Ask the Doctor

From Jamielynn:-
Thank you so much for the information that you provided in my previous post for my husband and I. Like I stated to you before, I printed out a copy of the information and we took it to the surgeon. After a few weeks the surgeon called us back and said that he was able to talk to the chief of lab to perform this test for my husband. So this week my husband took in his sample at 3:45pm. At 5pm (1 hours and 15min later) my husband called the lab and talked with a lady. She said that his sample was next to be ran. When my husband asked ” well doesn’t it need to be ran within 30min,” She couldn’t respond. All she knew that it was next. So the next day my husband went to medical records and picked up a copy of the results. The results read
POST VAS SPERM PRESENCE- Present- non-motile H
POST VAS SPERM COUNT- 0-4/hpf H
POST VASECTOMY COMMENTS- 0-4/hpf
At that time we called the surgeon to go over the results. The surgeon stated that the results mean there are no live sperm. I has asked the surgeon if they were not alive due to when the test was ran? The surgeon said that he would need to talk with the chief of lab to see whats going on. I also asked the surgeon if after a year after the vasectomy shouldn’t there be “No Sperm, dead or alive” That he shouldn’t be producing any sperm after a year. The surgeon also stated to me that there has to be a extremely large amount of sperm to create a pregnancy. My husband and I feel that the surgeon is looking at us like we are crazy. We know that there is something there. We do not want to have to go through all the pain of taking a chance on getting pregnant again.

Now we are at the point where the surgeon wants to have a meeting with my husband and I to come up with a plan. (Whatever that means). I wanted to get your response as a second opinion on what to do from here. Without the information that you were kind enough to provided us with on the pelleted semen test we would not have come this far…. My husband I thank you for that. We greatly appreciate it.

The standard protocol in most general hospital labs is different from that of specialized fertility centers when it comes to evaluating semen analyses irrespective if it is a quantitative or post-vasectomy semen analysis. Most regular hospital labs do not incubate the semen at body temperature until it is ready for microscopic evaluation. The sample is left standing on the counter at room temperature until the technician is ready to evaluate the specimen, sometimes for hours. It is well known that sperm will die or lose motility after as little as 30 minutes when the sperm are kept outside of body temperature. In this case it is difficult to say if the sperm were alive or dead when they arrived in the lab since the specimen was not handled appropriately for evaluation of live sperm. Also, centrifuging sperm at high speeds can cause damage of the tail of the sperm resulting in loss of motility prior to microscopic evaluation. Please also refer to a previous questions regarding fertility at very low sperm counts from our previous posts.