Post Vasectomy Semen Analysis Factors Predicting Compliance

Objective: To determine the impact of patient demographics, health care related factors, and financial factors on Post-Vasectomy Semen Analysis compliance (PVSA). Methods: A retrospective review was performed of 248 men who underwent the first-time vasectomy between January 2008 through March 2016. Baseline demographic factors were collected and analyzed according to PVSA compliance. Chi-squared analysis was used to evaluate the predictive value of these factors for PVSA return. Results: Forty-two percent of men returned at least one postvasectomy semen analysis while twenty percent returned two PVSA collections. Compared to non-compliant men, patients who returned at least one PVSA were more likely to have independent predictive factors of smaller family size (p<0.0003), older age (p<0.002) and Caucasian race (p<0.03). Marital status, tobacco use, alcohol use, comorbidities, body mass index, insurance, occupation, and direct patient expenses were not significant factors. Conclusion: Men older than 38 years, those with smaller family size, and those of Caucasian ethnicity were more likely to return at least one PVSA. Compliance for PVSA return has remained dismal despite relaxed semen analysis protocols when compared to historical recommendations. Further research is needed to determine additional factors and improve compliance with a postvasectomy semen analysis. All men should be encouraged and counseled on the importance of PVSA compliance for determining successful versus failed vasectomy to ensure future family planning.