Sex after vasectomy: where does the sperm go?

December 16, 2020

Vasectomies are a common procedure with about 500,000 vasectomies performed in the US each year. A vasectomy is an easy and practical approach to a contraceptive method that has a 0.15% failure rate. Our Austin vasectomy doctors (urologist Dr. Koushik Shaw or Dr. Lawrence Tsai) perform the procedure in-office. It takes just about 20 minutes or so, with very little need to prep, minimal recovery time and very few risks.

Couples typically come to the conclusion that it is “time” for a vasectomy when they have agreed that they no longer wish to conceive due to a multitude of reasons (age, finances, health risks) and prefer a more permanent method of contraception versus birth control pills, patches, condoms or they do not wish to conceive at all. 

A vasectomy is typically done in office in 20 minutes by a urologist. The procedure includes topical anesthesia. A small incision is made in the scrotum and the vas deferens which is a thick-walled tube that transports sperm cells from the epididymis, where the sperm are stored prior to ejaculation. Then, the vas deferens is tied off, removing a segment in between, along with cauterization (heating sealing) the ends. All of this provides three levels of protection from sperm getting from one side to the other. The small incision in the scrotum is then closed with a suture that disappears within a short amount of time.  It is considered a permanent form of contraception, although robotic vasectomy reversal and other fertility options are available if needed down the road. A vasectomy does not interfere with testosterone production, erections, orgasm or cause any potential for future urologic disease. 

Essentially, a vasectomy permanently closes the “hallway” for sperm to make their way out of the body (vas deferens). BUT, the body doesn’t stop making sperm even after a vasectomy is completed and considered successful and permanent. So where does the sperm go? 

Sperm is made by the testes which aren’t affected by a vasectomy. During puberty, testosterone and other hormones cause cells in the testes to transform into sperm cells and that process continues on throughout your life even after a vasectomy. Sperm are still produced, however, because the hallway is closed (vas deferens) the sperm can no longer move out of the body. The sperm die and are absorbed by the membrane (lining) of the epididymis where it dissolves. This is the body’s natural process. The body’s absorption of sperm does not interfere with testosterone production, erections, orgasm or cause any potential for future urologic disease. 

So if the sperm no longer come out and are absorbed in the body, what happens when ejaculating? Ejaculate (semen) is a combination of seminal fluid, made in the prostate gland, and seminal vesicles AND sperm. After a successful vasectomy, sperm are no longer part of the ejaculate. Some men may notice a slight decrease in ejaculate volume due to the missing sperm, but not enough to where it’s bothersome as sperm make up only two to five percent of the ejaculate volume.