1-2% of men have no sperm in their semen (azoospermia) - just naturally - for a variety of reasons.
- One reason for having no sperm in the semen is congenital bilateral absence of the vas deferens, a very rare condition readily diagnosed by physical exam. A man with such a condition will NEVER have sperm in his semen and there is no reason for a vasectomy.
- Other causes of azoospermia could be temporary, and although a return to a normal count in these cases is unlikely, these men may have few sperm in their semen occasionally and cannot count on these conditions to provide permanent sterility. So a vasectomy is needed to provide sterility.
- But if a man with azoospermia returns some day for a vasectomy reversal, won't it be nice to know that he had sperm in his semen before his vasectomy? Otherwise, he may be spending alot of money for a procedure destined to fail.
For these reasons, we recommend that men who have never caused a pregnancy have a test before vasectomy to be sure that there is sperm in their semen.
- Any man who has completed an online registration may bring a semen specimen to our office for testing before or on the day of his vasectomy. The advantage of bringing the specimen before the day of the vasectomy is that if no sperm are seen on microscopic examination, a physical examination can be performed by one of our doctors. If the examination is normal, more precise testing can be arranged if the patient so desires, or the patient can opt to proceed with vasectomy because azoospermia for reasons other than bilateral absence of the vas deferens may not be permanent.
- Men who live far from our Lutz office (our only location where we can evaluate semen microscopically) may want to get a home semen test kit like the ones available for post-vasectomy semen testing. One is called SpermCheck Vasectomy and is available on Amazon for $72.95 (as of 8/23/26) or one can search on "post vasectomy semen test". If the semen test is negative, the man can call our office and we can arrange for more precise testing if desired.
- A man who is coming for his vasectomy to our Lutz office from a distance can bring a specimen on the day of the vasectomy if he knows that he will proceed with vasectomy even if he has no sperm in his semen. The benefits of doing so are (1) we may not opt for another semen test post-vasectomy, and (2) the man will know that he may not be a candidate for vasectomy reversal in the future.
