Can a man with a blocked vas deferens still have children?

I have a blocked vas deferens, no sperm in my semen, and I've been married for three years without having children. What treatment should I seek? (Minh Hung, Dong Nai )

Reply:

The vas deferens is a vital structure of the male reproductive system, responsible for transporting sperm out during ejaculation. Normally, the duct is approximately 30-35 cm long, with an outer diameter of about 1.5-2 mm and an inner diameter of about 0.3-0.5 mm.

When the ducts are blocked, men can ejaculate normally, but the semen contains no sperm, making it impossible to fertilize the wife's egg. Men of all ages are at risk of this condition, leading to infertility.

There are many causes, the most common being congenital defects, genital infections, and sexually transmitted diseases. Genital trauma, post-operative damage from varicocele treatment, testicular cancer, or minor surgeries such as hernia repair or vasectomy can also be contributing factors. Individuals with tumors in the prostate gland, epididymis, or seminal vesicles may also experience this condition.

Doctor Khang advises on treatment plans for patients. Photo: Huu Trung — Doctor Khang advises on treatment plans for patients. Photo: *Huu Trung*

Blocked vas deferens in men is treatable. At Tam Anh Hospital, if more than six months have passed since your previous tests, doctors may recommend repeating procedures such as sex hormone testing, ultrasound, testicular biopsy, or genetic testing to accurately determine the cause. Depending on the location and severity of the blockage, the doctor will advise on an appropriate treatment plan.

In cases where the vas deferens is blocked in the scrotum due to disease or sterilization less than 8 years ago, it can be easily treated with vasectomy reversal surgery. This method allows men to have children without the need for assisted reproductive technologies.

Similarly, if you have a blocked vas deferens, you can be treated with laparoscopic resection surgery. After surgery, you may be able to conceive naturally without assisted reproductive technology. If the epididymis is blocked, techniques such as percutaneous sperm retrieval (PESA), mesodermal sperm retrieval (MESA), and in-vitro fertilization (IVF) can help men conceive.

If you have a blockage in the duct connecting the testicle and the epididymis, this is a difficult location for surgical intervention to create a connection. You will be advised to extract sperm from the testicle using TESE or micro-TESE techniques, followed by in-vitro fertilization.

All of these treatment techniques must be performed in a hospital or reputable facility to achieve the best results and avoid damage to adjacent organs.

Men who experience symptoms such as both testicles being smaller than normal, pain, tenderness, and discomfort upon palpation of the testicles or vas deferens, or married couples who have sex 2-3 times a week without contraception but have not conceived, should seek medical attention early. This will allow for early diagnosis and treatment.

Dr. Vu Nhat Khang
Center for Reproductive Support, Tam Anh General Hospital, Ho Chi Minh City

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