Has my vasectomy failed? I had the procedure in December 2018 and semen analysis shows I'm still not sterile.

I had a vasectomy performed in December 2018. As of my last monthly semen analysis in August 2019, I am still not sterile. My urologist wants to continue semen analysis with the belief that everything has yet to clear out. My July semen analysis was the only negative sperm result. August was positive again. Ejaculation count for non-sterile June analysis was ~35 and July was ~45. Assuming a normal 30 ejaculations a month, I am over 200 since the procedure. Looking for a welcomed second opinion.

ANSWERS FROM DOCTORS (1)


Answered by John C. McHugh, MD

You need to inquire and be assured as to the exact number of sperm seen. Some men never 'completely clear' as the semen will always show a small number. The problem is that even if there are any sperm per high powered field, few urologists will recommend going ahead with unprotected sex. Obviously, if it takes 20,000,000 sperm to achieve pregnancy, 35-45 is minuscule. I'd have a discussion with your doctor, either you repeat the vasectomy or you and he agree that you are one of those patients that continue to see small numbers of sperm after a vasectomy. I think if you were my patient, we'd talk it out and agree together on what to do based on the risks and benefits of our decision.

Published on Nov 14, 2019

Answered by John C. McHugh, MD (View Profile)

You need to inquire and be assured as to the exact number of sperm seen. Some men never 'completely clear' as the semen will always show a small number. The problem is that even if there are any sperm per high powered field, few urologists will recommend going ahead with unprotected sex. Obviously, if it takes 20,000,000 sperm to achieve pregnancy, 35-45 is minuscule. I'd have a discussion with your doctor, either you repeat the vasectomy or you and he agree that you are one of those patients that continue to see small numbers of sperm after a vasectomy. I think if you were my patient, we'd talk it out and agree together on what to do based on the risks and benefits of our decision.

Published on Jul 11, 2012


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