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Sperm still present after two samples

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  • Retired account

    I had my vasectomy in mid-December and had a No-scalpel Vasectomy with cauterization. At my 1st sample (6 wks), the results were that sperm was still present. At my 2nd sample, the results were that sperm was still present. I have had more than 45 ejaculations and yet sperm is still present. Everything that I have read has stated that it usually takes 20 ejaculations before a clean sample. Why am I still having results come back with sperm 3 months and 45 ejaculations later? What can I do to increase the amount of ejaculation, or the amount of sperm evacuated with each ejaculation?

    Dr. Edward Karpman

    After a vasectomy, sperm can remain in the downstream portion of the vas deferens for up to 24 ejaculates. You have definitely met and exceeded this criteria! At this point, it is important to know the quantity and quality of the sperm that are seen in your ejaculate. If your semen analysis only shows a rare non-motile sperm, then you probably have just not cleared the remaining sperm from your reproductive system downstream, despite a very good effort. This scenario is rare, but certainly poses a dilemma for any urologist who has a patient like yourself. The fertility potential of a man with a rare non-motile sperm is virtually zero, but few urologists would recommend that you have unprotected intercourse at this point.

    I would recommend that you continue to ejaculate on a routine basis and have another follow-up semen analysis until there is absolutely no sperm seen, prior to having unprotected intercourse. Now, if your semen analysis shows motile sperm, this is a different scenario and it can only represent a potency in your reproductive tract at the vasectomy site and you should consider having the procedure repeated.

    Retired account

    Thanks for your response. Love the new format. I followed up with the doctor’s office, and they did confirm it was rare non-motile sperm. They said the first sample was 1 to 5 (1-5, 1:5?) I don’t know what the numbers mean. The second sample was 0 to 5 (0-5, 0:5?) They left that portion of the message with my wife, who didn’t think to ask what it meant. And getting through to the nurse or doctor is always a tough one.They recommended bring samples every 10-12 ejaculations until we get the clear samples. So what do those numbers mean?

    Dr. Edward Karpman

    A result of 1-5 and 0-5 is the number of non-motile sperm that were seen per high power field under the microscope. This is a convention of reporting on semen samples after vasectomy. This DOES NOT mean that your vasectomy failed, but simply that you have had a prolonged period of time required to clear all of the sperm that exists downstream from the vasectomy procedure. Re-checking the semen analysis after another period of repeated ejaculations is important to confirm your sterility.

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