Vasectomy Reversal Post Operative Semen Analysis

Following your vasectomy reversal procedure a post operative semen analysis is important to monitor progress of sperm parameters to ensure full return of fertility. ICVR recommends the first post-operative semen analysis by 2 months following the vasectomy reversal. The regular semen analysis results are key in the vasectomy reversal aftercare. Low semen analysis parameters can be signs of prolonged inflammation or scarring and the need for anti-inflammatory medications.

When trying to interpret your post operative semen analysis results focus on three main values; volume (cc or ml), count (million sperm per ml or cc of volume), and motility (percentage of sperm moving around). Take these three numbers and multiple them together to give you the total number of motile sperm in the sample or total motile (TM). This is the only number that really counts after your vasectomy reversal! The volume should by 1.5 ml or higher, count 20 million/ml or higher, and motility 50% or higher leaving you with 20 million motile sperm or higher. If you have at least 20 million motile sperm in the sample you are considered fertile. Below 20 million motile sperm is considered subfertile. Subfertile does not mean you are sterile, but rather you may have more difficulties conceiving naturally. We have found that 10 million total motile provides a high level of fertility after a vasectomy reversal.

The quality of sperm on the first post operative semen analysis after your vasectomy reversal procedure is often below average and improves with regular ejaculations. ICVR puts little emphasis on morphology due to the great degree of variation in this testing procedure. Morphology is a measure of how normal sperm look. This includes perfect symmetry, perfect length of each section of the sperm (tail, mid piece, and head) and proportion to each section, and shape of head. There are many factors that can alter accurate morphology testing. Morphology is a controversial topic in the world of andrology. Many andrologists now believe morphology has little value to male infertility. If a sperm does not have a perfect shape, does that mean it is not a good sperm? Most likely no.

Following a sperm-healthy lifestyle before and after your vasectomy reversal can also improve sperm production and quality to improve conception rate.

International Center for Vasectomy Reversal, PC, Physicians & Surgeons-Medical-M.D., Tucson, AZ