Driving Time and Compliance With Postvasectomy Semen Analysis Drop-Off

Abstract

Current literature demonstrates low rates of compliance with post vasectomy semen analysis (PVSA). This study sought to determine factors that correlate with non-compliance with PVSA. A retrospective chart review was conducted for patients who underwent vasectomy within our institution. ArcGIS was used to securely calculate the shortest driving time from each patient’s home to the single PVSA drop-off site. Kruskal-Wallis and chi-squared tests analyzed characteristics of patients who did and did not submit PVSA samples, and odds ratios were calculated via multivariable logistic regression. Overall, 515 of 850 patients met inclusion criteria and 219 (42.5%) of these had no recorded PVSA. Of those with a PVSA, 59% were completed within 16 weeks. Compliance with PVSA was associated with a shorter median driving time (30.6min vs 34.2min), more vasectomy in the operating room (19% vs 10%), and attending a follow-up appointment (40% vs 17%) (p<0.005 for all). Age at vasectomy, race, ethnicity, BMI, paternity, and location of pre-operative consultation did not significantly differ between the groups. Each 30 minutes of driving time was associated with a 48% reduction in the odds of a patient submitting PVSA at any time (OR 0.52 [0.37, 0.73]). As driving time to a drop-off center appears to be a significant barrier to PVSA compliance, providers should consider alternative collection methods such as at-home or in-office semen analysis.