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Vasectomy, yet my wife is pregnant
I had a vasectomy three years ago. However, my wife is pregnant. This morning the doctor told me that not even one sperm showed up dead or alive in a recent test. Is it possible that I am the father or do I have to open the obvious can of worms?
Post-vasectomy fertilisation has been recorded. The risk is low and, of course, lower still if you've had negative sperm counts. However, it is possible.
The time taken to reach azoospermia (no sperm in the specimen) after a vasectomy varies according to the study, but ten weeks appears to be typical. The average number of ejaculations to azoospermia is between 25 and 30, but some specimens were not clear until 60 ejaculations.
Renewed patency (pregnancy after a vasectomy) can have several causes, such as technical error, early recanalisation and residual motile sperm in the seminal vesicle after a vasectomy. In medical literature a distinction is made between early and late recanalisation. Early recanalisation can be detected by an increasingly large amount of motile sperm in the post-vasectomy specimen. Late recanalisation is the presence of motile sperm after the post-vasectomy specimen(s) showed azoospermia. It can occur several years after a vasectomy and usually is detected only after a pregnancy has occurred.
Several studies have been done on pregnancy rates after a vasectomy. One article reported two pregnancies in a total of 3,178 vasectomised men. In one report six cases of DNA-proven fatherhood were down to azoospermic men. The authors explained this phenomenon by the intermittent production of viable sperm.
In a recent article by O'Brien the temporary reappearance of sperm 12 months after a vasectomy is described in six cases. Based on the literature, it can be assumed that men with small amounts of non-motile sperm after a vasectomy have a risk (albeit low) of contributing to pregnancy.
If you do feel the need to ‘open the can of worms’, I would do so in the presence of a counsellor who can guide the discussion. I wish you the best.
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