Has my vasectomy failed?
Aug 9th 2009adminPost vasectomy semen analysis
From Tom:-
I had a vasectomy in September, 08 from a board certified urologist. Post semen analysis at 3 months was positive (no other specifics available on this test). Another test was done at 6 months and was positive with a count of 20,000. Yet another test done at 9 months and results showed “Rare, non-motile”. My doctor says this happens in rare cases and I shouldn’t be worried. He wants another test at 12 months. I conservatively estimate I’ve had 50-60 ejaculations (probably closer to 70). The first 6-8 ejaculations contained blood, but that cleared after 3 weeks or so. I am 44 years old in good health.
I’m concerned that my vasectomy has failed and I’m angry. How do you recommend I proceed? Is there anything I should be doing to determine if my doctor did something wrong?
Thank you very much.
Persistent motile sperm at very low counts 6 months after a vasectomy likely represents recanalization of the vas deferens. This is the typical quantity of sperm seen after this occurence and emphasizes the importance of demonstrating two ejaculates without any sperm prior to confirming sterility. Contrary to common perception, the sperm counts of men with recanalization are usually very low in number with a low percentage of motile sperm. This is because the entire vas deferens has not grown back to its original state but instead a single or a few microscopic canals have formed allowing a small amount of sperm to get through the vasectomy site. The sperm count can intermittently show sperm with rare non motile sperm at other times. These patients should be followed closely and told to continue to use a contraceptive until two consecutive semen analyses 6-8 weeks apart are completely absent of any sperm or opt for a re-do vasectomy. Recanalization can be temporary with successful azoospermia demonstrated over time. This case also emphasizes to those couples wanting to have more children after a vasectomy but trying to avoid vasectomy reversal or sperm retrieval with IVF/ICSI the reality of recanalization. Recanalization sperm counts are usually too low and of poor quality to initiate a natural pregnancy, but we can’t tell patients wanting sterility that they are fine to have unprotected intercourse. Recanalization should not be perceived as a fault of the surgeon. Instead, it is more a reflection of how potent the growth factors released are after the vas deferens is cut or injured.
