Paternity seven years after negative post-vasectomy semen analysis: a case report

Dr Athena Michaelides & Mehrban Ghani at University of Nicosia Medical School, Nicosia, Cyprush have reported a case of paternity seven years after a negative post-vasectomy semen analysis.The case has been published in the Journal of Medical Case Reports .

Vasectomy is one of the permanent methods of contraception; however, the risk of conception still exists. Early failure, defined as a postoperative semen analysis showing persistent motile sperm, occurs in 1 in every 250 patients. Late failure, defined as the rejoining of the severed ends of the vas deferens, occurs in 1 in every 2000 patients.

A healthy 37-year-old British male came to our clinic because his wife had conceived seven years after he had undergone a vasectomy. The decision to have a vasectomy was motivated by him already having two children. The result of his semen analysis post-vasectomy was negative: no sperm were detected in a 5 ml sample of his semen. The histopathological report confirmed that the vasectomy sample contained a strip of tissue 1.5 cm in length from both the left and right vas deferens. This confirmed that the procedure was carried out successfully, and paternity seven years later could not be attributed to technical failure.

Seven years after the procedure, the patient's wife conceived. Semen analysis at this time confirmed that sperm were present within the sample. A total of 0.5 million sperm per milliliter of semen (World Health Organization [WHO] normal reference range, > 15 million/ml) was recorded in a total semen volume of 6.3 ml. The total number of progressive motile sperm recorded was 2.5 million (WHO normal reference range, > 7.2 million). This case shows that late recanalization can occur up to seven years after a vasectomy and despite oligospermia, conception is still possible.

This case shows that late recanalization can occur up to seven years after a vasectomy. Patients should be informed prior to the procedure that late recanalization, although rare, may still occur. Post-vasectomy paternity necessitates further counseling to ensure that the patient and the patient's partner fully understand the implications and options available to them.

For more details click on the link: https://doi.org/10.1186/s13256-020-02374-0