Football star Antonio Cromartie, a free agent credited with the longest play in NFL history, can’t seem to catch a break when it comes to his prolific sperm count. Cromartie is soon to be the father of thirteen children, but the crazy part isn’t that he’s gunning for a big family. It’s that he had a vasectomy. Three children ago.
But it turns out that’s not terribly uncommon. On one hand, vasectomies are among the most effective forms of contraception. A surgical procedure that involves severing and sealing the vas deferens so that men can ejaculate normally, except without the sperm, vasectomies fail only about 0.025 percent of the time. When vasectomies do fail, however, there’s almost always one of three factors to blame: non-compliant patients, sly sperm, or sneaky significant others.
After a vasectomy, physicians warn men against having unprotected sex for about six weeks and tell them to come back to the office later for a semen analysis. This is important because, even if the procedure works, it takes men different amounts of time to clear out all traces of sperm.
But a large proportion of men do not comply with the doctor’s instructions and, according to Dr. Marc Goldstein, director of the Center for Male Reproductive Medicine at Cornell University, only about 75 percent of men follow through and sit for semen samples. “Given how low the compliance is,” he told The New York Times in 2008 “I’m surprised the failure rate isn’t higher.”
We don’t have Cromartie’s medical records in front of us, but, if he had unprotected sex less than three months after his vasectomy (and failed to follow-up with semen samples), it’s possible that the vasectomy was technically solid and that his spare sperm did all the work. That could have explained how his wife became pregnant with twins in 2016.
What that does not explain is why now, more than one year later, she’s pregnant again. Because those spare sperm should be long gone. Which brings us to recanalization.
Recanalization: Sly Sperm
Recanalization is when channels within our bodies spontaneously put themselves back together. Blood vessels do it, fallopian tubes do it and, yes, vas deferens do it. Since Cromartie had his vasectomy some time ago, it is likely that his vas deferens repaired itself in what can only be described as the body’s least-appreciated act of self-healing since capsular contracture.
Here’s one way it might have gone down. After a vasectomy, spare sperm tend to leak from the surgical site and into the body. Our immune systems hate foreign bodies just swimming around, so this sets off an inflammatory response that catches the sperm in balls of tissue called sperm granulomas. Roughly 60 percent of vasectomy patients have a handful of these balls near their balls (yeah, we went there). Very rarely, these balls can progress into sperm-leaking growths that join up with what’s left of the upper vas deferens. And just like that, sperm is flowing through the vas again, even though the tube itself remains thoroughly severed.
Recanalization is also often chalked up to poor surgical technique. Sperm are creative little swimmers and, if there’s a lot of scarring after the procedure, they can sometimes wriggle through new pathways within the scar tissue called microchannels, bridging the gap between the severed ends of the vas and mixing into ejaculate.
Both are distinct possibilities in Cromartie’s unique case—especially since he keeps on fathering children. But, for most men, recanalization is a very unlikely outcome. Less than one in 4,000 vasectomies fail and most of them are due to non-compliance, not sly sperm.
But it happens. And hey, maybe it happened to Cromartie. Unless…
Sneaky Significant Others
Well, someone’s got to say it. Medicine isn’t perfect and vasectomies have their issues. But if a man follows his doctor’s instructions, maintains a sperm count of zero, and his vas deferens don’t recanalize, it could be time for him to ask his significant other a few tough questions.
Don’t get us wrong, the Cromartie family seems really nice and all. But, to paraphrase one urologist who was wise enough to ask not to be quoted for this story: If the vasectomy was performed properly and a semen analysis reveals no live sperm—get a paternity test.