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Home-based post-vasectomy semen analysis (PVSA) showed low compliance rates. Local lab-based testing improved PVSA completion, suggesting convenience may decrease adherence.

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Area of Science:

  • Urology
  • Reproductive Health
  • Public Health

Background:

  • Post-vasectomy semen analysis (PVSA) is crucial for confirming vasectomy success.
  • A shift from local lab-based (LB) to home-based (HB) PVSA testing occurred between 2014-2017, with a subsequent return to LB testing.

Purpose of the Study:

  • To compare PVSA compliance rates between HB and LB testing settings.
  • To identify factors influencing PVSA completion rates.

Main Methods:

  • Retrospective analysis of patients undergoing vasectomy.
  • Comparison of PVSA completion rates for HB (2014-2017) and LB (2017-2020) testing, focusing on surgeon X's data.
  • Inclusion of patient demographics and surgeon data to identify influencing factors.

Main Results:

  • HB PVSA compliance was 35% in the 2014-2017 cohort (n=285).
  • Surgeon X's PVSA completion was significantly lower with HB (29%) compared to LB (46%).
  • Factors influencing completion included age, number of children, and surgeon; more children decreased completion.

Conclusions:

  • PVSA compliance was inadequate in both HB and LB settings.
  • Local lab-based testing demonstrated significantly higher PVSA compliance than home-based testing.
  • The convenience of HB testing may paradoxically decrease compliance, highlighting the need to address surgeon and patient factors to improve adherence.