Dear Dr. Lissner:

Thank you for your feedback on your efforts to get magazine articles
relating to RISUG. I am sorry for the disappointing turn of events.

I read the Knot Magazine article with interest,

http://www.knotmag.com/?article=1272

In discussing simple wet heat, this article discourages its use,
saying,

"But don't grab your bubble bath and meat thermometer just yet. The
problem with this method is that it hasn't been thoroughly studied.
What limited research has been done appears very promising, but most
was done in the early 20th century with small sample groups. And if
you heat the testicles too much, it can cause permanent infertility."

Obviously TOO MUCH heat can cause permanent infertility, but the
question is whether a person could tolerate sitting in a hot bath
which is hot enough to cause permenant infertility. Voegeli said
that no one could. The Knot Magazine article states, to the
contrary, that simple wet heat "CAN cause permanent infertility." To
say this means something different than to say that some people have
evidence which indicates permanent infertility MAY be possible. To
say that it CAN cause permanent infertility indicates that known
cases exist. As far as you know, do such known cases exist?

As you probably know, the website

http://www.dontfixit.org

says that having a vasectomy invites all kinds of autoimmune
disorders. If simple heat can indeed cause permanent infertility--
like vasectomy--might not this sterilization technique be a safer
alternative to vasectomy?

Then there is RISUG. This method presumably would also avoid
autoimmune issues (I think that I saw that you also wrote this
somewhere). If the autoimmune issue is a big concern, then is this
not a strong reason to replace vasectomy with RISUG? As far as I
know, possibly mistakenly, sterilization with RISUG is not the reason
for delaying its approval, but rather the reversal process. Am I
right? If so, could not immediate progress be made by offering the
sterilization process, but not the reversal process, to vasectomy
candidates?

I do not hear the RISUG promoters screaming about autoimmune hazards
of vasectomy, and that the operation should be discontinued and
replaced with RISUG to avoid these hazards. Is this because I am not
reading the right sources? Or is it because the autoimmune concern
is not really the big deal that dontfixit.org says?

I would be grateful for whatever insight that you could provide, and
I thank you for all of your other efforts.

jp