Administering testosterone (shots, gels, patches, pills, etc.) will increase the blood levels of testosterone, but strongly inhibit the regulatory hormones FSH and LH, which results in a shutdown of sperm production. The administration of testosterone to men is in fact a very effective form of birth control!

In many men, this condition can be treated with medications which stimulate the production of LH (which drives the production of testosterone by the testis) and FSH (which stimulates sperm production or spermatogenesis). The most common medication currently used for this is clomiphene citrate, which blocks the effects of estrogen on its receptors, resulting in an increase in both FSH and LH. This will often result in a significant improvement in testosterone, and is often associated with an improvement in sperm count.

It should be noted that this drug, although commonly used in the treatment of female infertility, is not FDA approved for treatment of low testosterone in men or male infertility, and therefore this represents an off-label use of the drug. Nevertheless it does appear to be effective in many men for this condition, and is widely used by fertility specialists, although studies suggest the improvement in pregnancy rates is modest at best.

Aromatase inhibitors such as Arimidex, which block the conversion of testosterone to estrogen, are also helpful in improving testosterone levels, but their effects on sperm production and fertility are inconsistent and often not very helpful.

It should be emphasized that the presence of low testosterone may be result of a number of clinical conditions, and a thorough evaluation by a specialist should be undertaken prior to considering these drugs.

1920 Jefferson Ave
Tacoma WA 98402
(253) 627-7625

The Rock Wood-fired Pizza & Spirits is a family-focused, full service casual dining concept. Though focusing on gourmet wood fired pizza, The Rock offers an array of pastas, burgers, sandwiches and salads. Add unique microbrews and cocktails to the list and you truly have something for everyone.

Opened in 1995 as a gritty, local pizza joint in Tacoma, The Rock’s gourmet pies and unique atmosphere quickly gained recognition. Nearly 15 years on, numerous locations have been added to the original throughout Washington, Oregon, Canada and coming soon to Colorado.

The Rock’s continued success has earned the company recognition as America’s Number One Independently Owned Pizza Chain by Pizza Today Magazine.

• Menus
• Map

• Bleeding from the incisions – a small amount of bleeding is common and for 1-2 days after surgery. Ongoing bleeding is unusual, and is virtually always stops without further treatment.
• Bleeding within the scrotal sac (hematoma) – extreme care is taken at surgery to control even minor bleeding, but on rare occasion a substantial amount of blood can collect inside the scrotum, causing swelling and discomfort. In most cases this will not require additional treatment, although it can prolong the recovery from surgery considerably.
• Infection - minor infections of the incisions may occur on occasion, and are typically treated with local care measures and antibiotics. Serious infections inside the scrotal sac are extremely uncommon.
• Prolonged postoperative pain – most men have mild discomfort after surgery which generally resolves within 1-2 weeks. On occasion, the pain will persist longer. Long-term pain after vasectomy reversal is extremely rare.
• Testes atrophy (shrinkage) – The blood flow to the testes is redundant, and is carefully protected during reversal surgery. In extremely rare instances, blood flow to the testes may be impaired after surgery, resulting in shrinkage of the testes.

Dr Finnerty does not recommend the use of these medications, as there is no medical evidence that they reduce scarring or improve surgical success rates after vasectomy reversal. While anti-inflammatory medications are generally benign, and are useful for controlling mild postoperative discomfort, they may increase the risk of bleeding and can be hard on the intestinal tract.

The use of Prednisone is of greater concern, as it may have serious adverse side effects, impairs wound healing, and increases the risk of infection after surgery.

Vasectomy reversal is technically demanding, and even in the most experienced of hands is sometimes unsuccessful. The best antidote to surgical scarring is a precise microsurgical repair by a surgeon with extensive experience in microsurgical vasectomy reversal.

For more information on why vasectomy reversals fail, see this page.

Once again, thank you so much, you helped complete our family!!

1) The presence of non-motile or degenerating sperm in the mid or distal epididymal fluid does not prove that you are above the obstruction. When fluid is sampled from a point higher in the epididymis, the transition is often striking — you go from no active sperm to 70% active sperm or greater. There is usually a visual transition zone above which this change is seen.

2) In the normal, unobstructed epididymis, motility/fertility is not seen until you get more distally (lower) in the epididymis. In the obstructed epididymis, however, motility is seen much more proximally (higher), suggesting that a change in the physiology of the epididymis occurs after vasectomy. This is why aspiration in the proximal epididymis produces better quality sperm for IVF.

There is a trade-off to doing a VE more proximally: less sperm storage capacity. But the advantage is that by going high enough to find motile sperm when possible (not always there, unfortunately), postoperative sperm counts show substantially better motility. This was the rationale for Dr. Silber’s approach of sampling fluid until motile sperm are found; that is Dr. Finnerty’s experience as well.

Epididymal repairs are not automatically performed in the upper portion of the epididymis, but if possible at a point where motile sperm are present. If that is in the mid-epididymis or lower, that’s where the repair is performed. In Dr. Finnerty’s experience, however, it often ends up being in the upper 1/3.

Epididymal repair is also performed in two layers, using a variation of the “intussusception technique” on epididymal the tubule. This technique was developed by Dr. Finnerty to improve the precision and success rate of this difficult and delicate repair.

All reversal surgeries are now done under general anesthesia, administered by a board-certified anesthesiologist. This approach is extremely safe and comfortable, and affords the ideal environment for the successful performance of your reversal surgery.

The variability in the diameter of the vas, especially the inner lumen on the testicular side, is quite large from one patient to the next. The distal lumen (above the vasectomy) is almost always between 0.2 and 0.3 mm in diameter, while the proximal lumen (below the vasectomy, closer to the testes) may vary from 0.5 mm to 1.8 mm. To precisely align the inner channel the number of inner sutures needed will vary substantially, generally between 5 and 8 sutures. In Dr. Finnerty’s experience, using more sutures than this actually increases the risk of failure, as the delicate mucosa is shredded and frayed by too many stitches, promoting scarring.

Of course, the epididymal repair is technically quite different than a vas-to-vas repair, and generally requires fewer sutures on the mucosal layer than does the vas.