This case involves a patient who underwent a vasectomy. A laboratory study 5 months later revealed 93% non-movement in his semen and the urologist told him that this result meant that he could engage in intercourse without birth control and his partner would have no risk of pregnancy. However, despite his urologist’s assurance, he did impregnate his partner after the vasectomy. He went to another urologist whose clinical impression was that the vasectomy failed. The semen analysis revealed the presence of active sperm and the doctor recommended another vasectomy. He also reviewed the laboratory study and indicated that the previous urologist’s approval to engage in intercourse without birth control, was inappropriate given that there was 7% movement in the semen, indicating that the vasectomy had not been performed correctly.
Question(s) For Expert Witness
1. Do you routinely treat patients similar to the one described in the case? Please explain.
2. Have you ever had a patient develop the outcome described in the case? If so, please explain.
3. Should a post-laboratory study reveal zero percent movement in semen following a vasectomy?
4. Have you ever served as an expert witness on a case similar to the one described above? If so, please explain.
Expert Witness Response E-005437
As an expert in male infertility I perform a lot surgery on the vas deferens, including both vasectomies and vasectomy reversals. About 40% of my practice is male infertility which involves interpretation of semen analyses in all cases. In addition, I perform 5-10 vasectomies per month. Persistence of motile sperm is not uncommon in the immediate period of time following vasectomy. In these cases, continued contraception is recommended with repeat semen studies until the vasectomy is deemed either to be successful (zero sperm or less than 100,000 non motile sperm per mL). Any motility indicates that either the vasectomy failed or that sufficient time has not yet passed for the patient to have cleared sperm from his body.
About the author
