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Interpretation of Semen Analysis Results After Vasectomy Reversal

Conception involves a sperm navigating to the Fallopian tube to fuse with an egg. Likening conception to winning a lottery, the more active sperm present, the higher the likelihood of pregnancy.

Understanding Sperm Count Reports

Reports typically cover:

The movement capabilities of sperm play a crucial role in their ability to fertilize an egg. Laboratories often rate the average movement grade of all the sperm in a sample. The degrees of motility are typically defined as:

Note: A man with a motility grade of 1 doesn't mean all his sperm lack forward progression. Some will still possess better forward progression.

  • Days of Abstinence: Standard is 3 days. Fewer days can significantly decrease the sperm count.
  • Ejaculate Volume: Normal is between 2-7 ml, with 2-4 ml being most common. Larger volumes indicate more sperm, but low volumes can be misleading due to potential sample spillage during collection.
  • Time Between Production and Examination: Ideally, no more than 60 minutes should pass between ejaculation and the sample being examined, though some labs allow up to 120 minutes.
  • Appearance, Viscosity, pH, and Agglutination: These factors generally indicate the ejaculate's source and are rarely abnormal, so they can often be overlooked.
  • Motility:
    • Grade 0 (or Grade D): No motility.
    • Grade 1 (or Grade C): Sluggish movement with absent or minimal forward progression.
    • Grade 2 (or Grade B): Decent sperm activity with forward progression.
    • Grade 3 (or Grade A): Very strong activity with forward progression.
  • Sperm Concentration: Measures the number of sperms per ml, with normal ranging from 20-150 million per ml.
  • Antisperm Antibodies: Often referred to as the MAR test. It's typically recommended to disregard this result.
  • Morphology: Refers to sperm shape. Up to 85% abnormality is considered within the normal range.

Evaluating Your Results

The chance of conception depends on the number of active sperms:

Concentration x volume x motility % = total number of fertile sperms.

For instance, a sample might have 50 million sperms per ml with a 2.0 ml volume, resulting in 25 million active sperms.

Post-Vasectomy Reversal Sperm Counts

After a vasectomy reversal, there's typically a buildup of old sperm fragments. Fresh sperms, which take around three months to produce, will only appear after clearing this backlog.

After vasoepididymostomy, sperms can appear in the semen even after 12-18 months. 

  • Initial tests at 8-12  weeks help confirm the reversal's success.
  • Repeat the test in three-month intervals if sub-optimal results or sperm parameters. 
  • Regular intercourse, Zinc and Selenium supplements, non-restrictive underwear, and a healthy lifestyle can promote a swift return to fertility.

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