rates and reversal procedures will be discussed in a separate blog.

The sperm recovery rate of vasovasostomy is influenced by several factors.

1. The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between the vasectomy and the vasectomy reversal. Our clinic data is consistent with reported studies demonstrating that sperm recovery rate after vasovasostomy is inversely related to the duration of vasal obstruction after vasectomy. Vasectomy has time dependent adverse effects on the testis, epididymis, and vas deferens (this will be discussed separately).

2. The surgical technique of vasectomy also affects the success rate of vasovasostomy. If the surgeon or family physician uses a technique that is difficult to reverse, such as cutting or burning away too long of segments of vas, or cutting too high or too low, then it will be much more difficult to do anastomosis without tension due to the shortage of vas and too much scar in the tissue. The shorter the proximal end, the greater the “back-pressure”, which will cause “blowout” and scarring of the epididymal tubule.

3. The presence of sperm granuloma in the proximal end was associated with better sperm quality at the anastomosis site and had an improved outcome.

4. The quality of vasal fluid was correlated to a successful outcome after vasovasostomy. If the vasal fluid is clear and lightly milky in color, it is more likely that sperm will be found in the ejaculate following vasovasostomy.

5. The presence of sperm in the fluid retrieved from the proximal vas deferens before anastomosis was highly correlated with successful patency.

6. Finally, the surgeon’s experience and microsurgical skills is important for successful vasectomy reversal procedures.

  • If the ends of vas are not precisely aligned, it may result in leakage of sperm fluid, inflammation, and scarring. While technical failures can occur even with a very experienced microsurgeon, they are far more likely in less experienced surgeons.
  • Many vasectomy physicians use cautery during vasectomy procedures. Careless and extensive cauterization damages the blood supply to a long length of the vas. Vasectomy reversal procedures could further cause inadequate blood supply to the vas. Scar tissue develops at the site of anastomosis, causing a blockage and late failure. This type of failure usually results in some sperm being present early after surgery, with failure 3-12 months later.
  • Therefore, it is important to ask how many reversal procedures the surgeon does every year, as there are will be a big difference between a surgeon who does less than ten reversal procedures and a surgeon who does 200 reversal procedures every year.

    High Success Rate of Vasectomy Reversal | Minnesota

    Success rate for vasectomy reversal is generally reported in two ways: sperm recovery rate (patency success rate) and pregnancy rate. The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between vasectomy and vasectomy reversal.

    Although the statistical averages derived from large numbers of patients offer a general guide, your specific situation and results may differ from that of the average due of many personal variables, such as the surgeon’s vasectomy techniques, your age, you and your partner’s fertility, and a host of other factors.

    Based on all of the cases with the reported semen analysis results, the sperm recovery rate (Patency Success Rate) in our clinic is about 90% within nine years of vasectomy, 80% from 10 to 14 years of vasectomy, and 60% from 15 to 25 years of vasectomy.

    Getting Pregnant After a Vasectomy Reversal

    Many couples become frustrated when many months have gone by after vasectomy reversal and their female partners are still not pregnant. Months of negative pregnancy tests can certainly take its toll on any couple’s spirit. This blog is going to talk about getting pregnant after a vasectomy reversal; it’s important for couples to know what a realistic expectation should be and to understand the process of conceiving.

    Getting pregnant after a vasectomy reversal can be a long and frustrating process. Here is what you can expect after getting a vasectomy reversal.

    First, it takes a few months for sperms to return to a normal count following a vasectomy reversal. After vasovasostomy, semen analysis will be done to confirm whether or not the procedure is successful. The initial test can be done in four to six weeks. If the initial semen analysis is negative, the test should be repeated in a few months (within six months following the reversal procedure). If there is no sperm in the ejaculate after six months, then the reversal has not been successful.

    It takes time for sperm count to be normalized. Generally speaking, a man turns over his sperm reserve every three to four months. Getting pregnant after a vasectomy reversal is usually a six to twelve month process although some get pregnant within six months. It can take a couple of turnovers of sperm reserve, or more than six months, before sperm count returns to a level where getting pregnant is optimal. At this point, it can still take another six months or so for a couple to conceive. Some couple may get pregnant within a few months after the reversal, but it is not the norm.

    We recommend the initial semen analysis at the four to six week period, and then every two months for two more times. Once the semen analysis shows optimal sperm count and motility (although some men may never have normal sperm counts and motility), a couple should monitor ovulation, having timed intercourse every other day in 4 days before and after ovulation. Semen analysis should be repeated if a couple has not conceived within six months to make sure the sperm counts are still normal and then female partner should be evaluated for their fertility issues.
    Getting pregnant after a vasectomy reversal sometimes can be a long process. There are many factors that come into play for couples trying to conceive, from sperm count and quality to women’s fertility. Don’t become discouraged if you’re not pregnant after only a few months following the reversal.

    One Stop Medical Center Provides Vasectomy & Reversal Online Registration

    When patients seek the vasectomy or vasectomy reversal procedures, they often face frustration related to lengthy check-in processes involving necessary but substantial paperwork. To ease this burden, One Stop Medical Center recently unveiled an online registration forms in its website, EZvasectomy.com that allows patients to conveniently prepare for their visits and office procedures in advance, using either their computers or their mobile devices.

    There are many advantages to use the secure online registration. By using the online registration, the patients are required to review all information before they sign off. Therefore, the patients are completely informed after online registration. It will save time on the day of consultation and/or procedures. By registering in the privacy of patients ‘own homes or offices, the patients will not be distracted by other activity within doctor’s office on the day of visit. The patients are able to give more accurate information because they may also have access to medical information (prior surgeries, medications, names of doctors) that they may not recall on the day of visit. Moreover, Doctors are able to review patients’ history and to call them if there are any medical or social concerns before their office visits.

    When a patient registers online for a vasectomy or a reversal procedure, we can expedite their visit to make it much more convenient and easy. In fact, once they arrive, it’s basically just a matter of verifying who they are in order to see the provider, since we already have most of the information needed in our system.

    Vasectomy Online Registration

    Reversal Online Registration

    New Surgical Techniques in Vasectomy Reversal: No Scalpel, No needle, No suture

    Dr. Shu has been providing affordable vasectomy reversal (vasovasostomy) service with a high success rate in the past two years. Early this year, Dr. Steven Shu further improved his surgical techniques on vasectomy reversal by using the same minimal invasive principles and surgical instruments as the no-scalpel vasectomy. The innovative new surgical techniques of the no scalpel vasectomy reversal significantly minimize trauma and pain by only making a small, single punch in the skin of scrotum, as opposed to a conventional, more invasive open procedure. In order to further reduce the fear of pain and needle, Dr. Shu also adopted the same anesthesia technique as the no needle, no suture vasectomy. Now, he performs the no needle, no suture in the most reversal patients.

    Madajet is a spray applicator that delivers a fine stream of anesthetic at a pressure great enough to penetrate the skin and envelop the vas deferens tube beneath the skin with an almost 100% efficacy rate in the initial anesthesia. The additional anesthetics can be given accordingly during the dissection.

    The surgical trauma is minimized, and the wound no longer needs Penrose drainage. The skin incision is so small that it doesn’t need a suture to close it most of the time, which reduces the recovery time, the operative time, and the postoperative complications.

    “By offering no scalpel, no needle, and no suture vasovasostomy, we have mitigated the pain of the procedure and the fear that comes with it.” says Dr. Steven Shu. “We constantly improve our surgical techniques and the whole service system on vasectomy reversal procedure. I was thinking, no-scalpel, no needle, no suture 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.

    Vasectomy Reversal & Birth Defect | Minnesota

    Recently we got a question from a patient on the relationship of vasectomy reversal and birth control. The patient wanted to know if the vasectomy reversal procedure will increase the chance of birth defect. This blog post will specifically address this issue.

    Back in 2006, a study conducted at Chulalongkorn University in Bangkok showed that chromosomal abnormalities of sperms were more common in vasectomized men than men with healthy fertility. However, the authors of the study acknowledged that they were unsure whether these findings would support the theory that the risk of birth defects was higher after vasectomy reversal. So far, there have been no follow-up studies to confirm that such a link exists.

    Although vasectomy reversal birth defects are among the possible risks discussed during the consultation, most men are pleased to hear that there is no definitive evidence to suggest that the rate of birth defects after vasectomy reversal is significantly higher than that among the general population. In fact, the rate of birth defects may actually be higher among those who achieve pregnancy through in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), which has been indicated in many researches.

    Here are statistics that help you to better understand this issue:

    About 3 percent of all children born in the United States are born with major birth defects (or 6 to 7 percent when accounting for developmental abnormalities). The rate of birth defects after vasectomy reversal is slightly higher at 5 percent. On the other hand, research suggests that there is a greater risk of birth defects in both IVF (9 percent) and IVF-ICSI (8.6 percent) compared to their control group (4.2 percent).

    New Techniques in No-Scalpel Vasectomy Reversal | Minneapolis

    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.

    Roles of Anti-sperm Antibodies in Patients with Vasectomy & Vasectomy Reversal | Minnesota

    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 Antisperm 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.

     

    Sperm Recovery Rate (Patency Success Rate) | Minnesota

    Success rate for vasectomy reversal is generally reported in two ways: sperm recovery rate (patency success rate) and pregnancy rate. Although the statistical averages derived from large numbers of patients offer a general guide, your specific situation and results may differ from that of the average due of many personal variables, such as the surgeon’s vasectomy techniques, your age, you and your partner’s fertility, and a host of other factors.

    Vasectomy reversal can be a gamble, with the success rates and fees varying from office to office, so the evaluating couple must determine where they can get the greatest value from their investment. For example, if the candidate’s interval is 4-6 years and one office has a rate of 93% (sperm recovery) for a fee of $3000, and another office offers a competitive rate of 97% for $10,000, then only the couple can decide whether the increment in higher success is worth the difference in cost.

    The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between vasectomy and vasectomy reversal. Theoretically, the sperm recovery rate drops two percent every year after vasectomy. This is because the likelihood of obstruction in the epididymis increases—especially after 7-10 years. Many men, however, do not develop any obstructions after 15, even 20 years, and may therefore expect a better sperm recovery success rate with a vas-to-vas procedure.

    Based on all of the cases with the reported semen analysis results, the sperm recovery rate (Patency Success Rate) in our clinic is 93.3% for all cases within nine years of vasectomy. We have yet to obtain a large enough number of procedures from 11 years to 25 years of vasectomy to do a meaningful statistical analysis, but the general pattern of successful operations seen in our patients follows Dr. Doug Stein’s published data (Dr. Shu having adopted the same techniques from Dr. Stein).

    SpermRecovery

    Research shows that Tomatoes boost male fertility | Minneapolis

    The key nutrient that gives tomatoes their bright red color could boost fertility in men, according to a study. This research shows that lycopene could increase sperm count by up to 70 per cent.

    The report, which was published by the Cleveland Clinic in Ohio, reviewed 12 studies by different groups around the world.

    All of them showed that lycopene improved sperm count and swimming speed, and reduced the number of abnormal sperm.
    tomato_1

    Ashok Agarwal, director of the Cleveland Clinic’s Center for Reproductive Medicine, who led the study, said it was part of a general pattern showing lycopene benefited men’s reproductive organs. His team has already begun a trial giving lycopene supplements to men with unexplained infertility. They plan to announce the results next year.

    The discovery will bring new hope to the infertility couples in Minnesota.

    Vasectomy May be the New Condom for Fertility

    New research from four months ago published in the journal Andrology shows that very high reversal success makes vasectomy a temporary contraceptive. This study of more than 1,200 reversals (V-V, V-E) demonstrates a vasectomy reversal is possible almost 40 years after the original vasectomy. The author Dr. Turek predicts that a vasectomy can be used as temporary male contraception.

    For decades, it has been believed that the older the vasectomy, the less likely that a vasectomy reversal will work. But this is simply not true. This assumption has led many doctors to encourage couples to choose vitro fertilization (IVF), a much more expensive alternative, to build families.

    The study shows reversals performed even 38 years after the vasectomy did not have worse outcomes after reversal. In fact, the patency rate after reversal plateaus after 21 years doesn’t decrease much. The chance of achieving live sperm counts after reversal in men with older vasectomies (more than 15 years of obstruction) was 75% compared to 93% in men with younger vasectomies (less than 15 years). In addition, excellent sperm counts are achievable after reversing older vasectomies. The motility of ejaculated sperm after reversal decreases as vasectomy age increases.

    Low Cost Vasectomy Reversal in Minnesota

    Finally, low cost vasectomy reversal is here for men in Minnesota and surrounding states. Dr. Shu of One Stop Medical Center is quickly expanding his practice in vasectomy and vasectomy reversal by offering low cost procedures.

    Life changes and some people regret having their vasectomy, but can’t afford the reversal procedure. “That’s why we are here, so that anyone who needs a reversal can get one,” says Dr. Shu.

    These fees are less than what other places will charge. There are a number of reasons for this:

    • Since vasectomy reversal is performed in our accredited private surgical center, there are no facility fees.
    • Because it is done under local anesthesia, there are no fees for an anesthesiologist or nurse anesthetist.
    • We purposely lowered the price, so more people can benefit from it.

    According to published data, someone who receives a reversal within 10 years of having their vasectomy will have greater odds. The best chance for the returning of live sperm is less than three years after the original vasectomy.

    The minimally-invasive procedure performed at One Stop Medical Center is known as Vasovasostomy; it is performed under local anesthesia with the assistance of an operating microscope (microsurgery) and typically takes 2-3 hours to complete.

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