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. 2025 Jan 23;12(6):qfae094.
doi: 10.1093/sexmed/qfae094. eCollection 2024 Dec.

Definition of a European pre-vasectomy scoring system to identify patients at risk of vasectomy regret

Amandine Degraeve  1   2 , Lorenzo Tosco  3 , Bertrand Tombal  2 , Thierry Roumeguere  3 , Jeanne Beirnaert  3 , Robin Hamal  2 , Céline Bugli  4 , Marco Cosentino  5 , Lee Wai Gin Don  6 , Marta Skrodzka  7 , Maarten Albersen  8 , Koenraad van Renterghem  9 , Maxime Sempels  10 , David Penning  11 , Mikkel Fode  12 , Antoine Faix  13 , Marjan Waterloos  14 , Borja Garcia Gomez  15 , Damien Carnicelli  16 , Jean-Pierre Graziana  17 , Afonso Morgado  18 , Kathleen D'Hauwers  19 , Ege Serefoglu  20 , Celeste Manfredi  21 , Emmanuel Weyne  22 , Jack Beck  23 , Daniar Osmonov  24 , Chris Roller  25 , Ludovic Ferreti  26 , Giogio Russo  27 , Faysal A Yafi  28 , Beatrice Cuzin  29 , François-Xavier Madec  30   31   32 , Geoffroy Vanoverschelde  33 , François Hervé  34 , Eric Chung  35 , Ulla Nordström  36 , Andrea Cocci  37 , Rawad Abou Zahr  2 , François Triffaux  10 , Minhas Suks  38 , Hussain Alnajjar  6 , Julien Van Damme  2 , Sam Ward  33
Affiliations

Definition of a European pre-vasectomy scoring system to identify patients at risk of vasectomy regret

Amandine Degraeve et al. Sex Med. .

Abstract

Introduction: Vasectomy is a widely used, safe, effective method of permanent contraception and contributes to healthy sexuality.

Aims: We have conducted a 3-step observational clinical study to develop a vasectomy regret risk score and guide patients and clinicians when discussing a vasectomy.

Methods: A 3-step approach has been followed. First, experts involved in male health have proposed risk factors for regret (remorse) after vasectomy, defined by a vasectomy reversal surgery or medically assisted reproduction. The selected factors were evaluated in 1200 patients vasectomized in the last 15 years. Finally, the expert panel has constructed a score for predicting regret after vasectomy.

Results: Fifty-two international experts identified 17 risk factors for vasectomy regret. Five of the risk factors were significant: an age <35 years old, a high Barrat Impulsivity Score, a low level of education, and a patient who didn't understand that the vasectomy might not be reversible or for whom the contraception responsibility is ideally feminine, or no responsible partner. On multivariate analysis, 3 risk factors and 2 "sine qua non" conditions were used to build the decision algorithm. A risk score ≥ 4 required information on sperm cryopreservation before vasectomy, and those with a risk score ≥ 7 required extra time for reflection. The scoring system was proposed to 52 international experts and accepted with 86.7% strongly agreeing. The model's sensitivity and specificity were 0.98 and 0.53, respectively.

Conclusion: A decisional algorithm was established to identify patients requiring information on sperm cryopreservation before vasectomy or additional time for reflection to reduce the risk of vasectomy regret. The algorithm contains 3 risk factors and 2 "sine qua non" conditions.

Keywords: male contraception; male fertility; reflection time; regret risk factors; scoring system; semen cryopreservation; vasectomy.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Age at the time of vasectomy and regret (individual value and logistic regression).
Figure 2
Figure 2
Logistic regression mode—multivariate analysis.
See this image and copyright information in PMC

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