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Vasectomy Discussion

How do I know when I am sterile?

It’s simple—bring back your specimen, have it looked at, and see no sperm. There is no substitute for having a specimen analyzed. Despite this there are many who undergo vasectomy that do not bring a specimen back in for analysis. Studies have shown as many as 47% of patients do not bring back in a specimen.

A couple things need to be discussed. First—early failure of vasectomy. It takes multiple ejaculations to clear the sperm from the vas deferens down stream from where the vasectomy took place. Is it really possible to have enough sperm for a pregnancy from that residual sperm? The answer is a resounding yes. So that means get that first specimen in after about 30 ejaculations.

Second—late failures. Late failures are more likely true vasectomy failure. Around 1 in 2,000 vasectomies will have the two ends of the vas become reconnected. This is a process by which the sperm that may leak out of the end closest to the testicle can find their way back to the end of the vas that leads to the ejaculatory ducts. While rare, this is not impossible. A second specimen at least 6 weeks after the original vasectomy my be requested by your doctor. It does make sense to get the second specimen checked. Even with two negative specimens, there is always a chance the reconnection can take place even up to several years later.

There is one additional finding on post-vasectomy seminal fluid analysis that should be discussed. There are situations when after vasectomy someone consistently has very small number of non-motile sperm seen in post vasectomy semen analysis. In this case the specimen should always be collected fresh to check for motility, but if this were to continue to be an issue the vasectomy would be considered successful and secondary birth control could be discontinued after a comprehensive discussion with treating doctor.

To recap, you know you are sterile when there is no sperm seen under a microscope. Even with negative semen analysis, there can be failure although rare. Speak to your doctor about any concerns you have about sperm in your ejaculate after vasectomy.

Remember at the Weekend Vasectomy Clinic you can always bring in a specimen to be checked.

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