How quickly is sterility (azoospermia) achieved following no-scalpel vasectomy (NSV)?

Updated: Jan 19, 2016
  • Author: M David Stockton, MD, MPH; Chief Editor: Edward David Kim, MD, FACS  more...
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Failure rates with vasectomy using intraluminal cauterization and fascial interpositioning as described are approximately 1%.

Sterility is not instantaneous. Postvasectomy semen analysis to assure azoospermia is critical before releasing patients to stop using other forms of birth control.

Unfortunately, studies show that less than half (42%) of men return with a sample. [19]

The median time to loss of sperm motility is 3 weeks postprocedure; the time to azoospermia is 10 weeks. The absence of any sperm after 12 weeks is thought to reliably predict long-term sterility.

Many surgeons require that 2 negative semen samples 4-6 weeks apart be obtained to determine sterility. A recent paper from the Cleveland Clinic suggested considering a single azoospermic sample at 3 months postprocedure to be an adequate determination of sterility. [20]

Although infrequently utilized, distal vasal flushing with 30 mL of sterile water may shorten the time to azoospermia for between 20% and 30% of vasectomy patients. This modification may be an option for those who would like to shorten the time to azoospermia. [21]

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