Just got a message from JB and MC from Albuquerque, New Mexico. Great couple and he has to be on of the funniest guys I've met. They wanted to get pregnant naturally. The only problem was that she had had her fallopian tubes tied and he had had a vasectomy. In 2008, she underwent a tubal reanastamosis (where they reconnect the fallopian tubes) by Jim Thompson MD at the Center of Reproductive Medicine (Nice work, Jim!); and in 2009, he had a microsurgical vasectomy reversal after it was confirmed that her operation worked. During the vasectomy reversal, we were excited to find complete sperm coming from the pipes (vas deferens) when we opened them up and took a look at the fluid under the microscope. As a result, we were able to perform the more simple vasectomy reversal on both sides (vasovasostomies). Moving sperm was seen in his ejaculate at 4 weeks and they got pregnant 5 months after the surgery. While the chances of a pregnancy are lower since both the tubal reanastomosis and the vasectomy reversal have to work, it still is possible just like in this case. Pretty neat! As always, it's a joy to see great things happen to great people! Thanks for sharing the great news. -Dr. K

Just got a call from the wife of one of my patients who is now pregnant. Interesting situation. This couple came to me after J had had a vasectomy 11 years ago. Making sure they knew all of their options, they had already seen the IVF doctors and felt that a vasectomy reversal resonated best with their reproductive philosophy. We performed the vasectomy reversal and it required the more complex "bypass" vasoepididymostomy connection on one side and the more simple vasovasostomy connection on the other side. With every reversal, there are three steps in the journey...the first step is to bring the pipes together where it will give a couple the best chances of getting sperm back, the second step is that the body has to heal in a way to keep the pipes open and finally the testicles have to "come back up to speed" and start producing sperm the way they used to. Obviously, as vasectomy reversal surgeons, we have the most control over the first step and are able to bring the pipes together either with the more simple or the more complex reversal depending on what the fluid looks like coming from the pipes during the operation. The last two steps are harder for us to control; consequently, I put our men on anti-inflammatories and anti-oxidant therapy. In this man's situation, no one would have expected that he would have such a drastic inflammatory reaction to having the surgery. Without any obvious signs of infection and having received antibiotics during and after the surgery, his scrotum and all the associated tissues just became very inflamed. Unfortunately, this lingered for a while and even though we eventually got sperm back, the numbers and the motility were not sufficient for natural conception or inseminations. After discussing a redo vasectomy reversal, they decided on pursuing IVF. It is felt by some that testicular sperm that are fresh off the assembly lines may be a better source of sperm for some men, we performed a small office procedure to obtain some testicular sperm to be used in addition to his ejaculated sperm for the IVF. Staying in close contact with them throughout this whole reproductive journey, it is a real joy to see them achieve a pregnancy with IVF. They are expecting in October 2010. Thanks for keeping us up to date and letting us be a part of such a magical time in your lives. - Dr. K

Recently, Dr. Kuang was acknowledged for his compassionate care in the community. In addition to running the Southwest Fertility Center for Men that specializes in vasectomy reversal, he also helps out covering the local emergency rooms taking care of New Mexicans with urologic issues:

"Dear Paul,
Last night 10/14 Dr. Kuang was on call and it was also his birthday. As he was leaving the hospital we gave him not one but three consults. He was incredibly kind and pleasant and even took the messy hospice patient who needed a suprapubic catheter. I cannot tell you how appreciative we are in the Emergency Department for his professional and pleasant behavior. Thanks.
Kudos to Dr. Kuang! "

We received this email the other day from J from Albuquerque, New Mexico. A comprehensive evaluation determined that he had no sperm in his ejaculate and was missing the "pipes" or vas deferens that are carry sperm out to the penis. Fortunately, his testicles were still making sperm. We call this "obstructive azoospermia." Men in this situation need to receive genetic testing. It showed that he was a carrier for Cystic Fibrosis. Historically just a couple decades ago, there was no hope for these men to conceive; however, in the modern era of Assisted Reproductive Technology (ART) and In Vitro Fertilization (IVF), we were able to retrieve sperm from his testicles with a 20 minute minor procedure and used it for IVF and here is that email:

"Dr. Kuang: We've learned to grab a nap where we can. I've attached I few photographs to share with you and your staff.
Eliana was born on Thursday, March 26th. She weighed in at 7 pounds and 5 ounces with a head to toe length of 19 1/4 inches and was sporting a full head of red hair.
Would definitely like to stop by with the family to say hi. Perhaps sometime next week. I'll check with B and get back with you later to schedule a visit.

Thanks for sharing the great news! - Dr. K

Dr. Kuang was recently invited to give the University of New Mexico urology residents a lecture on the Microsurgical Skills and Techniques that are necessary for performing state-of-the-art microsurgeries such as vasectomy reversals and varicocele ligations. Normally homeschooling his children on the day of the lecture, Dr. Kuang made a field trip out of it and took his children to the lecture at the Cancer Center at UNM. With the children in the back of the hall drawing Star Wars clone troopers, Dr. Kuang enjoyed the opportunity to explain the nuances of using an operating microscope and the foot pedals, the different surgical palm and pencil grips, detailing the differences in microsurgical instruments and outlining tips and tricks to suturing and knot tying under a microscope on anatomical structures that are less than a millimeter wide. Educating the surgeons of tomorrow continues to be one of the most satisfying aspects of Dr. Kuang's professional life as an Assistant Professor at UNM.