Why should I choose Dr. Larry Lipshultz?
Larry I. Lipshultz, M.D., Professor of the Scott Department of Urology at Baylor College of Medicine, was born in Philadelphia, Pennsylvania, and graduated from Franklin and Marshall College. He earned his M.D. and completed residency training at the University of Pennsylvania. He also completed a two-year fellowship at the University of Texas Medical School at Houston in male reproductive medicine.

As a pioneer in urological microsurgery, Dr. Lipshultz is one of the world's leading experts in male infertility.  Active in numerous scientific organizations, Dr. Lipshultz is well respected by his medical colleagues and has served as a member of the Board of Directors of the American Society for Reproductive Medicine and as President of the Society for the Study of Male Reproduction. Dr. Lipshultz was President of the American Society for Reproductive Medicine from 1998-1999.  His research includes newly developed techniques for micromanipulation of sperm that have assisted a large number of infertile patients to achieve pregnancies over the last few years.  His clinical practice uses only the latest microsurgical equipment and performs approximately three vasectomy reversal procedures weekly on an outpatient basis.  Dr. Lipshultz' credentials and experience speak for themselves.  Choose the right doctor the first time for your procedure.

In his active clinical practice, Dr. Lipshultz specializes in male infertility and male reproductive disorders. As a member of Baylor's faculty, he is a popular teacher and has trained more than 30 fellows now in practice throughout the U.S. As Clinical Director of the Laboratory for Male Reproductive Research and Testing, his interests are in discovery of new growth factors secreted by the Sertoli cell and the development of new techniques for micromanipulation of sperm. The laboratory has received a large NIH grant to determine the correlates of fertility in spinal cord injured men. Newly developed techniques for micromanipulation of sperm have assisted a large number of infertile patients to achieve pregnancies over the last few years.

Well-known author, editor, and lecturer, Dr. Lipshultz has published more than 200 scientific papers, most of them on the subject of male reproduction. Dr. Lipshultz currently serves on the editorial boards of the journals Urology, Advances in Urology, and Contemporary Urology. He has acted as guest editor for complete issues of World Journal of Urology and Urologic Clinics of North America. In 1995 he edited a book Urology and the Primary Care Practitioner published by Mosby-Wolfe Medical Communications, a division of Times Mirror International Publishers Limited. Dr. Lipshultz is the editor and author of the authoritative textbook of male reproductive medicine and surgery entitled Infertility in the Male.

Active in numerous scientific organizations, Dr. Lipshultz has served as a member of the Board of Directors of the American Society for Reproductive Medicine and as President of the Society for the Study of Male Reproduction. Dr. Lipshultz was President of the American Society for Reproductive Medicine from 1998-1999.

Click here to view Dr. Lipshultz' Curriculum Vitae.

Vasectomy Reversals
(Microscopic Vasovasostomy and Epididymovasostomy)
A vasectomy reversal is an operation that reestablishes a connection between the two ends of the vas deferens that were separated at the time of a prior vasectomy.  Sometimes the vas deferens is reconnected to the epididymis (epididymovasostomy) because of a secondary obstruction in the epididymis.  The entire procedure is performed under a special microscope.

Sperm production takes place in the testis.  After passage through the efferent ducts, sperm are stored and undergo maturation within the epididymis.  Those sperm that have not passed through the epididymis are generally not able to fertilize eggs under normal conditions.  The epididymis is a continuous, tightly coiled tube approximately 15-18 feet in length, which leads into the vas deferens.  The vas deferens is responsible for directing and propelling the sperm into the urethra.

Increasing numbers of men are coming to the urologist for vasectomy reversals, most commonly because of remarriage and the desire to initiate a pregnancy.  Vasectomy reversals are also requested by couples who have merely "changed their minds," as well as by couples who have lost a child and are attempting to initiate another pregnancy.  Fortunately, microsurgical advances are now resulting in significant pregnancy rates.

The success of a vasectomy reversal depends on:
1.  The skill of the surgeon.
2.  The findings at the time of surgery.

The surgeon should be skillful with microsurgical technique, as precise suture placement is critical to the success of the procedure.  The surgeon must also have the ability to perform the more difficult epididymovasostomy procedure.

As mentioned previously, other important factors in determining a successful outcome are the surgical findings.  When the vas is opened, fluid will flow from the testicular side of the vasectomy site.  If sperm are present, then we expect 90% or more of patients to demonstrate a return of sperm with an associated 60%-70% pregnancy rate.  If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production (e.g., clear, watery), then a direct vasovasostomy is performed with a successful outcome of approximately 50%.  If poor-quality fluid is present (e.g., thick, pasty) and sperm are absent, or no fluid at all is found, then an epididymovasostomy  (connection of the vas to the epididymis) is performed with a successful outcome of approximately 40%-50%.

We use a two-layer anastomosis utilizing microscopic sutures and the latest microsurgical equipment.  We perform approximately three of these procedures weekly on an outpatient basis.  The arrangement allows you to return home or to a nearby hotel without actually being admitted directly to the hospital, thus saving considerable expense and making the overall experience much more pleasant.  We perform the surgery at the day surgery unit at St. Luke's Episcopal Hospital or The Methodist Hospital; both of these facilities feature state-of-the-art microsurgical equipment and a hospital staff well-trained to assist in these procedures.

Operating time for a vasovasostomy or epididymovasostomy is approximately 3 hours.  A general anesthetic usually is used, but a regional anesthetic (spinal or epidural) can also be selected.  We prefer that out-of-town patients stay in Houston for at least 1 day after surgery.  Postoperative follow-up includes an evaluation of wound healing at 10 days to 2 weeks and a semen analysis at 6-8 weeks.  Monthly semen analyses are then obtained for approximately 4-6 months, or until the semen analysis stabilizes.  If semen quality is less than expected, anti-inflammatory medication are often introduced to decrease scarring.

Cryopreservation of sperm (sperm banking) is routinely performed at the time of vasectomy reversal if whole, motile sperm are present.  Cryopreservation is performed as a safety "backup" in case inadequate sperm counts are present after surgery.  Because vasectomy reversals may infrequently scar, despite good initial results, cryopreservation may also be performed on ejaculated specimens early in the course of recovery when semen quality is exceptionally good.  Sperm are stored at the Scott Department of Urology's Sperm Bank.

How much will it cost?
The surgeon's fee is $3,750.00 US for a first-time vasovasostomy.  The fee is $4,400.00 US for an epididymovasostomy and/or redo vasovasostomy if the initial surgery was done elsewhere.  A two-week postoperative wound evaluation is included in the surgical fee.

How can the fee be paid?
If your insurance carrier is not going to pay for the procedure, a deposit of $2,200.00 US is required two weeks prior to surgery, with the total balance to be paid on the day of surgery.  
Our Billing Office will work with you, if needed, to establish a payment schedule for the balance.

Are there any other fees that I might incur?
At the time of the procedure, you have the option to harvest sperm to freeze for future use.  The fee for this is $625.00 US which includes the surgeon's fee and one-year storage.  Thereafter, storage will be an additional $100.00 US per year.
Any additional office visits and semen analyses will be charged accordingly.  Charges for the hospital and anesthesia are billed separately from the surgeon's fee.  These are paid at the hospital on the day of your procedure.  The hospital fees are $3,750.00 US which includes 3 hours of anesthesia.
There is also a $500.00 US cancellation fee which will be withheld from your surgery deposit should surgery be cancelled or rescheduled less than two weeks prior to the scheduled date and a $2,200.00 US cancellation fee if cancelled within 48 hours.
You are also responsible for your transportation fees to and from the facilities and accommodation fees.

How long is the procedure?
Operating time for a vasovasostomy or epididymovasostomy is approximately 3 hours.  A general anesthetic usually is used, but a regional anesthetic can be selected.  We prefer that out-of-town patients stay in Houston for at least 1 day after surgery.

How long is the follow-up period?
Postoperative follow-up includes an evaluation of wound healing at 10 days to 2 weeks and a semen analysis at 6-8 weeks.  Monthly semen analyses are then obtained for approximately 4-6 months, or until the semen analysis stabilizes.

What is your success rate?
The success of a vasectomy reversal depends on:
1.  The skill of the surgeon.
2.  The findings at the time of surgery.

Other important factors in determining a successful outcome are the surgical findings.  When the vas is opened, fluid will flow from the testicular side of the vasectomy site.  If sperm are present, then we expect 90% or more of patients to demonstrate a return of sperm with an associated 60%-70% pregnancy rate.  If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production (e.g., clear, watery), then a direct vasovasostomy is performed with a successful outcome of approximately 50-60%.  If poor-quality fluid is present (e.g., thick, pasty) and sperm are absent, or no fluid at all is found, then an epididymovasostomy  (connection of the vas to the epididymis) is performed with a successful outcome of approximately 40%-50%.

How do I make an appointment?
Just call our appointment desk at (713) 798-6163 or send a message using our contact form.
If you want to make a payment, make your check to Larry Lipshultz, M.D. and mail it to:

Larry I. Lipshultz, M.D.
6560 Fannin, Suite 2100
Houston, TX 77030
ATTN: Jo Vasquez

How can I get more information?
You are welcome to come by our office, call us at (713) 798-6163, or send a message using 
our contact form to get more information.  We will be happy to assist you.

For more information on the subject of male infertility, 
visit my other website at www.Infertility-Male.com

-Larry Lipshultz

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