FOLLOW UP SEMEN ANALYSES

 

 

One Test or Two?

 

An important issue raised in several reports is that patient compliance is an important consideration when deciding how many semen analyses is practical. Approximately 75% of patients will turn in an initial semen sample and only 30-40% will turn in a second sample. 

 

 

A review of the literature published by Attar et al and published in Scand J Urol Nephrol. 2010 Apr;44(3):147-50, concluded that one semen analysis was as indicative of vasectomy success as twoand that the presence of limited numbers (<100,000/mL) of nonmotile sperm was acceptable and not sufficient reason to withhold clearance.

 

 
The trend in follow-up recommendations appearing in the literature seems to be toward requiring only one semen analysis at 3-4 months post-vasectomy and allowing clearance with either azoospermia or severe oligozoospermia (<100,000 nonmotile sperm/mL).   In their paper entitled; The First Semen Analysis After Vasectomy: Timing and Definition of Success,  Bodiwala et al concludes: “On the basis of published evidence, we recommend a single SAV at 12 weeks, because compliance is excellent and ≈80% of submitted semen samples are azoospermic. For those with detectable spermatozoa at 12 weeks after vasectomy, ≈95% will be azoospermic 6 weeks later, and so we recommend a second SAV for them at 18 weeks.”

 
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