{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:23:27Z","timestamp":1780928607056,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Vasectomy occlusive success is defined by the recommendation of \u2018clearance\u2019 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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\u20132013\/2014\u20132019).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 58\u2009900 vasectomised men, 32\u2009708 (56%) and 26\u2009192 (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 (\u22120.22%, 95%\u2009CI \u22120.41% to \u22120.04%), but this difference was neither clinically nor statistically significant with one-test guidance in 2014\u20132019. There was no difference in late failure rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2021-201064","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T13:22:33Z","timestamp":1627478553000},"page":"54-59","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["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"],"prefix":"10.1136","volume":"48","author":[{"given":"Melanie","family":"Atkinson","sequence":"first","affiliation":[{"name":"Sexual & Reproductive Health, Aneurin Bevan University Health Board, Newport, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"James","sequence":"additional","affiliation":[{"name":"Audit Lead for Association of Surgeons in Primary Care (ASPC), Rugby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Bond","sequence":"additional","affiliation":[{"name":"Palliative Care, Aneurin Bevan University Health Board, Newport, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3029-5850","authenticated-orcid":false,"given":"Zoe","family":"Harcombe","sequence":"additional","affiliation":[{"name":"Independent Researcher, Newport, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Labrecque","sequence":"additional","affiliation":[{"name":"Department of Family and Emergency Medicine Laval University and Research Center, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Quebec, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,28]]},"reference":[{"key":"2025090511550705000_48.1.54.1","unstructured":"Faculty of Sexual and Reproductive Healthcare (FSRH) . Male and female sterilisation (Clinical guidance), 2014. Available: https:\/\/www.fsrh.org\/standards-and-guidance\/documents\/cec-ceu-guidance-sterilisation-cpd-sep-2014\/ [Accessed 16 Apr 2021]."},{"key":"2025090511550705000_48.1.54.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.09.080"},{"key":"2025090511550705000_48.1.54.3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.acuro.2012.01.005","article-title":"European Association of Urology guidelines on vasectomy","volume":"36","author":"Dohle","year":"2012","journal-title":"Actas Urol\u00f3gicas Espa\u00f1olas"},{"key":"2025090511550705000_48.1.54.4","unstructured":"Griffin TT . Post-vasectomy testing to confirm sterility: a systematic review (ASERNIP-S report; 39). North Adelaide: Australia: Royal Australasian College of Surgeons, Australian Safety and Efficacy Register of New Interventional Procedures (ASERNIP) - Surgical, 2003."},{"key":"2025090511550705000_48.1.54.5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.5489\/cuaj.4017","article-title":"CUA guideline: vasectomy","volume":"10","author":"Zini","year":"2016","journal-title":"Can Urol Assoc J"},{"key":"2025090511550705000_48.1.54.6","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2016-203731"},{"key":"2025090511550705000_48.1.54.7","first-page":"e391","article-title":"Reasons for not completing postvasectomy semen analysis","volume":"65","author":"Diederichs","year":"2019","journal-title":"Can Fam Physician"},{"key":"2025090511550705000_48.1.54.8","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.urology.2019.10.026","article-title":"Poor compliance with postvasectomy semen testing: analysis of factors and barriers","volume":"136","author":"Bradshaw","year":"2020","journal-title":"Urology"},{"key":"2025090511550705000_48.1.54.9","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.4.1.5"},{"key":"2025090511550705000_48.1.54.10","first-page":"1781","article-title":"Pourquoi les vasectomis\u00e9s ne se pr\u00e9sentent-ils PAS au spermogramme post-op\u00e9ratoire?","volume":"35","author":"Labrecque","year":"1989","journal-title":"Can Fam Physician"},{"key":"2025090511550705000_48.1.54.11","unstructured":"Royal College of Obstetricians & Gynaecologists . Male and female sterilisation. National evidence-based clinical guideline number 4. London, UK: RCOG Press, 2004."},{"key":"2025090511550705000_48.1.54.12","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.11.812"},{"key":"2025090511550705000_48.1.54.13","unstructured":"Herbert R . Confidence interval calculator: PEDro physiotherapy evidence database, 2013. Available: https:\/\/pedro.org.au\/english\/resources\/confidence-interval-calculator\/ [Accessed 16 Apr 2021]."},{"key":"2025090511550705000_48.1.54.14","first-page":"10388","article-title":"Post-vasectomy semen analysis compliance with use of a home-based test","volume":"27","author":"Trussler","year":"2020","journal-title":"Can J Urol"},{"key":"2025090511550705000_48.1.54.15","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/JU.0000000000001704","article-title":"Can a low sperm concentration without assessing motility confirm vasectomy success? 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