Additionally, in order to check sterility post-vasectomy, a semen analysis is performed after 3 months and 20 ejaculations to establish azoospermia (no sperm count in the ejaculate).Vasectomy can also be reversed, which is a more technically challenging procedure than a vasectomy that is performed by less urologists and is a heavier financial burden as it is usually not covered by insurances. Approximately 3-6% of people opt for a reversal due to the death of a child, change in partner, increase in financial abilities, or to find relief from postvasectomy pain syndrome. With advances in medical operations since the 1970s, there has since been increased interest in vasectomy reversals and greater chances of success for patency and pregnancy rates.Vasectomy reversal has a varying success rate. A recent study showed that the most important indicator of pregnancy after vasectomy reversal was the age of the female partner. The two most favorable predictors of success were having a female partner less than 40 years of age and having the reversal performed less than 15 years after vasectomy. Aside from the variation in success, vasectomy reversal also has major economic implications. The cost of a vasectomy reversal can range from $16,000-$30,000 and it is usually an out-of-pocket expense due to lack of insurance coverage. == References ==
Serological assays are the best means of diagnosing this disease, with the indirect microimmunofluorescence assay (IFA) being considered the best tool. However, underlying illnesses, such as rheumatologic and other immune-mediated disorders, can lead to false positives. To combat these limitations, a PCR test may also be used; this test looks for rickettsial DNA. It can sensitively detect the target DNA in a sample taken from an eschar or blood during the first few days of infection. Prevention
There is no vaccine available for this disease, so to prevent infection, the US CDC recommends taking personal safety measures when venturing out into areas known to harbour ticks. Before going into these areas, the following preparations should be followed:

Wear protective clothing that will cover your arms and legs, with closed-toed shoes. Wearing long socks that you can tuck your pants into will provide an extra layer of safety, especially if you are walking in areas with tall grass for an extended period of time. Use strong insect repellent such as DEET on your body and Permethrin on your clothes
If you are taking a pet with you, they should also be updated on all preventative medications, and a veterinarian should be consulted for any extra precautions.After you return from these areas, the following precautions should be taken to prevent ticks from entering your home:

Check clothes and gear used for any ticks. Dry clothes should be put into a dryer on high heat for 10 minutes to effectively kill any small ticks that may not be visible to the naked eye.