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Tag Archives: affordable vasectomy reversal

Vasectomy Reversal-What a Woman Wants to Know.

From Vasectomy.com

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The decision to reverse a vasectomy should be considered carefully by each couple. As a woman, you may have special concerns that are difficult to express.

Vasectomy reversal (and the microsurgery involved) raises questions for both men and women. Although men need to be forthcoming about any questions, concerns and fears they share with their physician, it is just as important for women to be informed and reassured about the procedure. You may be surprised to know that many women share the apprehensions about reversal surgery that you may have.

Candid questions, correct information, and the assurance of an experienced urologist are the keys to feeling more comfortable and sure about the decision you and your spouse have made to have a vasectomy reversal. Make a list of the questions that concern you most before meeting with your doctor.

Here are some of the questions women commonly ask:

“This is my first marriage– and his second. Will my spouse’s older age affect the health of his sperm or our babies born after his reversal?”

Generally speaking, a man who has healthy sperm can reasonably expect to father a healthy child. A man’s age does not affect fetal development the way a woman’s does. But time does have an impact on successful conception.

The longer the amount of time between a man’s vasectomy and his reversal, the less potent he may become. This is why: After a vasectomy, unreleased sperm collect in the testicles before being absorbed by the body. The body responds to the unspent sperm with a reaction that can affect, to some degree, sperm quality and health. Over time, this reaction can gradually reduce the mans sperm count, and impair sperm motility.

A successful reversal that results in pregnancy is proof that the man has a healthy, adequate sperm count. The course of pregnancy that follows a vasectomy reversal should be as normal as any other pregnancy. A vasectomy reversal merely restores sperm to the seminal fluid. It should not affect the health of an unborn baby in any way, no matter how old the man is at the time of his reversal.

“Will a vasectomy reversal affect a man’s ejaculation?”

Sperm is only a tiny portion of the seminal fluid that is released at ejaculation. Just as a vasectomy does not change the volume, color, or consistency of the ejaculate, neither does a vasectomy reversal. Sperm are impossible to detect in seminal fluid without the use of a microscope. The quality, intensity and duration of a mans orgasm and ejaculate will not change after a reversal.

“How long will it be until my spouse and I can resume sex?”

Physicians usually advise that it is best to wait three or four weeks following the reversal procedure before returning to sexual activity. It will take additional time before sperm returns to the ejaculate.

“Does the vasectomy reversal procedure leave scars?”

Despite the greater complexity and time involved in a vasectomy reversal procedure, there is usually no lasting or noticeable difference to the feel or appearance of the scrotum.

“How soon can I expect to get pregnant?”

If reversal is successful and healthy sperm rejoin the seminal fluid, it may take 12 months, on average, to achieve pregnancy. The range, from reversal to conception, is between one and 82 months. Most couples achieve pregnancy within a year.

“Can I and should I be examined and tested for fertility first, before we decide on a reversal?”

Since many couples consider reversal surgery a costly matter, women often do choose to consult with their own physicians or fertility specialists first, to determine whether there is any question or doubt about the woman’s ability to conceive and complete a healthy pregnancy.

“How long will my husband be in pain, and what can I do to help?”

You can expect your husband to experience some degree of discomfort and swelling in the first three to five days following reversal surgery. A gradually decreasing ache in the scrotal region will follow and may last for three to four weeks. His attention to doctors orders during the recovery process, lots of ice and rest, and your tender loving care will be the best medicine for your husband.

“Does a vasectomy reversal make you more, or less, susceptible to sexually transmitted diseases?”

Vasectomy and vasectomy reversal surgery do not protect couples from the risk of transmitting or contracting a sexually transmitted disease. These diseases are transferred in body fluids, such as saliva or semen. Both men and women should use condoms if any potential risk of sexually transmitted disease exists.

“How old is ‘too old’ for a couple considering vasectomy reversal?”

All women lose the ability to conceive by late middle age. Women over the age of 40 may experience difficulty conceiving with assisted reproductive techniques (ART).

Men can remain potent and father children even after the age of 70. However, a man may not want or be able to parent a new child at a later stage of life. The older you are, the fewer the years that you have left in which to raise an infant to adulthood. And older couples often have more health problems as they age.

“My husband does not want more surgery-he says that sperm aspiration is easier and just as effective as vasectomy reversal. Is it?”

A vasectomy reversal, performed under general anesthesia, is virtually painless, more natural and more likely to result in pregnancy than an assisted reproductive technique (ART) that begin with sperm aspiration as the first step. Besides a lower rate of success, ARTs have much higher costs, involve a greater number of complex, uncomfortable procedures, and take considerably more time than that required to perform a comparatively simple and safe reversal.

In a straight comparison, reversal surgery is preferable to ART and should be considered first, unless conception and pregnancy cannot be achieved any other way.

“What if we just want one child. Would not sperm retrieval and in vitro fertility be more efficient?”

Not necessarily. The rate of multiple order births–twins or triplets–is several times higher with in vitro fertility than with natural conception following a vasectomy reversal. The risk of having twins with IVF is 20 to 50 percent depending on which IVF center one is treated at.

In Summary:

  • A vasectomy should be considered permanent, so have reasonable expectations about the success of reversal surgery. Be informed and discuss all your options with your spouse and your physician.
  • Some men or couples may not be well suited or economically prepared for a vasectomy reversal or second family, particularly if either partner is over the age of 40 or in poor health. Vasectomy reversal microsurgery is often evaluated as a first course option; generally preferable to assisted reproductive techniques for many couples.

Myths about Vasectomy Reversal

The following is from a vasectomy reversal doctor in England. The process is similar to but not exactly the same as at Georgia Vasectomy Reversal, however it is informative and adds to the data base of the couple contemplating a vasectomy reversal.

Vasectomy reversal myths debunked

If you decide to undergo a vasectomy reversal, having accurate information at your fingertips will ensure you are as informed as possible. Here are some of the most popular myths associated with reversing a vasectomy.

If you’re too old, you can’t have a vasectomy reversal

The reality is, a vasectomy reversal can be performed at any age, so long as an individual is healthy enough to undergo the treatment.

A vasectomy reversal rarely works after 10 years

This is a popular misconception and is based on outdated studies. Modern techniques used today have increased the vasectomy reversal success rate even if the original vasectomy was performed years ago. Even after about 20 years, you still stand an 84% chance of success following a vasectomy reversal.

Anti-sperm antibodies cause infertility even after a vasectomy reversal

It is widely believed that anti-sperm antibodies attack healthy sperm following a reversal and can cause infertility. In actual fact, antibodies are present in the blood and not in sperm following a vasectomy reversal, so are normally not responsible for any fertility problems that may arise following the procedure.

IVF is a better option than vasectomy reversal

You will need to weigh up the pros and cons of choosing IVF or vasectomy reversal, but there are many benefits to choosing reversing a vasectomy over IVF. For starters, a vasectomy reversal is a quick, single procedure that has good success rates, enabling you to conceive a baby naturally. In contrast, IVF is a gruelling process that often requires several attempts to increase the chance of success. The cost of a vasectomy reversal is also much lower compared to IVF procedures. Bear in mind also that there is a greater chance of multiple pregnancies when opting for IVF, so if you are only hoping for one baby, a vasectomy reversal is easily a better option.

Vasectomy reversal successes are the same whoever you choose

This is not the case at all. Doctors and standards vary, so if you want to achieve the best results possible choose a surgeon who is specialised in vasectomy reversal and has extensive experience. Mr Harriss has many years of experience and is available to answer any questions that you may have.

 

Vasectomy Reversal-Age of the female is important.

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In addition to the skill of the surgeon, the character of the fluid at the time of the reversal, and years since the vasectomy…the age of the female is an important factor in achieving pregnancy.

What Affects Pregnancy, Patency Rates After Vasectomy Reversal?

Urology – October 30, 2015 – Vol. 33 – No. 4

The Silber grading scale appears to dictate pregnancy rates after vasectomy reversal with increasing female age being a negative predictive factor.

Article Reviewed: Impact on Pregnancy of Gross and Microscopic Vasal Fluid During Vasectomy Reversal. Ostrowski KA, Polackwich AS, et al: J Urol; 2015;194 (July): 156-159.

Background: The examination of the vasal fluid at the time of vasectomy reversal has implications for surgical decision making with effects on patency and pregnancy rates. The Silber grading system characterizes these findings and has been used to help surgeons with the decision to perform vasovasostomy (VV) or the more technically challenging vasoepididymostomy (VE).

Objective: To determine both intraoperative and patient factors that affect pregnancy rates after vasectomy reversal.

Design: Retrospective review of prospectively maintained database.

Methods: This paper reviewed the results of a single surgeon series that encompassed >30 years of vasectomy reversals. Vasal fluid was characterized as opalescent, creamy, pasty or clear and intraoperative light microscopy was used determined if sperm parts were present or motile. Univariate and multivariate analysis examined the data set for significant factors that affected pregnancy rates.

Results: 2947 vasectomy reversals were included in the analysis. Pregnancy status was only known for 31% of these cases. Bilateral VV was performed 83% of the time and most patients fell into a Silber 1 to 3 classification. No factors met statistical significance for increasing the pregnancy rate, although the presence of motile sperm was almost significant (P =0.075).

Negative predictive factors for pregnancy were identified on multivariate analysis with increasing female age and the findings of either no sperm (odds ratio [OR], 0.08) or sperm heads only (OR, 0.46) on microscopy decreasing pregnancy rates. Rarely were sperm parts identified when pasty fluid was encountered.

Conclusions: The findings from this paper echo the findings of the Vasovasostomy study group, with the Silber grading system essentially dictating pregnancy rates.

Reviewer’s Comments: The decision to perform VV or VE can be a difficult one and is based on many factors including findings from the vasal fluid, time since vasectomy, and surgeon skill level. Few papers have examined this decision-making algorithm since the landmark paper by the Vasovasostomy study group in 1991. While most microsurgeons prefer VV to VE due to increased patency and pregnancy rates, the need to perform a VE is generally encouraged when pasty fluid or no sperm parts are found in the vas at the time of reversal. These findings are interesting and are another important addition to the literature. Unfortunately, despite the authors’ efforts, relatively few predictive factors were found. Their findings do somewhat parallel those published by the Vasovasostomy study group, wherein the Silber grading system appears to correlate with pregnancy rates. The authors identified sperm heads only (Silber 4) or no sperm (Silber 5) as negative predictors with motile sperm (Silber 1) almost achieving statistical significance as a positive factor.(Reviewer–Charles Welliver, MD).

Info cartoon on Vasectomy Reversal

You can learn something from almost anything!

Does the type of vasectomy performed affect the microscopic vasectomy reversal?

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No Sireee Bob!

All methods of performing a vasectomy include removing a segment of the vas deferens and then doing something to close the two ends of the divided vas. Whether this is done by using electrocautery, clips, suture, or interposing tissue, the ability to remove the damaged areas of he vas ends and do the reversal is not impaired.

In general about an inch of the damaged ends of the vas tubes and scar tissue is removed at the time of a microscopic reversal. There is plenty of “play” in the vas above and below the vasectomy site to perform the reversal without tension.

Vasectomy reversal more cost effective than IVF?

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Vasectomy Reversal Remains More Cost-Effective Than IVF

Urology – October 30, 2008 – Vol. 24 – No. 11
Vasectomy reversal is more cost-effective than sperm aspiration and in vitro fertilization for obstructive azoospermia.
Article Reviewed: A Decision Analysis of Treatments for Obstructive Azoospermia. Lee R, Li PS, et al: Hum Reprod; 2008;23 (September): 2043-2049.
Background: Management of post-vasectomy obstructive azoospermia is either vasectomy reversal or sperm aspiration with in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI). The cost of IVF and issue of multiples has broad implications for public health policy and allocation of resources. The change in cost of male factor infertility over time with the evolution of new techniques like ICSI has not been studied.

Objective: To investigate and compare the economic impact of IVF versus vasectomy reversal for obstructive azoospermia over time using population data and analytic models. Continue reading Vasectomy reversal more cost effective than IVF?

$500.00 off vasectomy reversal-Schedule before 2017!

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Just call our vasectomy reversal coordinator and mention this post. She will schedule your reversal as soon as possible!  770-535-0001 ext 113 or kathy.burton@ngurology.com. 

Our contact page.

Because a vasectomy reversal is usually not covered by insurance, the patient usually pays an all inclusive fee to the surgeon. This fee covers all of the components of having a surgical procedure such as:

  • The fee of the surgeon to perform the reversal.
  • The facility fee which includes the cost of the nurses and staffing, the facility (operating room), suture materials and the operating microscope, the anesthesiologist and the anesthesia supplies necessary to put a patient to sleep.
  • The cost of overnight accommodations (if necessary).

At Northeast Georgia Urological Associates our facility is accredited and owned by our practice which in turn allows our all inclusive fee to be much less than if a hospital were used. Our anesthesiologists are board certified as well as Dr. McHugh.

The all inclusive cost for a  microscopic vasectomy reversal at the Northeast Georgia Ambulatory Surgery Center is $6,500.00. After promotion- $6,000.00.

Kathy Burton 770.535.0001 ext 113 or kathy.burton@ngurology.com is available to help with all things vasectomy reversal. CareCredit is an option for couples preferring to pay over time.

Post Vasectomy Pain Syndrome. Real? Will a vasectomy reversal help?

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Can There Be Complete Resolution of Pain for Men With PVPS?

One of the most complimentary letters I have ever received was from a patient on whom I performed a vasectomy reversal for relief of  chronic testicular pain which started after his vasectomy years previously. Go figure!

Urology – June 15, 2016 – Vol. 34 – No. 3

A subset of men have complete resolution of postvasectomy pain with vasectomy reversal. Most men have some improvement in pain scores with vasectomy reversal.

Article Reviewed: Vasectomy Reversal for Postvasectomy Pain Syndrome: A Study and Literature Review. Polackwich AS, Tadros NN, et al: Urology; 2015;86 (August): 269-272.

Background: Vasectomy is a common and effective procedure for sterility. Although complications are infrequent, postvasectomy pain syndrome (PVPS) does occur in some subset of patients. Most previous studies report that men who have PVPS do not generally seek additional medical treatment and have minimal affect on quality of life. However, a small subset has pain significant enough to require additional care and procedures.

Objective: To determine outcomes of vasectomy reversal (VR) for PVPS.

Design: Retrospective chart review.

Methods: A single surgeon series was reviewed for men who underwent VR for PVPS. Although there was not an algorithmic approach to preoperative pain management, patients were only considered for VR if they had worsening of pain with ejaculation or arousal. The location of vasectomy site along the vas deferens was recorded at time of the procedure in the operative note. Pain scores were evaluated with a non-validated questionnaire by recall.

Results: 31 patients from a pool of 123 potential patients were included. There was a 59% improvement in pain scores, with 34% of patients reporting a complete resolution of pain. Two patients required additional procedures for pain (epididymectomy and orchiectomy), and 84% of patients would recommend VR to a man with PVPS. There was no relationship between location of vasectomy and possibility of PVPS.

Conclusions: VR for PVPS demonstrated significant improvements in pain scores in this study.

Reviewer’s Comments: Although the questionnaire is non-validated and the pain scores are by recall, the fact that men generally reported an improvement in pain scores with VR is reassuring. As roughly one-third of men had total resolution of pain, there is likely an etiology of vasal obstruction leading to pain among these men. I have always wondered if some of the cases captured in studies looking at PVPS are really just the background of orchalgia in the population that we now attribute to the previous vasectomy. Considering how few men seek medical attention and undergo procedures for PVPS, I have always believed there is likely a group of men who have intermittent scrotal pain and a group who clearly have pain from vasectomy-induced obstruction. In their comments, the authors observe how patients seemed to group into complete (or almost complete) resolution of pain or minimal change in pain. As the authors were thoughtful by only considering men for reversal if they had pain with ejaculation or sexual stimulation, one would hope that this would only select men who truly have an obstruction-induced pain syndrome. This is a nice addition to the literature and does point out that there are some men who fully respond to reversal for PVPS. These men, however, may be difficult to identify preoperatively.(Reviewer–Charles Welliver, MD).

 

Tubal ligation vs. Vasectomy-which is more common?

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The more invasive tubal ligation still outnumbers vasectomy among the options for permanent sterilization for couples. The rationale for this involves speculation, but male partner anxiety surrounding issues of sexual function have been proposed and are certainly evident when counseling males before vasectomy.

Urology – April 30, 2016 – Vol. 34 – No. 1
Vasectomy is not associated with decreased frequency of sexual intercourse.
Article Reviewed: Relationship Between Vasectomy and Sexual Frequency. Guo DP, Lamberts RW, Eisenberg ML: J Sex Med; 2015;12 (September): 1905-1910.
Background: Men often report the concern that having a vasectomy will impair their future sexual function.

Objective: To determine in an objective and quantifiable manner if vasectomy leads to a decrease in sexual frequency.

Design: The authors analyzed data from the National Survey of Family Growth (NSFG), which is a large survey of American households.

Continue reading Tubal ligation vs. Vasectomy-which is more common?

Vasectomy reversal vs. ICSI after prolonged obstructive interval since vasectomy. Which is better?

Vasectomy Reversal after Obstructive Intervals

Urology – March 1, 2003 – Vol. 17 – No. 09

Even after prolonged obstructive intervals of 15 to 20 years, vasectomy reversal offers better or comparable success rates to intracytoplasmic sperm injection.

Article Reviewed: Outcomes for Vasectomy Reversal Performed After Obstructive Intervals of at Least 10 Years. Kolettis PN, Sabanegh ES, et al: Urology 2002; 60 (November): 885-888.

Outcomes for Vasectomy Reversal Performed After Obstructive Intervals of at Least 10 Years.

Kolettis PN, Sabanegh ES, et al:
Urology 2002; 60 (November): 885-888

Continue reading Vasectomy reversal vs. ICSI after prolonged obstructive interval since vasectomy. Which is better?

Helping couples achieve the new addition to their lives with microscopic vasectomy reversal.

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