AntiSperm Antibodies – Proteins formed in response to sperm much like other proteins formed by the body’s immune system to protect itself from something harmful (i.e., allergy, injury). ASA have possible significance in less than 5% of vasectomy reversal patients. No need for preoperative testing.

Epididymis – A sac that lies on the testicle containing very thin walled tubes where sperm mature and are stored prior to ejaculation.

Fertility Expert – Either an Ob/Gyn physician who specializes in female reproduction or an Andrologist who specializes in male reproduction.

Local Anesthesia – Placement of numbing medication with tiny needles in the vas region to allow painless surgery on the vas deferens.

Microsurgery – Surgery using optical magnification by use of a microscope.

Microsuture – Tiny material (thread) used during vasectomy reversal microsurgery to reconnect the two ends of the vas deferens.

Patency – Rate at which sperm returns to semen following a vasectomy reversal.

Pregnancy Rate – Rate of pregnancy for couples following a vasectomy reversal. Usually defined as a two year rate (two years after reversal) for couples who have no female fertility issues.

Prostate Gland – Gland, located below the bladder in which the ejaculatory ducts, the two vas deferens and the urethra join.

Scrotum – The sac that contains the vas deferens, epididymis, and testicles

Semen or Seminal Fluid – Fluid containing sperm and glandular fluid released by the urethra with ejaculation

Sperm Count – Number of sperm per volume, also less commonly described as the number of sperm in a sampling of semen (better described as total sperm count).

Testes or Testicles – Two male reproductive glands located in the scrotum which produce sperm

Total Motile Count – Figured by multiplying the total sperm count by the percentage of sperm with motility (movement). Normal Total Motile Count is 20 million.

Urethra – Tube that runs from the bladder to the penis that carries urine or semen

Vas Deferens – The tube where sperm are transported between the epididymis and the prostate. There are two tubes, one on each side of the scrotum.

Vasectomy – A surgery that causes infertility in men. Specifically, part of the vas deferens is removed or divided.

Vasectomy Reversal – A surgery that aims to bring fertility back to a man. Specifically, the vas deferens are reconnected. Also loosely used to describe a more complicated surgery to connect the vas to the epididymis.

Vasoepididymostomy – A complicated vasectomy reversal performed in about 5% of all reversal surgeries, but more commonly in patients over 9 years from vasectomy. It connects the vas deferens to the epididymis in order to bypass a blockage in the epididymis. See vasectomy reversal definition above.

Vasovasostomy – Simple vasectomy reversal that reconnects vas deferens. It is by far the most common surgery for vasectomy reversal. See vasectomy reversal definition above.

The same day the games began in Vancouver, I was doing the last operation of the week for a very pleasant couple from Delaware. I was listening to a symphony play “Ave Maria” in the background, and was really enjoying the surgery.

At that moment I was performing the anastamosis, the hook up between the upper and lower portions of the vas tube to repair the vas deferens. I was peering through the microscope that makes the vas look as big as a barn. I held in my right hand the titanium microsurgical needle holder that grasped the 4/1000ths of an inch needle and my left hand fingers cradled the titanium forceps with a 0.2 millimeter tip.

After running the needle precisely through the wall of the two vas ends, I was tying the microsuture (less than one third the diameter of a hair). I rhythmically intertwined the tips of the two instruments in order to tie the surgical knots. The image of a couple on the ice at the Winter Olympics came to mind as I methodically but gracefully performed the maneuvers to complete the exact reconnect.

Surgery has often been likened to an athletic event, and I was certainly enjoying the movement and execution of the vasectomy reversal maneuvers to help this couple with their dream.

Fast forward a week and a half – I walked into the living room where my wife was watching the live TV broadcast of the Winter Games. Belbin and Agosto, the veteran U.S pair were taking to the ice. They beautifully skated to the same song I had heard in the surgery room: “Ave Maria.” After the competition they spoke of their long-term commitment to excellence and the satisfaction of having done the best they could do.

So the truth really does beat fiction. I’ll never be on the ice center stage, but after years of sacrifice and preparation I know the joy of a job well done.