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clearance sperm after vasectomy is a function of time with the two large inter-individual variation and variability in published reports, including those who used the same vas occlusion technique. inter-individual variation may result from differences in the reproductive anatomy and age can be patient. The sperm may persist in the ejaculate for several months after the vasectomy. This persistence may be due to residual sperm in the seminal vesicles and ampullae of the Vasa, 252 recanalization, or, very rarely, a failure to have done vasectomy on a deferent. The main reason for the presence of non-motile sperm is likely that the residual sperm in the seminal vesicles and ampullae of the Vasa are slowly released from the reproductive tract. 252 there are large variations in the game of residual sperm in the seminal vesicles and ampullae of vasa in men due to inter-individual differences in the anatomy of these structures.
252 However, in most men, or no sperm or only a small number of non-motile sperm in the residual PVSA are seen at three months or more after vasectomy. Nevertheless, some men continued to have sperm or sperm in semen parts that have been found for as long as 31 years post-vasectomy. Regarding age, several studies have suggested that the sperm clearance may take longer in men older than young men. Published literature also contains mixed results regarding the relationship between the clearance of semen and number of ejaculations.
242 many practitioners recommend that the first PVSA should be done after 20 ejaculations. The committee’s opinion is that the azoospermia rate related to the number of post-vasectomy ejaculations are too variable to be useful in determining when to make the first PVSA. In addition, in many studies, although patients were asked to report to post-vasectomy specific intervals, a report for later intervals. This inconsistency between the time PVSA requested and actual PVSA schedule creates uncertainty regarding the actual rate of sperm release because all items clearly indicate when patients are actually returned for pvsas. In addition, in most studies about one third of patients do not return for the requested pvsas.
260 no monitoring of complete data also creates uncertainty regarding the true sperm clearance rate. Another source of variation in the proportion of men reaching azoospermia is a variation in laboratory techniques used to PVSA and report the results of PVSA. Rigorous examination of semen, including centrifugation and examination of hundreds of microscopic fields is likely to find more sperm than less rigorous laboratory techniques. The physician should also ask the laboratory to indicate both the presence or absence of sperm and the presence or absence of sperm motility. If only non-motile sperm are present, the doctor should ask the laboratory to report the number of non-motile sperm per ml.
Clearance of motile sperm is much faster than the clearance of non-motile sperm. Earlier studies suggest all mobile sperm disappear within three weeks after the vasectomy. laboratory techniques, particularly centrifugation, affect the presence or absence of azoospermia observed in a PVSA. Over the past two decades, the data suggest that the centrifugation resulted in the identification of more men with small numbers of sperm. This means that even fewer men are reported with azoospermia, leading to an increase in follow-up tests and repeated vasectomies, some of which may not be necessary. 268 However, centrifugation is not necessary to confirm that not only rare motile sperm are present.
Because centrifugation can interfere with sperm motility and 269 clinically relevant number of sperm can be identified without centrifugation, a surgeon must apply for a clinical laboratory does not perform centrifugation for PVSA. review of post vasectomy semen samples uncentrifuged Office. Now there is interest in developing a method for estimating the number of sperm per ml of semen from the number of spermatozoa per HPF found in a PVSA.