To compare post-vasectomy semen analysis (PVSA) completion rates between clinic-based and mail-in testing methods following an institutional protocol change. Mail-in PVSA kits may reduce barriers associated with in-person sample submission.

A retrospective review was performed to identify patients who underwent a vasectomy from January 2015 to September 2023. Outcomes included PVSA completion within 6 months, overall PVSA completion, semen analysis result, vasectomy failures, and repeat vasectomies. Chi-squared tests were used to compare categorical variables and student’s t-tests to compare continuous variables. PVSA completion was further analyzed using unadjusted odds ratios and multivariable logistic regression analysis controlling baseline characteristics.

Nine hundred sixty-six patients were included (592 clinic-based and 374 mail-based). Significantly more patients in the mail-based group had semen analysis results within 6 months (77.7% vs 83.42%, P = .0485). Overall completion rates did not differ significantly between groups (84.49% vs 80.57%, P = .101). On unadjusted analysis, mail-based testing, marital status, and travel time were associated with increased odds of 6-month PVSA completion. On multivariable analysis, only marital status and age were associated with PVSA completion.

Mail-based and clinic-based PVSA demonstrated comparable adherence, with completion more strongly associated with patient age and marital status than with testing modality. These findings support mail-based PVSA as a safe and effective alternative for post-vasectomy follow-up, particularly in populations with high baseline compliance