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Sperm after Vas Reversal
Jenniferjo posted:
My husband just has a vas reversal March 12th. He has 3 kids with his previous wife and had the vas 02/2008. We has the reversal at a VA hospital and the dr came out to tell me how it went. He said the sperm are present but have no tails at this time. He has more fluid on one side than the other. He didnt go into a lot of detail and he didnt tell my husband anything. He was a referal dr since the VA doesnt have much demand for vas reversals. My question is, how long does it take for tails to come back once a VR is done? Is there anything that can help this issue?
amyaalc responded:
At the time of reversal the vasal fluid is examined for sperm. Complete motile sperm, non-motile complete sperm, sperm with partial tails and/or sperm heads only all can be seen in the fluid at time of reversal. Sperm with long tails or complete sperm just indicate that the sperm seen is new production or fresh sperm. The sperm with only partial tails and just heads are old sperm that's been sitting in the vas getting broken down or degraded by the body. What is seen in the vasal fluid helps the doctor determine if a vas-to-vas connection or the bypass vas-to-epi connection is needed. If sperm is not see or just really old heads with no sperm this often indicates that a vas-to-epi connection is needed due to some obstruction blocking the fresher sperm from moving through.

If just sperm heads are seen and the fluid consistence along with a few other intra-operative parameters line up the vas-to-vas can be done.

Regular ejaculations are important after his initial healing period. We recommend 2 weeks of no activity to our patients for healing time and after that 2 weeks begin regular ejaculations on a daily basis to flush out old sperm and ramp up new production. Sperm should return to the ejaculate within a few weeks of surgery. He should test a semen analysis 4 weeks after surgery to see if fertility is returning and every 2 months after until pregnancy is achieved to monitor his fertility and ensure optimum results.

Tails do not grow back on those heads. You should see complete motile sperm or fresh production from the testicles moving through within weeks to the first couple months after a reversal.

Good luck and make sure to do that follow-up analysis to know if fertility is returning and he is healing properly so sperm can pass through the surgery connections.

Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal

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