Can you have children with blocked vas deferens?

I have a blocked vas deferens, no sperm in my semen, have been married for three years and have no children, what should I do? (Minh Hung, Dong Nai)

Reply:

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

When the tube is blocked, men ejaculate normally but there is no sperm in the semen so it cannot fertilize the wife's egg. Men of all ages are at risk of this condition, causing infertility.

There are many causes, the most common are congenital malformations, genital infections, and sexually transmitted diseases. Genital trauma, post-operative damage from varicocele treatment, testicular cancer, or minor surgeries to treat hernias, vasectomy during sterilization... can also be the cause. People with tumors in the prostate, epididymis, and seminal vesicles can also experience this condition.

Doctor Khang consults on treatment regimen for patient. Photo: Huu Trung — Doctor Khang consults on treatment regimen for patient. Photo: *Huu Trung*

Men with blocked vas deferens can be treated. At Tam Anh Hospital, if the previous tests you performed are more than 6 months old, doctors will recommend re-performing some methods such as sex hormone testing, ultrasound, testicular biopsy or genetic testing to determine the exact cause. Depending on the location of the blockage and the severity, the doctor will advise on an appropriate treatment regimen.

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 by vas deferens surgery. This method helps men have children without the need for assisted reproductive technology.

Similarly, if you have a blocked ejaculatory duct, you can be treated with laparoscopic ablation surgery. After surgery, you can have children naturally without assisted reproduction. If the epididymal duct is blocked, percutaneous sperm extraction (PESA), sperm extraction using MESA technique... and in vitro fertilization help men have children.

If you have a blockage in the duct connecting the testicles and epididymis, this is a difficult location for surgical intervention. You are indicated to extract sperm from the testicles using TESE or micro-TESE technique, followed by IVF.

All of the above treatment techniques must be performed at a hospital or reputable facility to achieve the highest efficiency and avoid damage to neighboring organs.

Men who have signs such as both testicles being smaller than normal, feeling pain, tension and discomfort when touching the testicles or vas deferens, or married couples having sex 2-3 times a week for a year, not using contraception but still not having children should see a doctor soon. From there, the doctor can diagnose and treat early.

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

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