A full semen analysis (sperm count) should be performed 4-6 months after your repair. The timing of your follow-up semen analysis will depend on which type of surgery was performed. Counts obtained earlier than this time may be low or even zero due to surgical swelling, and testing too soon can lead to needless anxiety about your surgical outcome.
Keep in mind that, depending on the type of repair (VV vs. VE), there can be a wide variability in the time before sperm will be seen in the ejaculate fluid. In most patients who undergo primary vas-to-vas repair (VV), sperm will return to the ejaculate fluid within 3-6 months. Epididymal repairs (VE), on the other hand, can take considerably longer: It is unusual to see sperm before 6-9 months, and in many cases may take a year or more. This is due to the extremely delicate nature and small size of the epididymal tubule.
Your sperm count may be arranged through our office, or by an independent or hospital lab if you live outside of our area. We generally encourage patients to use a laboratory associated with a fertility clinic if possible, since the high volume of semen analysis assays they perform generally result in a more consistent and accurate result. Semen analysis is not an automated test, but depends on the training and experience of the lab technicians performing it to get accurate results.
Costs for semen analysis can vary widely with different labs, so it may also be of benefit to check around with local laboratories regarding their pricing for this test.