To conceive a child, both partners must have optimal reproductive health. However, infertility does not always stem from the female partner. In Thai society, one of the major causes of infertility is male infertility, whether it's congenital or due to surgical sterilization. Let’s explore the question: "Can a man who has had a vasectomy still have children?"
What causes male infertility?
1. Genetic causes:
Klinefelter’s Syndrome is a genetic condition affecting males. These men are usually tall, may have enlarged breasts, infertility, and sometimes intellectual disabilities. It affects about 1.3 per 1,000 males. The cause is an extra sex chromosome (XXY), making the total chromosome count 47 instead of the normal 46. Some severe cases may have 48 chromosomes (XXXY). Symptoms include:
- Underdeveloped testicles
- Reduced sperm production
- Low testosterone levels
- Small testicles
- Decreased sexual desire and performance
There is currently no specific treatment for Klinefelter’s Syndrome, but in the future, gene therapy may help. Some men may still be able to produce sperm and should be evaluated individually upon reaching reproductive age.
2. Reproductive system abnormalities:
- Low testosterone levels: Testosterone is essential for muscle growth, bone mass, and sperm production. Low levels can lead to low libido and impaired sperm production.
- Injury: Trauma to the testicles may damage the sperm ducts or allow sperm to contact immune cells, leading to sperm destruction.
- Nutritional deficiencies: Lack of vitamin E (a-tocopherol), found in leafy greens and plant-based oils, may result in infertility in men and higher miscarriage risk in women.
- Lifestyle factors: Excessive alcohol increases estrogen levels, reducing sperm quality. Smoking introduces toxins that affect hormone levels and sperm count.
- Stress: Chronic stress can lower sex hormone levels and reduce libido, affecting fertility.
3. Medical Sterilization (Vasectomy):
Vasectomy is a simple procedure done under local anesthesia. A small incision (about half a centimeter) is made in the scrotum. The vas deferens is pulled out, tied in two places, and cut to prevent sperm from mixing with semen. The process takes around 8–10 minutes and is performed on both sides.
How Can a Man Who Has Had a Vasectomy Still Have Children?
Q: If a man is infertile, how many methods are available to help him have children?
A: Doctors typically recommend four methods: PESA / TESE / TESA / MESA, which are procedures to retrieve sperm from the testicles. These are followed by assisted reproductive technology known as ICSI (Intracytoplasmic Sperm Injection).
The retrieved sperm from PESA / TESE / TESA / MESA is injected directly into the female partner’s egg using the ICSI technique. The fertilized egg is then cultured into an embryo in a lab. Once the embryo reaches the blastocyst stage, it is transferred into the woman’s uterus to allow for implantation and pregnancy.
Q: What is PESA?
A: PESA (Percutaneous Epididymal Sperm Aspiration) is a procedure where a needle is inserted through the skin into the epididymis (sperm storage duct) to aspirate sperm. The sperm is then used in the ICSI process.
Q: What is TESE?
A: TESE (Testicular Epididymal Sperm Extraction) involves surgically removing small pieces of testicular tissue, from which sperm cells are extracted. The sperm is then used in the ICSI process.
Q: What is TESA?
A: TESA (Testicular Sperm Aspiration) is a procedure where a needle is inserted directly into the testicle to aspirate sperm. The sperm is then used in the ICSI process.
Q: What is MESA?
A: MESA (Microsurgical Epididymal Sperm Aspiration) is a microsurgical technique to locate the sperm storage duct (epididymis), insert a needle, and aspirate sperm. The retrieved sperm is then used in the ICSI process.
Can every man undergo these procedures?
Only men who are completely infertile — meaning no sperm present in the ejaculate — are eligible. A sperm analysis and medical evaluation are required to confirm infertility. If viable sperm remain in the testicles, these procedures may help retrieve them for treatment.
“At Beyond IVF, we specialize in TESE + ICSI procedures to offer more treatment options for couples struggling with male infertility and to increase the success rate of pregnancy.”
For consultation, visit Beyond IVF
Or add us on LINE: @beyondivf to inquire further