Here at The Vasectomy Reversal Centre, included in the price, is the postoperative semen analysis. This is obviously an important part of the reversal process and for many, it is the time when their surgery is found to be successful. The analysis looks at the number, health and formations of sperm along with the presence of other factors. Antisperm antibodies after vasectomy reversal have been routinely investigated until recently. The absence or presence of these antibodies often leads to high amounts of anxiety due to much information and hype online.
Basically, success after a reversal is determined by the presence of live sperm in the semen or sadly unsuccessful where nothing is seen. Success is not associated with the presence of antisperm antibodies.
In our results, the majority of patients have a successful outcome. The elation that comes from having a positive result has often been tampered by worries: is the sperm count high enough, are the sperm swimming enough, are there enough sperm normal and are there too many antibodies to enable pregnancy to take place. It is usually not appreciated that the post-operative sperm count may well reflect sperm levels before the vasectomy but also, the antisperm antibodies often act as a red herring.
All these factors of sperm health are important but by worrying about them, it can cause more harm than good. Many couples may have more than one of these factors whilst trying to conceive naturally and yet they still do.
Testing for antisperm antibodies
For many years, our post-operative semen analysis has taken place at CARE Fertility in Nottingham. The CARE group of fertility clinics was started by Dr Simon Fischel, a world expert in IVF having worked with Dr Steptoe assisting with the first IVF or “test-tube” baby. Dr Fischel has created a world-class clinic and IVF programme for all couples seeking a baby. As part of the IVF process at CARE, the semen analysis suite at CARE Nottingham is a state of the art designed to minimise the time from production of a semen sample to analysis. The CARE semen analysis laboratory fully meets current WHO guidelines.
For many years, as part of the post-vasectomy reversal semen analysis, one of the tests performed on the semen has been for antisperm antibodies. It is this test that has caused the most concern due to myths surrounding the chance of pregnancy when antisperm antibodies are present.
Antisperm antibodies after vasectomy reversal, are usually there prior to surgery because of the vasectomy itself. They are present at all levels, from zero to 100% and our results have shown a variety of levels postoperatively. However, our experience has always been that irrespective of the levels of antibodies, pregnancies have occurred.
This is so important, it is worth repeating: irrespective of the levels of antisperm antibodies, pregnancies have occurred.
We recently noticed that CARE Fertility stopped sending us information about antisperm antibodies along with the full semen analysis results. So, we questioned why and this was the information they gave. Within the CARE group, they have an Andrology focus group and decided to stop measuring the levels of antisperm antibodies for the following reasons:
- Not in line with NICE guidelines to test for antisperm antibodies
- Limited evidence of the value of the results
- Not possible to control for quality assurance.
For many reading this, this decision may be confusing as it doesn’t seem to match other information online. For us, though, this is the validation of everything that we have suspected for a while. Antisperm antibodies after vasectomy reversal do not create sufficient concern to be worth testing.
The testing of antisperm antibodies does not necessarily impact the outcome of pregnancy. We know this because we have had so many pregnancies to prove otherwise. It seems, that it can cause more worry than necessary, worry which could impact the chance of conception. We have certainly had many testimonials of pregnancies where at some point it is mentioned that when they stopped worrying and trying for a baby, they became pregnant.
Pregnancy occurs despite antisperm antibodies after a vasectomy reversal
Our advice remains the same therefore, a positive result for antisperm antibodies after vasectomy reversal means that there is a chance of pregnancy irrespective of what the actual figures say. It may be that these results were similar to those that created the children before the vasectomy. The antisperm antibodies are not worth testing for anymore, as their impact is negligible.