Factors and Reasons Influencing Compliance With Postvasectomy Semen Analysis: A Systematic Review.
Happy Tahirih Kampire, Souleymane Diabaté, Oscar Nduwimana et al.
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In 30 seconds
This systematic review examined factors associated with postvasectomy semen analysis (PVSA) compliance and reported reasons for noncompliance. It included 25 studies involving approximately 91,084 participants; study risk of bias varied, and heterogeneity precluded meta-analysis. Compliance ranged from 8% to 84%, with a median of 56% (IQR: 29%). Associations were reported for several logistical and sociodemographic factors, while findings for other factors were inconsistent. Barriers included specimen collection and delivery, forgetfulness, insufficient information, and embarrassment. The authors caution that the evidence is generally low quality.
Key findings
- Across 25 studies (N = ∼91,084), PVSA compliance ranged from 8% to 84%; median compliance was 56% (IQR: 29%).
- Compliance was associated with number of children, education, distance to the andrology laboratory, number of prescribed tests, provision of a semen container, and postal submission.
- Reasons for noncompliance included specimen collection, transport, and delivery constraints; forgetfulness, insufficient information, embarrassment, and concerns about repeat vasectomy.
- Studies were rated at lower (28%), moderate (32%), and higher (40%) risk of bias.
Why it matters
PVSA is recommended to confirm vasectomy success, yet compliance varies widely. The review highlights practical and informational barriers that may leave confirmation incomplete. Understanding which factors are associated with attendance can inform the design of accessible, patient-centred approaches, while the inconsistent findings and low-quality evidence underscore the need for cautious interpretation.
What to keep in mind
The included studies were heterogeneous and generally low quality, with varied risk of bias; meta-analysis was not possible.