Ask the Doctor

From Shelley:-
My husband and I are both 39 and have 3 kids together 12, 14 and 16. 12 years ago after the birth of our 3rd baby in 4 years our heads and wallets
told us 3 was enough so my husband had a vasectomy. Unfortunately my heart never agreed with that decision so on Feb 8 2008 he had the vasectomy reversed. The doctor gave us the highest success rate because we already have 3 kids together and all 3 were conceived the first month trying. March 10 was his first sperm check and the doctor reported that there was sperm but not as much as he would have liked to see. The next appt. was on April 21st and we were shocked to hear that he had no sperm on this visit. The doctor gave him a prescription for an anti-inflammatory and booked another appt. for 5 weeks down the road.

My question is this, my husband has a very hard time providing these “samples”, he finds it very stressful and can only get a small amount of semen. Is it possible that his stress could be affecting the sperm count?

The fact that sperm were present during the first semen analysis is an encouraging sign that the right surgery was done during a vasectomy reversal. The presence of sperm on the semen analysis represents a patent reproductive tract. Unfortunately, the absence of sperm on subsequent semen analysis may represent scarring at the vasectomy reversal site. This can also be a temporary phenomenon related to swelling in the vas deferens lumen which should resolve with time or anti-inflammatory medication treatment. Sometimes, steroidal anti-inflammatories are required. However, if sperm are not present 3-6 months after vasectomy reversal this likely represents a failed surgery. The amount of semen volume should not have any impact on the presence or absence of sperm so long as there is a seminal ejaculate present. Sperm are uniformly found in the ejaculate and should be present even with very small ejaculate volumes.