Factors affecting post-vasectomy semen analysis compliance in home- and lab-based testing

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.