Abstract Introduction The COVID-19 pandemic impacted nearly all aspects of life for American families. Urologic care was also disrupted, including access to elective sterilization procedures. In the setting of these social and economic changes, it is unknown how the advent of the COVID-19 pandemic affected the population pursuing vasectomy. Objective We sought to evaluate how the COVID-19 pandemic affected the age, paternity status, and fertility of men undergoing vasectomy. Methods We completed a retrospective cohort study of men undergoing vasectomy a single academic medical center across a ten-year period (11/1/2011-10/31/2021) that overlapped with the COVID-19 pandemic. The pandemic start date was defined as 04/01/2020, which coincided with the implementation of government-enacted restrictions on public activities. Patients undergoing vasectomy were identified via a systematic search of the electronic medical record. Patient age, BMI, paternity status, number of children, and procedure date were abstracted. To obtain a more granular appreciation of demographic changes, vasectomized men were divided into age categories spanning 5-year increments. Fisher’s exact and chi-squared tests were performed to compare age group prevalence and paternity status before and after the pandemic. T-tests were employed to compare the distribution of age, BMI, and number of children. Results 1999 vasectomized men were included in the cohort, 1829 (91.5%) of whom underwent sterilization prior to the start of the COVID-19 pandemic. Patients undergoing vasectomy during the pandemic were approximately one year older than those getting vasectomized before the pandemic (39.6 vs. 38.5 years, p=0.04, Table 1), while BMI was similar (29.0 vs. 29.2 kg/m^2, p=0.51). Paternity data was available for 59% of the cohort (n=1180/1999), the majority of whom attained fatherhood prior to obtaining vasectomy (n=822/1180, 69.7%). Men undergoing vasectomy during the pandemic were more likely to be fathers (89.9% vs. 67.8%, p=0.0001) and had more children, on average, than men being sterilized before the advent of COVID-19 (2.2 vs. 1.7 children, p=0.0004). Interestingly, there was also a statistically significant difference in the age category distribution of vasectomized men before and during the pandemic (p=0.02, Figure 1). Relatively fewer 30-34 year-olds underwent vasectomy after the debut of COVID-19 (12.4% vs. 21.1%, p=0.02), while relatively more 45-49 year-olds were sterilized during the pandemic (17.7% vs. 11.9%, p=0.04). Further illustrating this point, only 19.4% of the pandemic group was younger than 35 years of age compared to 28.5% of the pre-pandemic group (p=0.01). Conclusions Men obtaining vasectomies during the COVID-19 pandemic were older, were more likely to be fathers, and had more children on average than men who pursued sterilization beforehand. These findings imply that men with larger families exhibited greater interest in vasectomy following the advent of the pandemic. Additional investigation is required to validate these findings and better understand the social and economic forces that drove these demographic changes. Disclosure No
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Jun 16, 2023
David S Wang 
Open Access