After your surgery · Mr Musaab Yassin
Your Semen Analysis
A formal semen analysis is the only way to confirm definitively whether your microsurgical vasectomy reversal has worked. It is normally scheduled six to eight weeks after surgery. How you prepare for it changes the result, so the guidance below is worth following exactly — and the second half of this page explains what the numbers on the report actually mean.
- Timing
- 6–8 weeks post-op
- Abstain at least
- 2 days
- Abstain no more than
- 7 days
- To the laboratory
- Within 1 hour
- In transit
- Body temperature
Before the test
The abstinence window.
The timing of your last ejaculation directly affects both the concentration and the volume the laboratory measures. Too short a gap and the count reads low; too long and the sample fills with sperm that are no longer moving. There is a window, and it is genuinely narrow.
Minimum
2 days
Abstain for at least 48 hours
A shorter gap than this lowers both the volume and the concentration the laboratory can measure, and the result will understate your true position.
Maximum
7 days
Do not exceed one week
Beyond seven days the sample accumulates dead and non-motile sperm, which artificially depresses the quality of the result.
On the day
Collecting and delivering the sample.
Collecting it.
- Wash thoroughly. Hands and genitals, with ordinary soap and water. Rinse every trace of soap away and dry completely before you begin.
- No lubricants of any kind. Artificial lubricants, lotions and saliva are all toxic to sperm and will distort your result.
- Use the container provided. Ejaculate directly into the sterile specimen cup from the clinic. Never collect the sample in a condom — standard condoms contain spermicide.
Getting it to the laboratory.
- Within one hour. The specimen must be handed to the laboratory team within an hour of collection. Plan the journey before you produce the sample, not after.
- Keep it at body temperature. Sperm are sensitive to cold. Carry the sealed container close to your body — an inside jacket pocket works well — rather than in a bag or a cold car.
Reading the report
What each number is measuring.
A laboratory report arrives as a column of figures with no narrative attached, which is why it causes more anxiety than it should. Here is what each metric describes, and the reference figure it is being compared against.
Concentration
15 million per mL
How many sperm there are
The number of sperm in a single millilitre of the sample. After a reversal this figure typically climbs over several months rather than arriving at its final level straight away.
Motility
40 % or higher
How many are moving
The proportion of sperm that are actively moving. The laboratory also reports progressive motility — those swimming strongly in a straight line, which is the movement that matters most for natural conception.
Morphology
4 % or higher
How many are normally formed
The proportion with a normally shaped oval head and a full-length tail. It is entirely normal for the great majority of sperm to be abnormally shaped; four per cent normal forms is the usual reference point.
Volume
1.5 mL or more
How much fluid there is
The total volume of seminal fluid produced. If motility is lower than expected, a vitality test may also be run to establish what proportion of the non-moving sperm are nonetheless alive.
One caveat worth holding on to: after a reversal, it can take several months for the count to stabilise and reach its peak as natural flow is restored. An early result is a starting point, not a verdict.
Reference figures differ slightly between laboratories and between editions of the WHO reference values. Your report will state the limits your own laboratory has used; those are the ones to read your result against.
Afterwards
Numbers are one piece of the picture.
Male fertility is not decided by any single figure on a laboratory report, and a result that sits below a reference limit is not the same as an inability to conceive. Concentration, motility and morphology interact; so does your partner’s fertility; so does time.
At your follow-up consultation Mr Yassin will read the report as a whole, set it against your surgery and your examination findings, and set out the most effective path forward for you and your partner — whether that is watchful continuation, medical treatment, or a conversation with your fertility clinic about assisted conception.
Bring the report to your follow-up.
Rather than interpreting the figures alone, bring the laboratory report to your appointment. Mr Yassin will read it against your surgery and your examination and tell you plainly where you stand.