Post vasectomy semen analysis questions
Nov 19th 2008adminVasectomy reversal
From Michelle:-
My husband had his Vasectomy Reversal on Feb 29/08 of this year. The vasectomy was 2 years old. We have 2 boys. We had regretted our decision and opted for a VR. I did acheive a pregnancy result a few weeks ago. Three positive tests. I got my period 12 days late. I am very regular. My family doc told me those tests are very accurate and that I did miscarry. Being that I am 38 and have been trying for about 6 months my family doc referred us to the fertility clinic.
I went to the fertility clinic yesterday and the last SA test showed 95% antibodies! But the doc said everything improves with time. I have to go through a whole series of tests. They want to get the over all picure. Rob has to have another SA test. Here are our results the last 3 tests. We finally got the full copies after I asked if we could take them home. We just knew our count improved. We did not know the full results. The SA test we did on Oct 28th showed we have 95% antibodies!
1st SA test: May 06/08
Within 1 hour: Motility at 180 mins:
Total Sperm Count: 15.6 Rapid Progressive: 30%
Volume 2.2ml Slow Progressive: 11%
Sperm concentration: 7.1 ml Non Progressive: 1%
Rapid progressive: 28% Immotile: 58%
Slow Progressive: 6% Vitality: 70%
Non Progressive: 2%
Immotile: 64% Morophology: Normal Forms: 5%
Vitality: 67% Abnormal Heads: 95%
Immunology: 0 Abnormal Tails: 25%
Clumping: 0%
Cystoplasmic Droplets: 0%
Physical Apperance: Normal
Immunobeads GAM: 0%
2nd Sa Test: Aug 12/08
Motility within 1H Motility at 180 mins:
Total Sperm Count: 92.5 Rapid Progressive: 52%
Slow Progressive: 1%
Volume: 3.7ml Non Progressive: 2 %
Sperm concentration: 25.0ml Immotile: 45%
Rapid Prgressive: 52% Vitality: 82%
Slow Progressive: 0
Non Progressive: 3%
Immotile: 45%
Viatility: 80%
Immunology: Clumping 0%
Immunobeads GAM: no result
Morphology: Abnormal Heads: 89%
Abnormal Midpiece: 25%
Abnormal Tails: 26%
Cystoplasmic Droplets: 0%
Clumping: 0%
Immunobeads GAM: no result
3rd SA test: Oct 28th/08
Motility within 1 HR:
Motility at 180 mins:
Total Sperm Count: 106.6 Rapid Progressive: 45%
Volume: 2.6 ml Slow Progressive: 3%
Sperm Concentration: 41.0ml Non progressive: 2%
Motility within 1 hour: 43% Immotile: 50%
Slow Prgressive: 2% Vitality: 79%
Non Prgressive: 5%
Immotile: 50%
Vitality: : 88%
Immunology: Clumping: 0%
Morophology: Abnormal Heads: 85%
Immunobeads: 95%
Normal Forms: 15%
Abnormal Midpiece: 34%
Abnormal Tails: 6%
Cystoplasmic Droplets: 0%
What the fertility clinic can’t figure out is why the immunology showed 0% the last SA tests and this 3rd SA test showed 95%. I have to do some blood work on Day 3 of my cycle and then on day 6 of my cycle I have to have a HSG (Hysterosalpingogram). This is an x-ray of my fallopian tubes. It will help detect any abnormalities inside the uterus or fallopian tubes. Then on day 21 I will have another blood test. Then on Nov 28th my husband will have another SA test. Then on my next cycle on day 3 I will have another blood test. And so on. We will follow up with the fertility clinic on Dec 10th. They also said should I get pregnant again (like I did last month and I miscarried) I should phone them and they will put on progesterone right away. The blood tests they want me to have check for Rubella Immune Status, TSH (thyroid), FSH levels, LH, ESTRAD. I don’t even know what it all means.
Our count has improved each time. My husband is getting another SA test on Nov 28th and we are doing follow up on Dec 10th. Just wondering what your view of these results are. We are not sure what all of the SA’s mean. Can we acheive a pregnancy with all of this? Is there anything we can do to improve the Immunobeads? Anything you could tell us would be greatly appreciated.
Many couples experience miscarriages during the early stages of pregnancy. However, the vast majority of couples are not seeking fertility treatments and these miscarriages go unnoticed or unreported to medical professionals because women perceive their cycle just to be somewhat irregular that month. A positive pregnancy test and a late cycle would support that that was the case. Couples should not get discouraged by a miscarriage as this can be just some bad luck and this happens often in relationships. I will often tell couples that a miscarriage is good news, in a sense, if the couple has been having difficulty conceiving. For example, we don’t know if a particular man’s sperm can fertilize the woman’s egg in a relationship. Miscarriage tells us that this man’s sperm can fertilize this woman’s eggs and that some other factor after fertilization is responsible for this. Likewise, miscarriages will occur just as frequently after a vasectomy reversal as they would in a couple that has not undergone the surgery. Semen parameters consisting of 41 million sperm/ml with a motility of 50% is considered normal by World Health Organization (WHO) parameters. It is really no surprise that a man has anti-sperm antibodies after a vasectomy reversal. In fact, virtually every man will have these antibodies and we still see a 60% pregnancy rate after vasectomy reversal. Anti-sperm antibodies have been reported to cause problems with fertilization of the egg, which is obviously not the case in a couple that has had a miscarriage. Once the sperm has fertilized the egg, anti-sperm antibodies are meaningless. Performing some additional testing is never harmful, but I would be very optimistic that this type of situation represents a potentially successful vasectomy reversal.
Michelle on 05 Dec 2008 at 5:27 pm #
My husband had a reversal after 5 years. We have three children but regretted having done the reversal after the second year. The urologist said it was one of “the more difficult reversals he had daone beacause so much of the vas deferen had been removed but said that he was able to join them end to end after 3 1/2 hours of surgery. He had a lot of post-op swelling. He did do a sperm analysis, but the only info my husband was given was that 1 out of ten were motile after 30 days. He said it was probably because of swelling. It has been almost 9 months and we don’t know where to go from here…what tests etc. I am turning 37 this month and I have taken ovulation tests and can feel when I am ovulating so I am confused as to what to do next. Could you suggest something? The urology office embarassed my husband because he was told the sample had to be 45 minutes old so he showed up to give the sample there. They then told him it could have been 48 hours old and didn’t understand why he didn’t bring it from home. He says he is never going back!