Article Text

Download PDFPDF
Comparison of postal and non-postal post-vasectomy semen sample submission strategies on compliance and failures: an 11-year analysis of the audit database of the Association of Surgeons in Primary Care of the UK
  1. Melanie Atkinson1,
  2. Gareth James2,
  3. Katie Bond3,
  4. Zoe Harcombe4,
  5. Michel Labrecque5
  1. 1Sexual & Reproductive Health, Aneurin Bevan University Health Board, Newport, UK
  2. 2Audit Lead for Association of Surgeons in Primary Care (ASPC), Rugby, UK
  3. 3Palliative Care, Aneurin Bevan University Health Board, Newport, UK
  4. 4Independent Researcher, Newport, UK
  5. 5Department of Family and Emergency Medicine Laval University and Research Center, CHU de Québec-Université Laval, Quebec, Quebec, Canada
  1. Correspondence to Dr Melanie Atkinson, Sexual & Reproductive Health, Aneurin Bevan University Health Board, Newport, UK; melatk{at}doctors.org.uk

Abstract

Background Vasectomy occlusive success is defined by the recommendation of ‘clearance’ to stop other contraception, and is elicited by post-vasectomy semen analysis (PVSA). We evaluated how the choice of either a postal or non-postal PVSA submission strategy was associated with compliance to PVSA and effectiveness of vasectomy.

Methods We studied vasectomies performed in the UK from 2008 to 2019, reported in annual audits by Association of Surgeons in Primary Care members. We calculated the difference between the two strategies for compliance with PVSA, and early and late vasectomy failure. We determined compliance by adding the numbers of men with early failure and those given clearance. We performed stratified analyses by the number of test guidance for clearance (one-test/two-test) and the study period (2008–2013/2014–2019).

Results Among 58 900 vasectomised men, 32 708 (56%) and 26 192 (44%) were advised submission by postal and non-postal strategies, respectively. Compliance with postal (79.5%) was significantly greater than with non-postal strategy (59.1%), the difference being 20.4% (95% CI 19.7% to 21.2%). In compliant patients, overall early failure detection was lower with postal (0.73%) than with non-postal (0.94%) strategy (−0.22%, 95% CI −0.41% to −0.04%), but this difference was neither clinically nor statistically significant with one-test guidance in 2014–2019. There was no difference in late failure rates.

Conclusions Postal strategy significantly increased compliance to PVSA with similar failure detection rates. This resulted in more individuals receiving clearance or early failure because of the greater percentage of postal samples submitted. Postal strategy warrants inclusion in any future guidelines as a reliable and convenient option.

  • contraceptive agents
  • male
  • contraceptive effectiveness
  • family planning services
  • sterilization
  • reproductive

Data availability statement

Data are available upon reasonable request. The original data and the authors summary spreadsheets can be made available to any interested parties.

Statistics from Altmetric.com

Data availability statement

Data are available upon reasonable request. The original data and the authors summary spreadsheets can be made available to any interested parties.

View Full Text

Footnotes

  • Twitter @zoeharcombe

  • Contributors MA conceived the idea. GJ collected the data. MA extracted the data. MA, KB, ZH and ML analysed the data. MA and GJ drafted the original manuscript, which was refined by ZH, KB and ML. All authors discussed the results, and contributed to and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.