Vasectomy outcomes as reported in the literature vary widely. Although the predominant factor that determines outcome is the occlusion techniques employed, it has been suggested that surgeon experience and the methods for defining success are also factors. Even when the same surgical techniques are applied, outcomes can differ significantly depending on how the surgeon interprets the results of the semen analysis and what conclusions are drawn.
Some surgeons will consider the procedure a failure unless azoospermia is obtained. Others will accept severe oligozoospermia (<100,000 nonmotile sperm/mL) as an acceptable outcome to clear the patient. Some surgeons will determine the procedure a failure if any motile sperm are found in the first semen analysis and others will follow such patients up with further semen analyses. Some surgeons conduct the first semen analysis after 6-weeks, and some after 12 to 16-weeks. Some surgeons don’t consider time-frame but rather base the timing for the semen analysis on a certain number of ejaculations. These variations in follow-up protocol contribute to the wide differences found in the reported results of vasectomy.
Adding to the inconsistencies that can be found in the published literature is the non-standardized use of terms such as; “azoospermia”. Although most know that azoospermia refers to a complete absence of sperm, the term is often used in the literature to describe severe oligozoospermia.
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