Clearance after vasectomy with a single semen sample containing < than 100 000 immotile sperm/mL: analysis of 1073 patients.

Abstract

To evaluate the safety and efficacy of a new semen analysis protocol after vasectomy, where clearance is given to patients who provide a single semen sample with <100 000 immotile sperm/mL at > or = 3 months after vasectomy. Between 1 July 2005 and 31 March 2008, 1073 men provided a first semen sample at > or = 3 months after vasectomy. Semen was first evaluated on a wet-slide preparation. Those samples with no ('azoospermia') or sporadic immotile spermatozoa could be cleared without further analysis. Samples with motile sperm were immediately labelled as potentially fertile, while those with a significant number of immotile sperm were re-analysed using a Neubauer haemocytometer. All samples with <100 000 immotile sperm/mL were cleared. Of men providing semen at 3 months after vasectomy, 96% could be cleared. No sperm were seen ('azoospermia') in 51.3% of samples, and 44.7% of samples contained <100 000 immotile sperm. No paternity has been reported in the cleared group after a follow-up of at least 1 year. A protocol stipulating that patients can be cleared after a single semen sample containing <100 000 immotile sperm/mL at > or = 3 months after vasectomy is safe and dramatically reduces the number of men who cannot be cleared at 3 months after vasectomy.