Can a Semen Infection or Inflammation Lower Vasectomy Reversal Success Rates?

This review of information discussed at the annual American Urological Association (AUA) meeting of urologists from around the world, held in in San Francisco, was prepared by vasectomy reversal global expert Sheldon Marks, MD, to help couples understand the importance of white blood cells and the potential negative impact of infection and inflammation on sperm and male factor fertility after a vas reversal.

Doctors and researchers know that excessive white blood cells (WBC) are usually a sign of inflammation or infection. If the WBC numbers are elevated in a sperm check following a vasectomy reversal, then these excess white cells can create “oxidative stress” which can damage the sperm. When we check semen analysis tests after a reverse vasectomy to monitor sperm counts and motility, evidence of too many white blood cells can suggest excessive inflammation. The good news is that if there is an infection, these findings can give us an early warning so the patient can be treated with oral antibiotics.

When there are too many white blood cells, then many doctors would treat empirically with antibiotics to be sure that there is no low-grade infection slowly developing. Most often we would then check a culture of the semen to see in there is significant bacterial growth. If there is no infection, then a high WBC count in the semen can suggest excessive inflammation which can be treated with an antioxidant rich diet as well as antioxidant vitamins, supplements as well as anti-inflammatory medications such as oral steroids and NSAID’s like naproxen or ibuprofen.

Excessive WBC’s with elevated levels of inflammation in the semen can damage the sperm and decrease the chances for natural conception and pregnancy, even if the sperm counts and motility are normal. The increased WBC’s have been shown to reduce chances for a successful intra-uterine insemination (IUI) as well, which might drive couples to move to the more expensive and higher risk in-vitro fertilization with intra-cytoplasmic sperm injection (IVF + ICSI).

How to reduce inflammation and boost antioxidants?
It is recommended that men increase the amount and variety of antioxidant rich foods in their diet before and after vasectomy reversal by eating more colorful fresh fruits, berries, nuts and vegetables. The darker and richer the color of the fruits and vegetables, the higher the antioxidant levels. In our vas reversal practice, we encourage men to increase their berry intake, as berries – especially blackberries and blueberries – are very high in healthy antioxidants. And of course, don’t forget the nuts – walnuts, pecans and almonds are also very powerful antioxidant rich foods. In fact, a recent study presented at the ASRM (American Society for Reproductive Medicine) 2020 Congress showed significant improvement in sperm with a diet supplemented with walnuts.

Bottom line – stay healthy, eat wisely and follow the semen analysis tests regularly after vasectomy reversal to maximize chances for fathering children again after vasectomy!

If there are any signs of infection or elevated WBC’s seen on a semen analysis, then talk to the doctor right away about a possible infection and treatment options to include antibiotics.

For any questions about semen infections, inflammation or semen analysis results following a vas reversal, please feel free to contact any of our senior vas reversal and fertility professionals at (888) 722-2929 .

This article was reviewed, edited and updated on January 1, 2023, by Dr. Sheldon Marks.