Vasectomy: My Wife is Pregnant!

My wife is pregnant; however, I had a vasectomy three years ago. 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?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Of course, postpartum DNA profiling of the baby can prove paternity; however, I think you should keep the lid on the can of worms.

Post vasectomy fertilization 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 to azoospermia (no sperm in the specimen) after a vasectomy varies according to the study, but 10 weeks appears to be typical. The average number of ejaculations to azoospermia are between 25 and 30, but some specimens were not clear until 60 ejaculations.

Renewed patency (pregnancy after vasectomy) can have several causes, such as technical error, early recanalization and residual motile sperm in the seminal vesicle after vasectomy. In the literature, a distinction is made between early and late recanalization. Early recanalization can be detected by an increasingly large amount of motile sperm in the postvasectomy specimen. Late recanalization is the presence of motile sperm after the postvasectomy specimen(s) showed azoospermia. It can occur several years after vasectomy and usually is detected only after a pregnancy has occurred.

Several studies have been done on pregnancy rates after vasectomy. One article reported two pregnancies on a total of 3,178 vasectomized men. In one report, six cases of DNA-proven fatherhood were caused by azoospermic men. The authors explained this phenomenon by the intermittent production of viable sperm.

In a recent article by O'Brien, temporary reappearance of sperm 12 months after vasectomy is described in six cases. Based on the literature, it can be assumed that men with small amounts of nonmotile sperm after 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 counselor who can guide the discussion. I wish you the best. Both of you need much support during this stressful time.

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