Andrology Care

  • Sheldon H. F. Marks


The presence of an in-house, full-time andrologist overcomes many hurdles and delays in the microscopic analysis of vasal or epididymal fluid looking for sperm or parts. A skilled andrologist can reduce surgical time and improve reversal outcomes by more efficiently identifying a rare sperm intraoperatively that leads to accurate decision-making and so more appropriate procedure with higher success. Plus, an in-house andrologist can participate in the continued postop care to our reversal patients, reducing demands on the surgeon’s time and improving patient education. Including an andrologist as part of the reversal team also provides the option to perform an intraoperative diagnostic TESE or bank sperm at any time during or after the reversal.


Andrologist Andrology lab Cryopreservation Sperm banking Vasal fluid analysis Post-reversal semen analysis interpretation Patient counseling Diagnostic TESE 


  1. 1.
    Kolettis PN, Burns JR, Nangia AK, Sandlow JI. Outcomes for vasovasostomy performed when only sperm parts are present in the vasal fluid. J Androl. 2006;27:565–7.CrossRefGoogle Scholar
  2. 2.
    Kolettis PN, D’Amico AM, Box L, et al. Outcomes for vasovasostomy with bilateral intravasal azoospermia. J Androl. 2003;24:22–4.PubMedGoogle Scholar
  3. 3.
    Scovell JM, Mata DA, Ramasamy R, et al. Association between the presence of sperm in the vasal fluid during vasectomy reversal and postoperative patency: a systematic review and meta-analysis. Urology. 2015;85:809–13.CrossRefGoogle Scholar
  4. 4.
    Smith RP, Khanna A, Kovac JR, et al. The significance of sperm heads and tails within the vasal fluid during vasectomy reversal. Indian J Urol. 2014;30:164–8.CrossRefGoogle Scholar
  5. 5.
    Ramasamy R, Mata DA, Jain L, Perkins AR, Marks SH, Lipshultz LI. Microscopic visualization of intravasal spermatozoa is positively associated with patency after bilateral microsurgical vasovasostomy. Andrology. 2015;3(3):532–5.CrossRefGoogle Scholar
  6. 6.
    Glazier DB, Marmar JL, Mayer E, Gibbs M, Corson SL. The fate of cryopreserved sperm acquired during vasectomy reversals. J Urol. 1999;161:463–6.CrossRefGoogle Scholar
  7. 7.
    Boyle KE, Thomas AJ Jr, Marmar JL, Hirshberg S, Belker AM, Jarow JP. Sperm harvesting and cryopreservation during vasectomy reversal is not cost effective. Fertil Steril. 2006;85:961–4.CrossRefGoogle Scholar
  8. 8.
    Schrepferman CG, Carson MR, Sparks AE, Sandlow JI. Need for sperm retrieval and cryopreservation at vasectomy reversal. J Urol. 2001;166:1787–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sheldon H. F. Marks
    • 1
  1. 1.University of Arizona College of MedicineInternational Center Vasectomy ReversalTucsonUSA

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