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Reduced Postvasectomy Semen Analysis Testing With the Implementation of Special Clearance Parameters
Jared M Bieniek1, Tyler B Fleming2, Joseph Y Clark1
1Department of Urology, Geisinger Medical Center, Danville, PA.
Urology
|July 3, 2015
Summary
Including rare nonmotile sperm parameters significantly increases postvasectomy clearance rates. However, patient compliance with postvasectomy semen analysis testing remains a challenge for effective contraception.
Area of Science:
- Urology
- Reproductive Health
- Public Health
Background:
- Postvasectomy semen analysis (PVSA) is crucial for confirming successful vasectomy.
- Current clearance parameters may exclude men with nonmotile sperm, potentially leading to unnecessary further testing.
Purpose of the Study:
- To evaluate the American Urological Association's suggested postvasectomy clearance parameters (<100,000 nonmotile sperm/mL).
- To determine the cost savings associated with adhering to these parameters and avoiding additional testing.
Main Methods:
- Retrospective review of vasectomy patients from December 2009 to August 2012.
- Collection of patient demographics and postvasectomy semen analysis (PVSA) results.
Main Results:
- Of 111 patients with initial PVSA, 36.0% had sperm present.
- 38 of 39 patients (97.4%) with nonmotile sperm met clearance criteria.
- Incorporating nonmotile sperm parameters increased clearance from 64.0% to 98.2%, saving $2356 in repeat testing.
Conclusions:
- Including nonmotile sperm parameters enhances postvasectomy contraceptive clearance.
- Poor compliance with postvasectomy semen testing hinders effective contraception confirmation.
